Aims: To show that ankle fusion using an intra-medullary nail is effective with low morbidity and high patient satisfaction and improvement in postoperative AOFAS scores in selected patients. Methods: The þrst twenty ankle fusions performed with the Biomet intra-medullary nailing system by one surgeon were reviewed over a two year period. The Biomet system offers superior advantages, allowing longitudinal compression and posterior to anterior distal locking in the calcaneus.

Data sets were recorded for each patient. Information with regard to each patients age, sex, occupation, presenting complaint, mechanism of injury if applicable, index procedure if applicable, diabetic status, associated comorbidities and smoking habitus were recorded. The pre-operative and post-operative AOFAS score was also recorded for each patient. Results: All patients except one showed a marked improvement in their AOFAS score when treated with intra-medullary nail for ankle fusion. The average improvement in score was 150%. Morbidity from the procedure was low. There was one case of mortality not attributed to the nail. 19 out of 20 patients went on to solid fusion. Conclusion: The use of an intra-medullary nail for fusion of the ankle is a reliable technique in selected cases. AOFAS scores consistently improve, morbidity is low and fusion is usually successful. We would advocate this technique for fusion.