Most patients are placed in a splint or walking boot based on the injury pattern. Ankle sprains are most frequently treated without surgery. Initial rehabilitation consists of rest, ice, compression (elastic wrap) and protected weight bearing. For mild sprains, patients should discontinue the use of crutches as soon as they can tolerate full weight on the ankle.
Physical therapy consists of range of motion, exercises with isometrics and proprioceptive retraining. Bracing or taping are used when patients need to immediately return to their sport. For mild sprains taping and bracing can be discontinued three to four weeks upon returning to their sport. For more involved sprains, bracing or taping programs and supervised rehabilitation programs are continued for six months. A year after the injury, occasional intermittent pain is present in up to 40 percent of patients. Surgery is not usually necessary for ankle sprains, but can be recommended for patients with excessive hyper-mobility of the ankle joint.
Ankle fractures may require operative treatment based on the stability of the ankle joint which is related to the pattern of injury. Lateral malleolus fractures are the most common type of ankle fracture. While isolated fractures of the lateral malleolus can usually be treated without surgery, injuries involving the medial or syndesmotic complex of ligaments, or fractures involving the medial and lateral malleolus (bimalleolar fractures) typically require surgery to re-establish the bony architecture of the joint and confer ankle stability. Surgery for ankle fractures consists of one or two incisions placed on the lateral and medial aspects of the ankle over the site of the fracture. The bony fragments are re-positioned and held in place with a combination of plates and screws.
Reviewed by health care specialists at UCSF Medical Center.