Analysis Of Therapeutic Effect Of ERAS Concept In The Perioperative Period Of Posterior Pilon Fracture

Objective:Later pilon fracture patients were the research objects,the application of ERAS(rapid rehabilitation surgery)in the perioperative period of posterior pilon fracture was discussed,and a safe and efficient individualized treatment process and scheme was developed for the rapid diagnosis and treatment and rehabilitation of posterior pilon fracture.Finally,the application of ERAS concept in the field of foot and ankle surgery is explored and verified.Methods:Retrospective analysis was performed on the case data of 80 patients with posterior pilon fracture who underwent open reduction and internal fixation in the department of bone trauma,the second hospital of shanxi medical university from March 2016 to December 2019.In the perioperative period,40 patients were treated by the concept of rapid rehabilitation surgery(ERAS group)and 40 patients were treated by the traditional rehabilitation method(traditional rehabilitation group).All the patients met the inclusion criteria,and the two groups were randomly divided into the observation group and the control group by digital table method.There was no significant difference in preoperative basic data between the two groups(P > 0.05).The observation group was treated with the concept of fast reading rehabilitation surgery,and the control group was treated according to the routine procedure.Compare and statistics group 2 patients had total operation time,intraoperative blood loss,postoperative down time for the first time,after 6 h,12 h,24 h,48 h of static VAS(Visual analog Visual Analogue Scale),pain score,length of hospital stay,postoperative complications,3 months follow-up AOFAS(Ankle Hindfoot Scale)Ankle daily activities dysfunction rate,and so on and so forth.Results:All patients were followed up for 11.20±2.1 months.Compared with the traditional rehabilitation group,the rapid recovery group had shorter operation time,less intraoperative blood loss,shorter hospitalization time,lower static VAS score,and higher AOFAS ankle function score at the 3-month follow-up,with statistically significant differences(P < 0.05).In the ERAS group(rapid recovery),1 case of deep vein thrombosis of lower extremity was found,3 cases of delayed fracture healing and 3 cases of deep vein thrombosis of lower extremity were found in the traditional rehabilitation group,all of which were cured by routine anticoagulation and extended bed time.All patients presented with wound infection,nerve or vascular injury,nonunion of fractures,failure of internal fixation,and traumatic ankle arthritis.Conclusion:The concept of ERAS(rapid rehabilitation surgery)is adopted for perioperative treatment of patients with posterior pilon fracture.The comprehensive efficacy is better than traditional rehabilitation treatment,and the complications are less,which is worthy of clinical application.