Broken Ankle Surgery Recovery Time: Plates, Screws and the Week-by-Week Timeline
What happens after plates and screws, week by week: when you can walk, work and drive, how long the swelling lasts, and whether the metal ever has to come out.
Surgery for a broken ankle, usually an operation called ORIF, puts the broken bones back in line and holds them with a plate and screws while they heal. The metal holds the position, but the recovery still runs on the bone's timetable: about 6 weeks of protecting the leg, then months of getting the ankle moving, strong and less swollen.
Below: the week-by-week timeline, walking, work and driving, swelling, whether the hardware comes out, and the warning signs that need a same-day call.
ASG Foot & Ankle patient education. Updated October 27, 2026. General information, not a diagnosis.
The short answer
Broken ankle surgery recovery time is about 6 weeks for the bone to knit enough to come out of the cast or boot, about 3 to 4 months to get back to most normal activities, and often 6 to 9 months for the pain and swelling to settle, with improvement continuing past a year. Most people go home the same day or the next, have stitches out at about 2 weeks, and keep some or all weight off the leg for 2 to 6 weeks, depending on the fracture and the surgeon's plan. Desk work is often possible after 2 to 3 weeks; manual work and sport usually wait until about 12 weeks.
Get Help Urgently After Ankle Surgery If
Call 911 for chest pain or sudden trouble breathing. Contact your surgical team the same day, or go to an emergency room out of hours, if:
- •Your calf is painful or newly swollen on the operated side, which can be a blood clot
- •You have a fever or feel unwell, or the wound is red, hot, swollen or leaking
- •Pain inside the cast keeps climbing despite raising the leg and taking pain relief
- •Your toes are cold, pale, blue or numb
- •The cast cracks, softens or rubs, or you fall onto the leg and the pain or shape changes
- •You have diabetes or neuropathy and the foot becomes hot, red or swollen, even if it hardly hurts
What Broken Ankle Surgery Involves: Plates and Screws
ORIF stands for open reduction and internal fixation. Through an incision, the surgeon lines the broken pieces back up (the reduction) and holds them there with metal (the fixation). It is offered when the ankle has shifted or is unstable, so that the joint heals in its proper position. What is fixed, and how, depends on which bones broke:
| What broke | Usual hardware |
|---|---|
| Outer ankle bone (lateral malleolus, the end of the fibula) | A plate and screws, or a rod or screw inside the bone |
| Inner ankle bone (medial malleolus) | One or two screws; a plate and screws if a large piece breaks into the joint |
| Back of the shinbone (posterior malleolus) | Screws alone, or a plate and screws |
| Both sides of the ankle (bimalleolar) | Most need surgery, usually plates and screws or a rod |
| The joint between the two shin bones (syndesmosis) | One or more screws, or a suture button; the screws may or may not come out later |
The fracture pattern drives your weight-bearing plan, which is why two people with "a plate in the ankle" get different instructions. Fracture types and recovery without surgery are in the ankle fracture recovery timeline, and stable breaks that do not need an operation in minor ankle fracture recovery time. Torn ligaments between the two shin bones are covered in high ankle sprain recovery.
How Long Does a Broken Ankle Take to Heal With Surgery?
AAOS puts early bone healing at at least 6 weeks and complete healing at 10 to 12 weeks, with most people back to normal activities in 3 to 4 months. The milestones, at a glance:
| Milestone | Typical timing after plates and screws |
|---|---|
| Hospital stay | Usually home the same day or the next day |
| Stitches or clips out | About 2 weeks |
| No weight on the leg | Usually 2 to 6 weeks; some people walk in a boot as pain allows from the start |
| Splint, cast or boot | About 6 weeks in total |
| Bone healing | Early healing by about 6 weeks; complete in about 10 to 12 weeks |
| Desk work | Often after 2 to 3 weeks, sooner for some if the foot can be raised |
| Driving | Not before 6 weeks; about 9 to 12 weeks after a right ankle fracture |
| Manual work | At least 6 weeks for lifting work; full duties from about 12 weeks |
| Sport | Not before about 12 weeks, and sometimes later |
| Normal everyday activities | About 3 to 4 months |
| Pain and swelling settle | 6 to 9 months, still improving after a year |
Typical ranges from NHS surgical leaflets and AAOS, not permissions: your surgeon's plan comes first.
Broken Ankle Surgery Recovery, Week by Week
The usual course after a plate and screws. Follow-up X-rays are commonly taken at about 2, 6 and 12 weeks.
