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Background  Ankle arthrodesis may have internal or external stabilization.  We assessed whether the type of stabilization after ankle arthrodesis will affect: (1) functional outcome in Foot and Ankle Ability Measure (FAAM) scale, (2) pain level, (3) period of hospitalization, (4) rate of complications.    Methods  We retrospectively studied 47 individuals after ankle arthrodesis with Ilizarov fixation (group 1,  n  = 21) and internal stabilization (group 2,  n  = 26) at our institution in years 2007–2015. Clinical outcomes were measure by: (1) functional outcome in FAAM scale, (2) pain level, (3) period of hospitalization, (4) rate of complications.    Results  Total number of complications in Ilizarov group was 13, which corresponded to 0.62 complications per patient on average. In group 2 there were 15 complications, which corresponded to 0.58 complications per patient on average. The intergroup difference in rate of complications was not statistically significant ( p  = 0.066). In group 1 the mean VAS pain level before treatment was 4.69 and after treatment was 1.5 ( p  = 0.037). In group with internal stabilization the mean VAS pain level before treatment was 4.71 and after treatment was 2.9 ( p  = 0.044). In group 1 the mean period of hospitalization was 5.29 days, in group 2 was 5.71 days ( p  = 0.517). In group 1 the mean functional outcome in FAAM scale was 79.38, in group 2 was 70.11 ( p  = 0.458).    Conclusions  Ankle arthrodesis with Ilizarov stabilization is associated with lower prevalence of VAS pain level after surgery than after internal screws stabilization. Rate of complications, FAAM functional score and period of hospitalization were not statistically significant between group 1 and 2. Clinical outcome was satisfactory in group 1 and 2, but outcomes in Ilizarov group were slightly better than after internal stabilization.

Clinical evaluation of ankle arthrodesis with Ilizarov fixation and internal fixation