Abstract： Objective： To observe the effects of Xiaozhong Dingtong Decoction combined with progressive joint functional rehabilitation training on patients after ankle fracture surgery. Methods：A total of 106 patients with ankle fractures treated at Wenzhou TCM Hospital of Zhejiang Chinese Medical University from October 2023 to October 2024 were selected and divided into the control group and the trial group using the random number table method，with 53 cases in each group. Both groups underwent open reduction and internal fixation surgery. The control group received progressive joint functional rehabilitation training postoperatively， while the trial group received additional treatment with Xiaozhong Dingtong Decoction on the basis of the control group's regimen. Postoperative swelling and pain degree， lower limb function， inflammatory factor levels， and complication rates were compared between the two groups. Results： After six weeks of treatment， the total clinical efficacy rate was 94.34% （50/53） in the trial group and 81.13% （43/53） in the control group，showing a statistically significant difference between the two groups （P＜0.05）. On postoperative day seven，the Visual Analogue Scale（ VAS） scores for pain and the difference in ankle circumference between the healthy and affected sides decreased in both groups compared to postoperative day one （P＜0.05），with the trial group showing lower VAS scores and smaller ankle circumference differences than the control group （P＜0.05）. One month after surgery，the Ankle-Hindfoot Scale scores and the Fugl-Meyer Assessment of Lower Extremity （FMALE） scores increased in both groups compared to preoperative （P＜0.05），with the trial group showing higher Ankle- Hindfoot Scale scores and FMA-LE scores than the control group （P＜0.05）. On postoperative day seven，serum levels of procalcitonin （PCT）， C-reactive protein （CRP）， and tumor necrosis factor-alpha （TNF-α） decreased in both groups compared to postoperative day one （P＜0.05）， with the trial group showing lower levels of PCT， CRP， and TNF-α than the control group （P＜0.05）. The postoperative complication rate was 3.77% （2/53） in the trial group and 15.09% （8/53） in the control group， with a statistically significant difference between the two groups （P＜0.05）. Conclusion：The combination of Xiaozhong Dingtong Decoction and progressive joint functional rehabilitation training can promote the recovery of postoperative swelling and pain，improve lower limb function，downregulate inflammatory factor levels，and reduce the risk of postoperative complications in patients with ankle fractures.