Considering various forms of immobilization that enable early weight-bearing or exercise initiation, rehabilitation following an ankle fracture can start shortly after the fracture has been repaired. Alternatively, after the period of immobility, physical or manual therapy may be used to begin rehabilitation. This systematic review aimed to compare different rehabilitation strategies after ankle fracture surgery. Four different databases (Scopus, Web of Science, PubMed/MEDLINE (Medical Literature Analysis and Retrieval System Online, and Google Scholar) were used to retrieve the relevant data using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Randomized and quasi-randomized controlled trials involving people undergoing every type of rehabilitation therapy following an ankle fracture surgery were taken into consideration. The main result was a limitation in activities. Adverse events and impairments were instances of such secondary outcomes. A total of 31 studies were found to be eligible for inclusion in this systematic review. The use of exercise and a removable form of immobilization during the immobilization phase to enhance activity limitation is supported by very little evidence. The patient's capacity to adhere to this treatment plan is crucial due to the possible higher risk. To support the available data, more carefully planned and sufficiently powered clinical trials must be conducted.

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