Aim: To evaluate the efficacy of ankle arthrodesis by using Retrograde SIGN Nail. Study Design: Retrospective study. Place and Duration of the Study: Department of Orthopaedic & Spine Surgery, Ghurki Trust Teaching Hospital, Lahore from 1st January 2018 to 30th June 2020. Methodology: Thirty patients were enrolled for arthrodesis by using retrograde nails. Clinical and radiological examination confirmed the severe arthritis of the subtalar joints in all cases. Surgical procedure was initiated by using lateral incision fibula segment of 1.5 cm was excised 6-8 cm proximal to the fibula tip. After adequate exposure, from proximal lateral to distal medial, approximately 5-6 cm transaction of the fibula was made obliquely. Soft tissue was the initiating point of dissection and the portion was placed on the back table for further use as an autogenous bone graft. To expose the medial gutter, approximately 2-3 cm incision was carefully made at medial to the tibialis anterior tendon without indulging saphenous nerve and vein. Results: A weak positive Pearson correlation was found between BMI and FAAM score but a significant (P=0.00001). Conclusion: Retrograde nailing techniques help to achieve the goals of the union. It also assists in the preservation of hind foot alignment. Keywords: Ankle deformity, Ankle arthrodesis, Ankle arthritis, Retrograde nailing
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