Ankle arthrodiastasis provides an alternative surgical treatment of the mild to moderate posttraumatic ankle arthritis. Ankle arthrodesis or ankle implant arthroplasty is usually reserved for the end-stage ankle arthritis and after conservative treatment options have been implicated for a long period of time. Ankle joint destructive procedures are often considered for the older and less active population with strict selected surgical criteria and prolonged rehabilitation. In either ankle joint-sparing or ankle destructive procedures, lower extremity deformity correction will need to be addressed before or at the time of index surgery for the overall patient’s successful outcome.