ERAS for orthopedic trauma management

Editor's Note

ERAS can become the standard of care for orthopedic trauma patients, especially with advances in technology integration, precision medicine approaches, and adaptation to resource-limited settings. This is according to a December 17 narrative review in Cureus that examined the current evidence for ERAS implementation in orthopedic trauma care.

In the review, literature on the subject from major medical databases were synthesized and demonstrated how ERAS protocols can improve patient outcomes by reducing hospital length of stay, decreasing complication rates, reducing incidence of delirium and infection and reducing opioid consumption. These benefits were shown to positively influence specific orthopedic trauma events such as for patients with hip fractures, as well as for ankle and other extremity fractures. Outcomes evaluated in the study showed shows similar benefits for both trauma fractures, including a faster return to function and improved patient satisfaction.

Key ERAS protocol elements analyzed that proved most effective for these patients included preoperative optimization, intraoperative stress reduction, and aggressive postoperative mobilization.

The investigators noted that despite the evidence, ERAS implementation challenges such as knowledge gaps and organizational barriers are a reality. They suggested that successful ERAS programs for orthopedic trauma management require dedicated multidisciplinary teams, institutional commitment, clear protocols, ongoing education, and robust measurement systems.