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Trauma is the most common cause of ankle arthritis.Unlike the hip and knee joints, the ankle is rarely affected by primary arthritis, even in the elderly.Modern techniques of ankle arthrodesis provide a high rate of union with few complications.Gait analyses and clinical studies have shown the preferred position of ankle fusion to be plantigrade with 5° of hindfoot valgus, external rotation comparable with that of the contralateral extremity, and the talus translated posteriorly in relation to the tibia.Precise indications for total ankle replacement are yet to be defined.

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