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目的:观察保留腓骨的前外侧入路行胫距跟关节融合术（TTCA）治疗的疗效。方法:回顾性分析2018年3月至2021年2月北京积水潭医院足踝外科收治的23例采用保留腓骨的前外侧入路行TTCA的患者资料。其中男15例，女8例；年龄28~72岁（平均54.4岁）；创伤性关节炎11例，Charcot关节病2例，神经源性马蹄内翻足6例，创伤性马蹄内翻足2例，大骨节病2例。比较患者术前及末次随访时的美国足踝外科协会（AOFAS）的踝-后足评分、疼痛视觉模拟评分（VAS）、足部功能指数（FFI）、后足力线角度（HA）、后足力线距离（HD）、后足力线比率（HR），记录末次随访时负重侧位胫足角、患者满意度及术后并发症发生情况。结果:所有患者术后获12~48个月(平均24.7个月）随访。末次随访时AOFAS的踝-后足评分[（78.2 ± 9.2）分]、VAS评分[2.0（0.5, 2.0）分]、FFI为[19.0（10.5, 35.0）]、HA(2.7° ± 5.8°)、HD[(0.1 ± 0.8) cm]、HR[44.2(36.4, 59.2)%]均较术前[（43.4 ± 12.7）分、4.0(4.0, 6.0)分、98.0(60.0, 127.0)、22.0° ± 14.3°、(2.2 ± 1.6) cm、86.0(66.3, 100.0)%]显著改善，差异有统计学意义（n P<0.05）。末次随访时负重侧位胫足角为89.0°（87.1°，90.4°）。Likert手术满意度：非常满意17例，满意4例，一般2例，满意率为91.3%（21/23）。发生感染1例，不愈合1例。n 结论:保留腓骨的前外侧入路对需要行TTCA的患者进行治疗具有良好的中短期疗效，对踝与后足内翻及足马蹄畸形的矫正能力强。“,”Objective:To evaluate the clinical and radiographic outcomes of tibiotalocalcaneal arthrodesis via the fibula-preserving anterolateral approach.Methods:From March 2018 to February 2021, 23 patients underwent tibiotalocalcaneal arthrodesis via the fibula-preserving anterolateral approach at the Department of Foot and Ankle Surgery, Beijing Jishuitan Hospital.Of them, 15 were males and 8 females. Their average age at surgery was 54.4 years (range, from 28 to 72 years). There were 11 cases of traumatic arthritis, 2 cases of Charcot arthropathy, 6 cases of neurogenic equinovarus, 2 cases of traumatic equinovarus, and 2 cases of Kashin-Beck disease. Comparisons were made between preoperation and the last follow-up in ankle-hindfoot score of American Orthopedic Foot and Ankle Society (AOFAS), visual analogue scale (VAS), foot function index (FFI), hindfoot alignment angle (HA), hindfoot alignment distance (HD), and hindfoot alignment ratio (HR). The tibia-foot angle on lateral weight-bearing and patient satisfaction at the last follow-up and postoperative complications were documented.Results:This cohort were followed up for an average of 24.7 months (from 12 to 48 months). The AOFAS ankle-hindfoot score (78.2 ± 9.2), VAS [2.0 (0.5, 2.0)], FFI [19.0 (10.5, 35.0)], HA (2.7° ± 5.8°), HD [(0.1 ± 0.8) cm] and HR [44.2 (36.4, 59.2)%] at the last follow-up were significantly improved than the preoperative values [43.4 ± 12.7, 4.0 (4.0, 6.0), 98.0 (60.0, 127.0), 22.0° ± 14.3°, (2.2 ± 1.6) cm and 86.0 (66.3, 100.0)%] (alln P<0.05). The tibia-foot angle on lateral weight-bearing was 89.0° (87.1°, 90.4°) at the last follow-up. By the Likert scale, 17 cases were very satisfied with the surgery, 4 cases satisfied and 2 cases tolerate, giving a satisfaction rate of 91.3%(21/23). Infection occurred in one case and nonunion in one.n Conclusion:Tibiotalocalcaneal arthrodesis via the fibula-preserving anterolateral approach yields good mid- to short-term clinical and radiographic outcomes, showing a strong capability to correct ankle and hindfoot varus and equinus.