Surgery and Home
- Most people go home the same day or the next day
- Usually a splint (a half cast called a backslab that leaves room for swelling) or a boot. Keep it dry
- Raise the foot above hip level whenever you rest; this eases pain and wound leakage and lowers infection risk
- Crutches or a walking frame, with no weight on the leg unless told otherwise
- Your team will discuss blood clot prevention
Elevate and Protect
- Pain and swelling are usually at their worst in the first 2 weeks
- Strip wash rather than shower while you cannot put weight on the leg: hopping on a wet floor invites a fall
The First Clinic Check
- The wound is checked and stitches or clips come out
- The splint becomes a full cast or a walking boot, often with an X-ray
- Your weight-bearing plan is confirmed: some people start walking in a boot, others stay off the leg until about 6 weeks
The Bone Knits
- Either no weight in a cast, or weight as advised in a boot, usually with crutches
- A boot can usually come off for sitting, sleeping and gentle exercises, if your team allows it
- Desk work, if you are comfortable and can raise the foot
Cast Off, Weight On
- An X-ray and review with your surgical team
- A cast usually comes off and weight bearing is stepped up, often in a boot at first
Walking Again
- The fracture has healed in most people; activity builds up gradually, guided by pain
- Complete bone healing usually takes 10 to 12 weeks
- Wean from the boot into a supportive shoe as your team advises
Back to Normal Life
- Most people are back to normal everyday activities by 3 to 4 months
- Full manual work and sport from about 12 weeks if you are able, sometimes later for sport
The Long Tail
- Pain and swelling can persist for 6 to 9 months, still improving past a year
- An ankle brace for sport may be suggested for several months
- Complete recovery from some fractures can take up to 2 years
When it is not on schedule
NHS surgical guidance asks you to get back in touch if pain is getting worse, or is still moderate or severe at 12 weeks, and to speak to a physical therapist if stiffness, walking or balance problems are still affecting daily life at 12 weeks.
When Can I Walk After Ankle Surgery?
Traditionally, people kept all weight off the leg for about 6 weeks after an ankle was fixed. That is changing. In the UK WAX trial, 561 adults whose surgeons judged them suitable either started walking at 2 weeks or waited until 6 weeks. At 4 months, ankle function was at least as good in the early group (66 versus 61 on a 100-point score), complications were similar (16% versus 14%), and by a year there was no difference in function.
Often walking from about 2 weeks
When the surgeon is happy with the fixation, some hospitals now let people walk in a boot as pain allows, from the start or from the 2-week check, usually with crutches at first.
Often no weight for about 6 weeks
Surgeons judged that 42% of the 2,218 people assessed for the trial needed the full 6 weeks, so early walking is not for every fracture. Unplanned operations were slightly more common with early walking: 8% versus 6%.
Either way, stick to your plan: AAOS warns that weight too early can let the pieces shift or heal poorly. After a cast, many people walk in a boot, worn when standing but not at night, then wean into a supportive shoe. People interviewed for the trial said recovery took longer than expected, and fear of pain and re-injury held them back more than pain itself.
Swelling After Ankle Surgery: How Long Is Normal?
Swelling outlasts everything else. It is worst in the first 2 weeks, but NHS surgical leaflets say pain and swelling may persist for 6 to 9 months, still improving after a year, long after the bone has healed.
What helps
- Raising the foot above hip level whenever you rest, especially in the first 2 weeks
- Raising the leg again at the end of the day in the months after, when swelling builds
- Shoes with laces or straps that adjust as the ankle swells through the day
Not normal: call the same day
- A painful or swollen calf, which can be a blood clot
- A red, hot or leaking scar, or a fever
- New or worse swelling after it had been settling
Swelling in both legs, or without an injury, has other causes, covered in swollen feet and ankles.
Physical Therapy After Ankle Surgery
Many hospitals refer you to outpatient physical therapy once the fracture is healing. A typical NHS program builds in stages:
| Stage | Exercises | How often |
|---|---|---|
| Weeks 0 to 6 (in a boot, if allowed out of it) | Ankle pumps, circles, seated toe and heel raises | 10 of each, 5 times a day |
| Out of the cast | Foot up and down, circles, side to side; calf stretch with a towel held 30 seconds | 10 of each, 3 to 4 times a day; stretch 3 times |
| From about 6 weeks | Stretches held 10 seconds and exercises against resistance | 10 of each, 5 times a day |
| Back to sport | Balance, heel raises and hopping, with a physical therapist | As guided |
Still stiff enough to limit daily life at 12 weeks? Ask for a referral. Why the weeks after the cast matter most is explained in the ankle fracture recovery timeline.
