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After a Grade-2 ATFL ankle sprain complicated by infection and incision drainage it is very common to have localized swelling just below the ankle bone even after pus has cleared and blood markers ESR CRP are normal this swelling is usually due to ligament injury, scar tissue and lymphatic congestion from both the sprain and the surgical procedure, not ongoing infection such focal swelling can persist for 2–3 months or longer and settles slowly keep the ankle elevated when resting, avoid prolonged standing and use supportive footwear swelling reduces gradually with time if the swelling becomes painful, warm or does not reduce over the next few weeks a clinical review or repeat imaging may be needed to rule out residual ligament or soft-tissue problems