A variety of surgical approaches and bone grafting techniques for ankle and tibiotalocalcaneal arthrodesis have been described. Wed used transfibular approach and lateral malleolus was used for bone graft. This permitted excellent visualization of the ankle and subtalar joint so that the fusion can readily be achieved under th direct visualization. And also we didn't need to prepare the additional bone graft from another site. Ten ankle fusions and two tibiotalocalcaneal fusions were carried out and reviewed. The average age of the patients was 43 years(range, 27 - 58 years). The average follow-up was 27.8 months(range, 24 - 34 months). We evaluated the clinical and radiological results, and complications. All cases were satisfied and fused. But we experienced one minor complication that was posteroplantar heel pain caused by prominence of cannulated screw head. So, we suggest that this procedure has benefit for ankle or tibiotalocalcaneal fusion.