Ankle Fracture Repair Protocol

Keys to a Successful Outcome

Make sure incisions are well healed before more aggressive movements/exercises
Ice and elevate frequently to minimize swelling
Between 0-6 weeks from surgery, end range motion should not be stressed and pain should be minimized as to not disrupt the repair

Phase	Splint/Boot	ROM	WB	Exercises
Weeks 0-2	Splint	None	NWB	None
Weeks 2-4	Walking boot	PROM/AAROM	NWB	AROM for ankle, subtalar, midtarsal within comfortable levels; ankle alphabet
Weeks 4-6	Walking boot	Full AROM	NWB	Progress as tolerated, towel stretch, e-stim, retrograde massage
Weeks 6-8	Wean from walking boot	Full AROM	WBAT	Begin WB, gait training, stationary bike, open chain theraband, seated heel raise
Weeks 8-12	Regular shoes	Full AROM	WBAT	proprioceptive exercises, leg curl/ext, mini-squat, standing heel raise
Weeks 12+	Regular Shoes	Full AROM	WBAT	Closed chain theraband exercises, progress proprioception, agility exercises, sport and job specific training

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