Going Back to Work, Driving and Sport
A desk job
Usually after about 2 to 3 weeks off, starting with light duties. Some people manage office work sooner if they can keep the foot raised.
A manual or standing job
At least 6 weeks off for lifting or driving work, at least 2 months for active duties, and a full return from about 12 weeks.
Sport
Not before about 12 weeks, and sometimes later. An ankle brace for sport may be suggested for several months.
How long after ankle surgery can I drive?
Not while the pedal foot is in a cast or boot, not for at least 6 weeks after ankle fracture surgery in NHS guidance, and only once you can do an emergency stop without pain or hesitation; AAOS suggests about 9 to 12 weeks after a right ankle fracture. The left foot, automatic cars and insurance are covered in when you can drive after foot or ankle surgery.
Do Plates and Screws Need to Come Out?
Usually not. Metalwork is normally left in once the bone has healed, to spare you another operation. Removal is still common: in a 20-year Finnish registry of 68,865 adults who had ankle fracture surgery, 27% later had hardware removed; an Irish study found 13%.
Common reasons for removal
- A plate or screw head that rubs in shoes or irritates the tissue around it
- Hardware that has loosened or moved, or presses on the skin
- A deep infection, a metal allergy, or bone that has not healed
- A screw across the joint between the shin bones, which some surgeons take out and others leave
When it happens
On average about 14 months after surgery. But 43% of removals came in the first 3 months, which the authors think were mostly screws across the shin bone joint, and the evidence does not support removing those routinely.
What hardware removal involves
Usually a day case operation through a small incision, with no cast: you go home in a post-op shoe with crutches and can usually put weight on the foot. Stitches come out at 2 to 3 weeks, and the average time off work is 3 to 4 weeks. Swelling for 3 to 6 months is normal, with full recovery by about 12 months.
Risks include infection, blood clots, numbness from damage to small nerves and, rarely, the bone breaking again.
Complications to Watch For After Ankle Surgery
AAOS lists infection, bleeding, damage to nerves, tendons or blood vessels, and problems with the plates or screws among the risks. The ones to know about:
Wound infection
In a multicenter study of about 1,500 ankle fracture operations, 4.4% developed an infection: about 3% superficial and 1.3% deep. After open fractures, where bone broke the skin, it was 16%. Signs: fever, feeling unwell, more pain or swelling, redness, or a leaking wound.
Blood clots
About 1 in 100 people develop a clot in a leg vein after ankle fracture surgery, causing leg pain and swelling. Rarely a clot travels to the lungs, causing chest pain or trouble breathing. That is an emergency: call 911.
Wound healing problems
Raising the foot reduces wound leakage. Once healed, the wound can usually get wet. Let scabs fall off on their own, and report a scar that turns red, swollen or itchy.
Healing out of line, or not at all
Malunion (healing out of position) and nonunion (not healing) are why there are follow-up X-rays, and why you should not load the leg ahead of your plan.
Arthritis later
Arthritis can develop in the ankle years later. Pain still moderate or severe at 12 weeks is worth a review.
What an infected wound looks like is in infected foot wound signs.
Diabetes, Neuropathy, Smoking and Ankle Surgery
AAOS notes that people who smoke, have diabetes or are older have a higher risk of complications after ankle fracture surgery. The research puts numbers on it:
- •In a US study of 90 people with diabetes who had ankle fracture surgery, 28.6% had a major complication (deep infection, an unplanned return to the operating room, or failed fixation), most often bone that did not heal. Four needed an amputation.
- •Neuropathy was linked to about 4.6 times the odds of a complication, and kidney disease from diabetes to about 5 times.
- •Smokers had about 1.5 times the odds of a wound infection after fixation of a closed ankle fracture, mainly deep infection.
With diabetes, tell your surgeon about numbness or kidney problems, keep your blood sugar as steady as you can, and check the skin around the wound and under the boot daily, because pain is not a reliable warning with neuropathy. Some surgeons protect the ankle for longer when neuropathy is present, borrowing from the care of Charcot foot. If you smoke or vape nicotine, stopping helps healing. A wound slow to close needs early attention: see diabetic foot and wound care.
