Pilon fracture is one of the most common and complex fractures in clinic. It has many postoperative complications, such as limitation of motion, pain, swelling, and decreased muscle strength. Complications will seriously affect patients’ ankle function. If the accelerated rehabilitation support can be obtained, patients can obtain a good functional recovery in the later stage. At present, there are few reports on enhanced rehabilitation related to Pilon fractures. This article introduces the rehabilitation treatment protocol for perioperative accelerated rehabilitation of Pilon fractures, mainly including rehabilitation evaluation, preoperative rehabilitation and postoperative rehabilitation treatment, aiming to provide some reference for standardizing the rehabilitation treatment of Pilon fractures in the perioperative period.
ObjectiveTo compare short-term efficacy of non-intubated video-assisted thoracic surgery (NIVATS) in patients with lobectomy and intubated video-assisted thoracic surgery (IVATS) for rapid postoperative recovery. Methods The CNKI, Wanfang Database, VIP, China Biology Medicine disc, Web of Science, Clinicaltrials.gov, The Cochrane Library and EMbase, PubMed were searched by computer for RCT literature and observational literature on topics related to routine thoracoscopic lobectomy under non-tracheal intubation were collected. The search period was from inception to April 1, 2023. After literature collection and quality evaluation with strict inclusion criteria, the effectiveness and feasibility of the two anesthesia methods were systematically analyzed. Results A total of 14 articles were included in this study, consisting of 4 randomized controlled studies and 10 retrospective studies, including 1 840 patients. The results showed that NIVATS in the treatment of lung cancer compared with IVATS, there were significant differences in operative time [MD=–13.39, 95%CI (–20.16, –6.62), P<0.05)], postoperative anesthesia waking time [MD=–20.34, 95%CI (–26.83, –13.84), P< 0.05], incidence of postoperative airway complications [MD=0.49, 95%CI (0.34, 0.71), P<0.001], length of hospital stay [MD=–0.86, 95%CI (–1.46, –0.26), P<0.05], chest tube indwelling time [MD=–0.73, 95%CI (–1.36, –0.10), P<0.05], total drainage of chest tube [MD=–231.82, 95%CI (–328.64, –135.01), P < 0.05] and postoperative feeding time [MD=–5.68, 95%CI (–7.63, –3.73), P < 0.05] were safer and more effective, and can significantly accelerate the rapid recovery of patients after surgery. Conclusion Under the current ERAS concept at home and abroad, NIVATS is a safe and technically feasible anesthesia method for patients undergoing thoracoscopic lobectomy, which can replace IVATS to a certain extent and can be widely used in clinical practice, providing a basis for clinical decision-making.