Comparison of Fracturoscopy and Fluoroscopy for Intraoperative Assessment of Fracture Apposition During Indirect Reduction of Simulated Diaphyseal Radial Fractures

Introduction: “Fracturoscopy” refers to inserting an endoscope through a limited surgical approach to visualize fracture reduction. The application of fracturoscopy in dogs has thus far been limited to articular fracture repair. This study evaluated the feasibility and accuracy of using fracturoscopy to assess fracture apposition during the indirect reduction of simulated diaphyseal antebrachial fractures. We hypothesized that fracturoscopy would be comparable to fluoroscopy for intraoperative assessment of fracture reconstruction.

Materials and Methods: Simple, transverse diaphyseal radius and ulnar fractures were uniformly created in dog cadaver forelimbs. Fractures were indirectly reduced by a single surgeon under fluoroscopic guidance. A blinded second surgeon used fracturoscopy to: (1) characterize the direction of fracture displacement, and (2) estimate the millimetre displacement of the distal segment. Post hoc measurements of fracture displacement were obtained from fluoroscopic images and compared with observations made with fracturoscopy.

Results: Displacement direction was accurately identified with fracturoscopy in 80.5% of comparative trials. The weakest agreement was observed between fracturoscopy and fluoroscopy for the detection of caudal displacement (57.6%). Ability to accurately quantify segment displacement with fracturoscopy varied with displacement direction. No differences were observed in estimated lateral, cranial, proximal and distal displacement, while caudal (p = 0.0003) and medial (p = 0.012) displacement estimated using fracturoscopy were significantly different from fluoroscopic measurements.

Discussion/Conclusion: Fracturoscopy represents a viable adjunctive technique for intraoperative assessment of fracture apposition during indirect fracture reduction. Segment displacement can be grossly characterized and quantified accurately with fracturoscopy. This technique warrants further investigation in clinical cases to determine its value when performing MIPO procedures.

Acknowledgment

This study was funded by the UF College of Veterinary Medicine’s Resident Research Grant Competition (2023–2024).

Publication History

Article published online:
15 July 2025