A meta-analysis of 20 randomized controlled trials evaluating the impact of early weight-bearing and range of motion following operative ankle fractures. The outcomes of interest were functional outcomes, range of motion, complications and infection rates. Pooled analysis demonstrated that early weight-bearing did not increase complications or infection rates when compared with delayed weight-bearing protocols. No differences in functional outcomes or range of motion were found between early and delayed weight-bearing protocols. When evaluating early range of motion, no differences in overall range of motion was found between groups. There were significantly higher rates of complications with early range of motion which consisted mostly of wound complications when compared to delayed range of motion.