[Objective] To compare clinical outcomes between the technique of Proximal Humerus Internal Locking System (PHILOS) plate plus two headless cannulated screws and crossed screws for TTC arthrodesis by peroneal approach. [Methods] A retrospective analysis was performed on 49 patients (51 feet) who received TTC arthrodesis in our hospital from 2015 to 2018. 22 patients (24 feet) accepted the technique of PHILOS plate plus two headless cannulated screws, and 27 patients (27 feet) accepted the crossed screws technique. The perioperative, follow-up and imaging data of the two groups were compared. [Results] All patients successfully completed the operation, and there was no statistically significant difference between the two groups in operation time, intraoperative blood loss, hospital stay, complications and use of bone graft materials (P>0.05). All patients were followed up for more than 12 months. Postoperative AOFAS and VAS scores in both groups were significantly improved compared with those before surgery (P<0.05). There were no statistically significant differences in preoperative and postoperative VAS scores and subjective satisfaction between the two groups (P>0.05). Postoperative AOFAS score and overall satisfaction in the plate group were significantly better than those in the screws group (P<0.05). [Conclusion] The technique of PHILOS plate plus headless cannulated screws exceeded in AOFAS scores and overall satisfaction compared to crossed screws, and was proven to be an effective tool for TTC arthrodesis.