Henry and his team authored a Systematic Review of Level 1 Randomised Controlled Trials looking at the optimal time to initiate weight-bearing and movement after ankle fracture surgery. Their analysis found that the optimal time to permit range of motion exercises was once the surgical wounds had healed: typically at 10 to 14 days post-op. They also concluded that immediate weight-bearing was safe after ankle fracture surgery, and conferred the lowest risk of complications and revision surgery. The authors advocated that the UK BOAST guidance be updated.

The post-operative regime should be:

• Days 0 to 14: plaster backslab post-op, weight-bearing with crutches and a plaster shoe.
• Day 14: wound check, X-ray and conversion to weight-bearing boot. Begin ROM exercises and wean off as able.

(If there are specific pre- or intra-operative concerns regarding fracture stability or wound/bone healing, then these should be assessed on a case-by-case basis, and the reasons for deviations from this protocol should be stated in the operative note.)

Congratulations to Henry and his team for this highly practical award-winning research!