Infections in primary total ankle replacement: Anterior approach versus lateral transfibular approach

•We investigated the infections frequency in total ankle replacements through anterior and lateral transfibular approach.•We compared surgical time, tourniquet time, superficial and deep infections frequency during the first postoperative year.•The infections frequency was lower in the lateral approach group. The difference was not statistically significant.•Lateral approach for ankle replacement is as reliable as anterior approach in terms of infections frequency. Total ankle replacement (TAR) represents an alternative to fusion for the treatment of end-stage ankle osteoarthritis. The aim of the present study was to retrospectively assess the frequency of infections between TARs with anterior and lateral transfibular approach at 12-months follow-up. 81 TARs through an anterior approach and 69 TARs through a lateral approach were performed between May 2011 and July 2015. We compared surgical time and tourniquet time, as well as superficial and deep infections frequency during the first 12 postoperative months. In the anterior approach group, there were 3 (3.7%) deep infections and 4 (4.9%) superficial wound infections. In the lateral approach group, there were 1 (1.4%) deep infection and 2 superficial wound infections (2.9%). There were not statistically significant differences between the groups. There was a significant difference between anterior approach (115minutes) and lateral approach group (179minutes) in terms of surgical time (P