Proper treatment of failed total ankle replacement remains a challenge. Several revision modalities and techniques exist to either preserve or salvage the ankle joint. Among them there is revision total ankle replacement, amputation, or ankle arthrodesis. The goal of salvage ankle fusion is to restore height and alignment of the hindfoot and to get a stable but pain-free plantigrade and functional foot. Loss of bone and additional deformities pose specific problems for the surgeon and must be taken into consideration during preoperative planning. Meticulous preparation of the fusion sites is crucial to achieve later union of the bones. Although screw fixation alone could be used to get solid fusion, anterior double plating offers an intriguing alternative and provides great stability and high-compressive forces across the fusion site.