Inclusion Criteria:  Age 18 or older Unstable ankle fracture  Diagnosis of Diabetes:  Fasting BG > 120 Non-fasting BG > 200 HbA1c > 6.5  Exclusion Criteria:  Patients not meeting inclusion criteria (stable fracture patterns, non-diabetics) Poly-trauma patients (multiple [>2] extremity injuries that interfere and/or limit patient mobilization Open fractures Delayed presentation of fracture (>4 weeks) Fractures that the treating surgeon indicates requires a posterior approach to achieve stability Patients with an active infection or wound at the ankle Utilizing worker's compensation at the time of screening Any previous ligament or fracture surgery on the index ankle Inflammatory rheumatic disease or other rheumatic disease Immune compromised patients (hepatitis, HIV, etc.) Non-English speaking patients Unwilling or unable to follow study protocol