ORIF Ankle Fracture Rehabilitation Protocol

PHASE I: 0-2 weeks:

Weight Bearing

  • NWB on the operative extremity

Splint/Brace

  • On at all times

ROM

  • ROM at the knee and hip as tolerated
  • Focus on elevation of extremity when able

PHASE II: 2-6 weeks

WEIGHT BEARING

  • NWB on the operative extremity

SPLINT/BRACE

  • Transition from post-op splint into a CAM walker boot
  • On at all times except for hygiene and exercises

ROM

  • Begin active and passive ankle ROM for dorsiflexion and plantar flexion
  • Air alphabet
  • Continue knee and hip ROM

PHASE III: Post-op week 6+

WEIGHT BEARING

  • Progress to WBAT on the operative extremity

SPLINT/BRACE

  • Wean out of CAM walker boot over 2-4 weeks

ROM

  • Full AROM and PROM
  • Proprioception
  • Gait/balance training
  • May begin strengthening as tolerated

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