Enhanced recovery after surgery principles in pediatric fractures and sports injuries: strategies, technologies, and outcomes.

Enhanced Recovery After Surgery (ERAS) protocols have been widely validated across adult surgical specialties, with consistent evidence showing their ability to improve patient outcomes and shorten recovery durations. In contrast, the application of ERAS principles in the management of pediatric fractures and sports-related injuries is still in the early stages of development; although the supporting evidence remains limited, it is gradually accumulating. This review is designed to systematically summarize the current status of ERAS implementation in the perioperative care of pediatric fractures-especially common injuries such as hand fractures-and sports-related trauma. By integrating epidemiological data regarding the unique characteristics of these injuries in children, this review explores the effective integration of core ERAS components, including multimodal analgesia, minimally invasive surgical approaches, early mobilization, and active family engagement, into pediatric trauma care pathways. Synthesis of the available clinical evidence highlights that ERAS protocols hold considerable potential for optimizing clinical outcomes, accelerating rehabilitation progress, improving the quality of life of young patients, and reducing healthcare expenditures. Despite the promising preliminary findings, several challenges persist, particularly in the standardization of ERAS protocols specifically tailored to the pediatric population. This underscores the necessity for further in-depth research and multidisciplinary collaboration in this field. Overall, this review provides a comprehensive overview of the current strategies, technical considerations, and clinical outcomes associated with ERAS application in pediatric orthopedic trauma, with the goal of guiding clinical practice and future research in this rapidly evolving area.