Ankle Fracture Healing Timeline: Grades, Treatment, and Factors Affecting Recovery
Healing Duration by Fracture Grade
- Grade 1 (non-displaced): 6–8 weeks non-operative (cast/boot).
- Grade 2 (displaced, reducible): 6–8 weeks; may require closed reduction + immobilization.
- Grade 3 (comminuted, open, unstable): 12+ weeks; usually ORIF (open reduction internal fixation).
Modifying Factors
- Age: Younger = faster.
- Comorbidities: Diabetes, vascular disease, smoking delay healing.
- Nutrition: Protein, vitamin C, D, calcium adequacy.
- Adherence: Weight-bearing restrictions, follow-up, PT compliance.
Rehabilitation
Post-immobilization: progressive ROM, strengthening, proprioception, gait training. Full return to sport often 4–6 months.
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