Abstract
In this review, we tried to describe the findings of postoperative ankle rehabilitation protocols based on timing, and methodology of the intervention. Interventional arms of randomised controlled trials were categorised as immediate ankle motion, early ankle motion, immediate weight bearing and early weight bearing. In each category, we explored to see if the intervention was delivered individually or as an additional component to another treatment. We excluded studies with non-randomised and retrospective designs to minimise the bias associated with the intention of intervention from the findings. We believe this categorisation can clarify many of our questions related to the efficacy of ankle motion or weight bearing on the recovery of ankle fractures. The findings have clarified that either immediate/early ankle motion or ankle weight bearing programs can improve function and lead to earlier return to work if they are individually compared with delayed rehabilitation recovery. It is more likely that adding weigh bearing component to ankle motion program can lead to better functionality however the additional benefit of ankle motion on weight bearing component requires more investigation. In terms of complications, the review demonstrated an increased risk of superficial wound infection associated with immediate ankle motion or weight bearing. However, there was no evidence of reduction loss following immediate/early ankle motion and weight bearing. The studies reviewed in this literature review often recruited participants with various type of ankle fracturs including type C and syndesmotic fractures. Therefore, the conventional belief that patients with severe fractures may require more time before weight bearing could be questioned. Further investigation is needed to determine whether immediate/early weight bearing can benefit patients with type C and syndesmotic fractures.