Aims: Tibiotalar fusion is considered as gold standard for end-stage posttraumatic arthritis of the ankle. This study analyses the long-term results after talar joint fusions, especially the health related quality of life, correlated to the clinical and radiological results. Methods: We examined 16 males and 1 female patient, with 18 ankle fusions, clinically, radiographically and in regard of quality of life with the SF-36 Health Survey after a minimum follow-up period of 20 years (mean 23, range 20–33). Mean age at operation was 37 years (SD=8y), at follow up 61 years. Between injury and arthrodesis was an interval of six years in average. In eleven cases an external þxation was used. Results:. Subjectively 50% were not handicapped performing daily life activities and 44% were in the same job as at the time of injury. Out of 11 complications, the most frequent one was wound infection in seven cases (68%). On clinical examination þve feet were stiff at the forefoot. Eight patients had 25%, three had 50%, one had 75% and one the full range of motion. We found one valgus and seven varus deformities of the ankle. Following roentgenographic measurements with the MORREY as well as the TAKAKURA score, degenerative arthritis in the subtalar and Chopart joints was 2.7 (SD=0.77). The mean OMA score was 59.4 points, the visual analogue scale was 1.99, the radiologic score was 2.7 and the SF-36 revealed for physical functioning, emotional role functioning and bodily pain signiþcant deþcits. A signiþcant correlation was found between the OMA and the radiological score at 0.05, and between the clinical and the SF-36 score at 0.01. No correlation was found between the radiologic score and the SF-36 questionnaire. Conclusion: Ankle arthrodesis leads to deþcits in the functional outcome, to limitations in the activities of daily living and to roentgenographic changes in the adjoining joints. The clinical outcome and the SF-36 score correlate tightly.