Background: Ankle fractures are considered the most common types of lower extremity bony injury in orthopedic practice and constitutes the most chief complaint in the emergency department. Objective: Evaluate the effect of rehabilitative protocol on health outcome and functional abilities for patients with ankle open reduction and internal fixation surgery. Settings: This study was conducted at inpatient and outpatient orthopedic clinics, El- Hadra University Hospital, Alexandria -University. Subjects: A convenience sample of 40 adult patients with ankle open reduction and internal fixation surgery. Subjects were assigned into two equal groups as follows; (control group & study group), which include 20 patients in each group. Tools: Three tools were used for data collection in this study. Three tools were developed by the researcher based on the review of recent related literature to collect the necessary data for this study; Tool I: ankle fracture patients sociodemographic and clinical data. Tool II: Observational check list for neurovascular and wound assessment to assess patient problem. Tool III: Ankle ability index for patients with ankle open reduction and internal fixation surgery. Results: The results of the present study concluded that more than half (55%) of the studied patients had a fair total level of knowledge, while (35%) had a good total level of knowledge regarding ankle fracture patients undergoing ORIF surgery Furthermore, study group patients had improvement regarding foot and ankle ability measure, range of motion exercise, skin and neurovascular assessment post rehabilitative exercise program. Conclusion: The results of the present study Showed improvement of both physical activity and functional ability level after the application of rehabilitation protocol. Recommendations: Providing copy of the rehabilitative protocol for patients with ORIF surgery in the trauma units and out patients clinic of orthopedic to be readily available for all patients with ankle fracture and further educational programs should be recommended and suggested for all health care workers especially newly recruited nurses should attend in-service training program about dealing with orthopedic patients.