Clinical Research on Foot & Ankle
Open Access

Ankle fracture; Rehabilitation; Recovery; Physical therapy; Strengthening exercises; Pain management

Introduction

Ankle fractures are a prevalent form of injury that can occur due to a variety of causes, such as sports accidents, falls, or even simple missteps [1]. These fractures can range from mild sprains to severe breaks, often requiring medical intervention, including immobilization, surgery, and extensive rehabilitation. The rehabilitation phase is crucial for ensuring that the injured ankle regains its full strength, mobility, and function. Effective rehabilitation not only aids in healing but also plays a significant role in preventing complications, such as chronic pain, instability, or long-term disability [2-5]. This guide aims to provide a thorough understanding of the rehabilitation process following an ankle fracture. It will explore the various stages of recovery, from the initial post-injury period to the final stages of regaining strength and flexibility. Special attention will be given to the role of physical therapy, which is key to improving mobility, strength, and function. Additionally, it will address common challenges faced during rehabilitation, such as pain management and the gradual return to daily activities, with a focus on evidence-based strategies to ensure the best possible outcomes for individuals recovering from an ankle fracture.

Materials and Methods

This section outlines the approach taken to guide the rehabilitation process for patients recovering from an ankle fracture, emphasizing the materials, techniques, and methods involved in optimizing recovery [6]. The rehabilitation program includes a combination of clinical assessments, therapeutic interventions, exercise protocols, and patient education. Below are the materials and methods used throughout the rehabilitation stages: Patients diagnosed with a closed or open ankle fracture, regardless of fracture type (e.g., lateral malleolus, medial malleolus, bimalleolar, or trimalleolar). Patients with concurrent lower limb injuries, significant medical comorbidities that impede physical activity, or individuals who are non-compliant with prescribed rehabilitation protocols [7]. A detailed clinical assessment involving physical examination, radiographic imaging (X-rays, CT scans), and the assessment of pain, swelling, range of motion (ROM), and functional mobility.

Orthotic Devices: Ankle braces or splints for immobilization during the initial phase of healing. Ice packs, compression bandages, elevation, and non-steroidal anti-inflammatory drugs (NSAIDs) for managing pain and swelling during the acute phase. Resistance bands, balance boards, ankle weights, and therapeutic ultrasound machines to assist in strengthening exercises and promoting tissue healing. Crutches or walkers, if needed, to facilitate non-weight-bearing activities during the early stages of rehabilitation. During the first 1-3 weeks, the ankle is immobilized using a cast or splint. Pain and swelling are managed through rest, ice, elevation, compression, and the use of pain medications or anti-inflammatory drugs [8]. The goal is to reduce swelling and allow initial healing of bone tissue. After the immobilization period, the focus shifts to gentle range-of-motion exercises, such as ankle circles, dorsiflexion, and plantarflexion stretches, to maintain joint mobility and prevent stiffness. Weight-bearing is gradually introduced, beginning with partial weight-bearing using assistive devices.

From 6-8 weeks, strengthening exercises using resistance bands or ankle weights are implemented. The rehabilitation protocol includes exercises to improve balance, proprioception, and neuromuscular control, along with gradual progression to more dynamic activities, such as walking and light jogging. In the final phase, emphasis is placed on returning to normal activities and sports-specific rehabilitation (if applicable). Exercises focus on agility, stability, and functional movements to reduce the risk of re-injury and promote long-term ankle health [9]. Regular assessments are conducted to evaluate the patient’s progress in terms of pain levels (Visual Analog Scale), range of motion (goniometric measurements), and weight-bearing tolerance. Isometric and isotonic strength measurements are used to assess the strength of ankle muscles and compare it to the uninjured side. Standardized questionnaires, such as the Ankle Hindfoot Scale (AOFAS) or Foot and Ankle Disability Index (FADI), are used to monitor functional recovery, pain, and overall quality of life. Data is collected through patient progress notes, rehabilitation logs, and outcome measures to assess the effectiveness of the rehabilitation program [10]. Follow-up visits are scheduled at regular intervals (4, 8, 12, and 16 weeks) to track healing progress, adapt the rehabilitation plan as necessary, and ensure that patients are progressing toward their functional goals. By following this structured rehabilitation approach, the goal is to maximize recovery, prevent complications, and return the patient to their normal activities as safely and efficiently as possible.

Conclusion

Rehabilitation following an ankle fracture is a critical component of the recovery process, playing a pivotal role in restoring function, strength, and mobility. A well-structured rehabilitation program, encompassing early pain management, gradual weight-bearing, targeted strengthening exercises, and balance training, significantly reduces the risk of long-term complications such as chronic pain, instability, and re-injury. Through the use of appropriate materials, therapeutic techniques, and a stepwise progression of rehabilitation phases, patients can achieve optimal recovery outcomes. By emphasizing both clinical and patient-centered approaches—tailoring the program to the individual’s needs and addressing common rehabilitation challenges—successful recovery can be ensured. Furthermore, the integration of outcome measures and regular follow-up evaluations allows healthcare providers to monitor progress, make necessary adjustments, and ensure that patients regain full functional capacity. Ultimately, comprehensive rehabilitation not only facilitates physical healing but also supports psychological well-being, helping patients return to their daily activities and sports with confidence.

Acknowledgement

None

Conflict of Interest

None

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