Treated without surgery? Fracture types, month by month. Ankle Fracture Recovery Timeline →
Told it was a small, stable break? Minor Ankle Fracture Recovery Time →
Wondering when you can drive? Driving After Foot Surgery →
Broke a bone in the foot rather than the ankle? Broken Foot Recovery Time →
Frequently Asked Questions
How long does a broken ankle take to heal after surgery?
The bone usually knits enough to come out of the cast or boot in about 6 weeks, and complete bone healing takes about 10 to 12 weeks. Most people are back to normal activities in 3 to 4 months. Pain and swelling often last 6 to 9 months, with improvement continuing for more than a year, and some fractures take up to 2 years to recover fully.
When can I walk after ankle surgery?
It depends on the fracture and your surgeon. Traditionally, people kept all weight off the leg for about 6 weeks. Some hospitals now let suitable patients walk in a boot from about 2 weeks or earlier: in a UK trial of 561 adults, walking at 2 weeks gave ankle function at least as good as waiting 6 weeks, with similar complication rates. Surgeons judged that 42% of the people assessed still needed the full 6 weeks.
How long after ankle surgery can I drive?
Not while the pedal foot is in a cast or boot, and not until you can do an emergency stop without pain or hesitation. NHS surgical guidance says not for at least 6 weeks after ankle fracture surgery, and AAOS suggests about 9 to 12 weeks after a right ankle fracture. With a left ankle and an automatic car, some people can drive sooner if they pass the same test and their surgeon agrees.
Do plates and screws need to come out after ankle surgery?
Usually not. Metalwork is normally left in once the bone has healed. It comes out if it rubs or hurts, works loose, presses on the skin, becomes infected, or, in some practices, if it is a screw across the joint between the two shin bones. In a large Finnish registry, 27% of adults had hardware removed, on average about 14 months after surgery. Removal is usually a day case operation.
Is it normal to have swelling months after ankle surgery?
Yes. Swelling is usually worst in the first 2 weeks, but NHS surgical leaflets say ankle pain and swelling can persist for 6 to 9 months, with improvement continuing for more than a year. Raising the foot helps. Swelling that suddenly gets worse, a painful or swollen calf, or a red, hot or leaking scar is not normal and needs checking the same day.
When can I go back to work after broken ankle surgery?
For a desk job, often after about 2 to 3 weeks, and sooner for some people who can keep the foot raised. Jobs with lifting usually need at least 6 weeks off, NHS hospitals suggest at least 2 months for more active duties, and full manual work usually waits until about 12 weeks. Jobs that involve driving need at least 6 weeks.
How long do you wear a boot after ankle surgery?
Usually about 6 weeks in total in a splint, cast, boot or a mix of them. Some people go straight into a boot and walk in it as advised; others have a cast until about 6 weeks, then a boot for walking. The boot is worn when standing and walking but usually not at night, then you wean into a supportive shoe as your team advises.
Sources and further reading
- AAOS OrthoInfo: Ankle fractures (broken ankle)
- NHS Greater Glasgow and Clyde: Ankle fracture surgery, physiotherapy advice
- Chelsea and Westminster Hospital NHS Foundation Trust: Advice and information following ankle fracture surgery
- James Paget University Hospitals NHS Foundation Trust: Non-weight bearing following ankle or foot surgery
- The Royal Orthopaedic Hospital NHS Foundation Trust: Removal of internal fixation (foot and ankle)
- NIHR Evidence: Walking just 2 weeks after ankle surgery is safe for many (the WAX trial)
- Partio N et al. Hardware removal after ankle fracture surgery, a 20-year registry study. Acta Orthopaedica (2020)
- Sun Y et al. Surgical site infection after ankle fracture ORIF, a multicenter study. Medicine (2018)
- Tran DNA et al. Smoking and surgical site infection after ankle and heel fracture fixation, a meta-analysis. EFORT Open Reviews (2024)
- Polachek WS et al. Complications after ankle fracture surgery in people with diabetes. Foot & Ankle Orthopaedics (2022)
General patient education. Your surgeon's instructions and your individual treatment plan take priority.
See a Podiatrist Near You
ASG Foot & Ankle has offices in Homewood, South Chicago Heights and Mokena. Our board-certified podiatrists accept most insurance. Find the office closest to you:
Recovering From Ankle Surgery?
ASG Foot & Ankle can check a healing incision, keep an eye on swelling and skin, help with the move from boot to shoe, and assess a plate or screw that rubs, with extra care when diabetes or neuropathy is part of the picture.