Purpose: Fracture-dislocation of the talus is one of the most severe injuries of the ankle. Opinion varies widely as to the proper treatment of this injury. Since Blair’s original description of the tibiotalar fusion in 1943, there is little mention in the literature of his method. The present study reports tibiotalar arthrodesis with modification in Blair’s technique.

Method: Eleven cases of modified Blair’s tibiotalar arthrodesis were retrospectively studied. The average age was 32.4 years (range, 26 to 51 years). Six patients had avascular necrosis; five had neglected fracture-dislocation of the talus

Results: All the 11 ankles united. Nine cases having 150–200 tibiopedal motion had excellent results and two ankles having 100–150 of tibiopedal motion had good result. The follow up ranged from 3 to 12 years.

Conclusion: The principal modification in the present study is retention of the talar body while performing arthrodesis with anterior sliding graft. The retention of the talar body provides intraoperative stability and in long term, the retained talar body share the load transmitted to anterior and middle subtalar joints thus resulting into improved hind foot function and gait.