After broken ankle surgery, the bone takes at least 6 weeks for early healing and about 10 to 12 weeks to heal fully. Most people are back to normal activities in 3 to 4 months.
Swelling and stiffness last MUCH longer.
Ankle swelling by the end of the day for 6 months to a year is common, and some breaks take up to two years to fully recover.
When you can put weight on the foot is your surgeon’s call, based on your fracture and how it was fixed. Many people now start walking in a boot from about 2 weeks. Others stay off the foot for 6. Follow your surgeon’s protocol over any timeline here, including this one.
Week by week
- Weeks 0 to 2: splint or cast, crutches or a frame, and the leg raised as much as possible. Your team will talk to you about preventing blood clots
- Around week 2: wound check. Many people move from a cast into a removable walking boot at this point
- Weeks 2 to 6: boot on. You either start putting weight through it or stay off the foot, depending on your surgeon. If allowed, you take the boot off to gently move the ankle
- Weeks 6 to 12: weaning out of the boot into a supportive shoe, and down from two crutches to one, then none. The bone finishes healing
- Months 3 to 4: most people are back to normal daily activities, with a limp that fades as strength returns
- Months 4 to 12: building strength and balance, returning to sport, and waiting out the swelling
Early walking: what’s changed
- It used to be 6 weeks off the foot for almost everyone after surgery
- Trials now show that for many fixed ankle fractures, walking in a boot from about 2 weeks gives better ankle function in the first few months, the same result at a year, and no clear rise in complications
- Early walkers also get back to work and daily life sooner
- It isn’t right for every break. Some fractures and some fixations need longer protection. Your surgeon knows which kind you have
The bone heals in weeks. The swelling runs on its own calendar.
Swelling and stiffness: what’s normal
- Swelling that builds through the day and goes down overnight. This can go on for 6 months to a year. It’s normal, even after the bone has healed
- A stiff ankle once the boot comes off. Bending the ankle UP, bringing your shin toward your toes, is usually the hardest direction, and it matters most for stairs and squatting
- A limp for weeks after you’re out of the boot, while calf strength and balance come back
- Aching after a busy day on your feet, which settles with rest and elevation
The American Academy of Orthopaedic Surgeons has a detailed guide to ankle fractures, including the different types and how each is treated.
What helps
- Raise the leg above your heart, especially in the first two weeks. Lying down with the foot up on pillows is easiest
- Move the ankle every day once you’re allowed, a few times a day. Little and often beats one long session
- Walk as much as your surgeon allows. Walking and exercise ease stiffness better than rest
- Keep the foot up at the end of the day for the months the swelling lasts. See swelling after foot surgery for more tactics that work the same way
- Work on balance once you’re walking without aids. Standing on the operated leg is the start. The balance exercises in ankle sprain recovery work well here too
When can I…
- Drive: after a right ankle fracture, usually around 9 to 12 weeks from the injury. You need to be out of the boot and able to do an emergency stop without pain. After a left ankle break in an automatic car, it may be sooner. Check with your insurer
- Go back to a desk job: often early, if you can keep the foot raised and get there safely
- Go back to active or manual work: at least 2 months, and often longer
- Play sport: often somewhere between 3 and 6 months, later for running, jumping and pivoting. Many surgeons suggest an ankle brace for several months after you return
The plate and the long term
- The plate usually stays in. Plates and screws are normally left in to spare you another operation
- It comes out if it causes trouble, for example rubbing on shoes, prominent screws, or infection
- Arthritis can develop years later after some ankle fractures
Go to the emergency department if
- You have sudden pain or swelling in your calf or thigh
- You have chest pain or sudden shortness of breath
- Your toes look blue or white, or feel cold and numb
Call your surgeon today if
- The wound is red, swollen, hot or leaking
- You have a fever or feel unwell
- Pain keeps getting worse, or the cast feels too tight and raising the leg doesn’t help
Mention it at your next review if
- The ankle is still very stiff several weeks after the boot comes off
- Pain over the plate is stopping you wearing normal shoes
- You’re still limping badly at 3 months
Walk when your surgeon says, move the ankle every day, and give the swelling a year.