Jingwei Wu,1– 3 Peng Wang,1– 3 Zhihua Gao,1– 3 Shibao Lu1– 3 

1Department of Orthopedics, Xuanwu Hospital of Capital Medical University, Beijing, 100053, People’s Republic of China; 2National Clinical Research Center for Geriatric Diseases, Beijing, 100053, People’s Republic of China; 3Beijing Municipal Geriatric Medical Research Center, Beijing, 100053, People’s Republic of China

Correspondence: Shibao Lu, Department of Orthopedics, Xuanwu Hospital of Capital Medical University, 45 Changchun Street, Xicheng, Beijing, 100053, People’s Republic of China, Email shibaoluspine@sina.com

Background: Enhanced Recovery After Surgery (ERAS) has been extensively applied across numerous surgical specialties. However, there remains a paucity of research regarding the implementation of ERAS in advanced age patients (≥ 75 years) who undergo InterTAN nail surgery for intertrochanteric femoral fractures (ITF). This study aimed to assess if our ERAS protocol improves satisfaction and clinical outcomes in such patients.
Methods: This was a retrospective cohort study included advanced age patients who underwent InterTAN nail surgery. The ERAS group included patients who underwent surgery between January 2022 and December 2024, while the non - ERAS group consisted of those who had the same surgery between January 2019 and December 2023. Demographics, comorbidities, surgical details, ERAS compliance, outcomes, complications, and length of stay (LOS) were evaluated.
Results: A total of 144 patients were included in the ERAS group and 135 in the non - ERAS group. Analysis of demographic data showed no statistically significant intergroup differences. ERAS compliance was 100%. There were no significant differences between the ERAS and non - ERAS groups in terms of operative side, anesthesia type, operating time, intraoperative blood loss, and postoperative Visual Analogue Scale scores. Moreover, 30 - day follow - up revealed no significant differences in readmission rates and mortality between the two groups. However, the LOS was significantly shorter in the ERAS group (5.68± 2.34 days vs 6.54± 2.04 days in the non - ERAS group; p = 0.03). The overall complication rate was also significantly lower in the ERAS group (10/144 vs 23/135; P < 0.01).
Conclusion: In this cohort of advanced age patients with ITF managed via our ERAS program, it was evidenced that this program is safe and can effectively reduce the LOS and the incidence of complications.

Keywords: enhanced recovery after surgery, intertrochanteric femoral fracture, geriatric