Functional bracing and rehabilitation of ankle fractures.

For normal daily activities, 10 degrees of ankle dorsiflexion is essential. Plantiflexion follows dorsiflexion and exceeds it by an average of 5 degrees. Normal ankle motion takes place with the talus rotating on an obliquely oriented axis distal to the tips of the medial and lateral malleolus. Mortise widening of less than 1 mm accommodates the talus with the fibula apparently rotating along its vertical axis. Ankle fractures treated nonsurgically will regain functional range of motion if immobilization in equinus is avoided and early weight-bearing with early functional bracing is applied. With the aid of a functional brace, fractures treated surgically may start weight-bearing and exercise within five to seven days, provided all fracture components have been stabilized. The functional brace allows dorsiflexion and plantiflexion via a rigid hinge and reduces rotational stresses acting on the fractured ankle.