Twenty-nine patients with 30 isolated arthrodeses of the upper ankle done by a resection and compression technique to treat post-traumaticarthrosis or irreparable pilon fractures, were assessed clinically and radiologically 15–32 years (average, 23.5 years) postoperatively. Footposition, talar retrodeviation, and the various angles of the hindfoot were determined by clinical and radiologic evaluation. Eighteen patients(60%) achieved a good or very good result (American Orthopaedic Foot and Ankle Society AOFAS Score more than 70 points). In contrast,the radiologic examination revealed that additional development or increased arthrosis of the hindfoot and midfoot was present in 26 feet. Nocorrelation was found between the foot position in which the arthrodesis was done and the localization and extent of secondary arthrodeses.Arthrodesis done in a neutral position without talar retroposition can be done without deterioration of longterm effects.q 2003 Elsevier Science Ltd. All rights reserved.