Ankle fracture is one of the most common fractures of the lower limb, especially in older women and young men. It is generally treated by surgical or non-surgical orthopaedic management, followed by a period of immobilisation to protect the fracture. Because of the fracture and the subsequent immobilisation period, people often experience pain, stiffness, weakness and swelling at the ankle, and a reduced ability to participate in activities after an ankle fracture. This review identified the most reliable evidence on the effectiveness of rehabilitation interventions used to address these problems.
Only limited evidence is available at present. For people who require ankle surgery, using a removable brace or splint after the surgery so that gentle ankle exercises can be performed may enhance the return to normal activities, reduce pain and improve ankle movement. However, the incidence of adverse events (such as problems with the surgical wound) may also be increased.
After surgery, commencement of walking early during the immobilisation period or using no immobilisation instead of a plaster cast may improve ankle movement.
After either surgical or non-surgical management of the fracture and the immobilisation period, having manual therapy (passive movement performed by a trained health professional) may benefit ankle movement.
There is no evidence of improved function from other therapies such as electrotherapy, hypnosis or stretching.