One hundred and ninety four patients with operative ankle fractures were randomized to undergo early weightbearing (EWB) at 2 weeks postoperatively (n=95) or nonweightbearing (NWB) (n=99) until 6 weeks postoperatively. This was a noninferiority trial design. The primary outcome of interest was the mean difference in the Olerud-Molander ankle score (OMAS) between the two groups at 12 month follow-up. Additional outcomes of interest included time to full weightbearing, time to return to preinjury activities and patient satisfaction. The EWB group demonstrated a noninferior mean difference in the OMAS score when compared to the NWB group. There was no difference in the proportion of patients who were satisfied at 12 month follow-up. The EWB demonstrated shorter time to full weightbearing and return to preinjury activities than the NWB group (p<0.001). No differences in adverse events were noted.