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A posterior bone-block operation is one of the few treatment options in cases of paralytic footdrop. A case with a flail ankle and no bony deformity is ideal for this approach. Two cases of acquired flail ankle with equinus deformity were treated using a new modification of the bone-block technique that does not interfere with subtalar joint motion. A bone block harvested from the iliac crest was fixed at the posterior talus after partial resection of the posterior tubercle. The graft was in contact with the posterior malleolus of the tibia. Satisfactory correction was achieved, and both patients could walk without the use of external splints. (J Am Podiatr Med Assoc 97(2): 160–164, 2007)