Ankle fracture recovery protocol

Ankle fracture recovery protocol

General principles

• The patient will move in crutches, without stepping on the operated limb, for 4-6 weeks postoperatively
• The patient will have his foot immobilized in a leg-foot splint for 6 weeks, maybe even longer, depending on the radiological evolution.
• Avoid unnecessary walking or prolonged standing for the first 2-3 weeks to control local edema and pain.
• Apply ice for 15 minutes 3-5 times a day to monitor pain and inflammation
• Raise the foot above the heart level as much as possible to prevent local edema and inflammation.
• No ankle mobilization exercises for 4 weeks postoperatively - isometric ankle exercises, inside the splint, should be performed daily
• No impact exercises in the first 3 months post-surgery.

Rehabilitation protocol

• Isometric ankle exercises, under immobilization, immediately postoperatively. Perform 5 contractions of 5 seconds, 5 times a day.
• No ankle mobilization exercises in the first 4 weeks.
• Walking with crutches to minimize compensation

• Active finger movements
• Lifting movements of the lower limb with the knee extended
• Quadriceps / gluteal muscles exercises
• Cycling (using only your healthy foot)

• Radiological control at 4 weeks to monitor healing
• Depending on the radiological control, partially progressive loading is allowed, with the help of crutches, and the foot still immobilized in a foot-leg splint
• Start easy ankle mobilization exercises and isotonic ankle exercises without/with partial load
• Soft tissue treatments to control local swelling, mobility, and healing

• Radiological control at 6 weeks
• Depending on the radiological control, you can progress the degree of loading, giving up a crutch
• You can give up immobilization by switching to an ankle orthosis instead
• Walking exercises to normalize the movement pattern
• Seek to achieve a full range of motion
• Start strengthening exercises and balance exercises

• Progress the exercises and functional activities, with the full load of the operated limb. Avoid impact activities until week 12.
• The patient can give up the ankle orthosis if he has dynamic control and satisfactory stability of the ankle.
• The goal is the full range of motion at 12 weeks postoperatively

• Start the exercises specific to the sport you practice
• Increase the intensity of strengthening, balance, coordination exercises for the gradual return to sports activities
• After a careful evaluation by the physical therapist, you can return to the sport you practice