Fracturoscopy is comparable to fluoroscopy for intraoperative assessment of fracture apposition during indirect reduction of simulated diaphyseal antebrachial fractures in dog cadavers.

OBJECTIVE

To evaluate the feasibility and accuracy of needle scope fracturoscopy for assessing fracture segment apposition during indirect reduction of simulated diaphyseal antebrachial fractures in dog cadavers.

METHODS

Data were collected from July 29 through October 2, 2024. Simulated transverse radial and ulnar fractures were created in dog cadavers and stabilized using a 2-ring circular fixator. A single surgeon performed predetermined, randomized targeted reductions (poor, good, or excellent) under fluoroscopic guidance. A second blinded surgeon assessed fracture apposition in the frontal, transverse sagittal, and longitudinal sagittal planes using a semirigid endoscope. Qualitative and quantitative fracturoscopic findings were compared with post hoc fluoroscopic measurements.

RESULTS

59 reduction trials were completed using 19 thoracic limbs from 11 dog cadavers. Qualitative displacement assessment with fracturoscopy agreed with fluoroscopy in 80.5% of trials (κ = 0.61). Agreement was strongest for frontal plane alignment (medial 88.8%, κ = 0.78; lateral 86.4%, κ = 0.72) and weakest for transverse sagittal alignment (caudal 57.6%, κ = 0.07; cranial 74.6%, κ = 0.22). Quantitative displacement measurements were similar between modalities, although caudal segment displacement magnitude was greater with fracturoscopy. Reliability decreased when reductions were classified as excellent.

CONCLUSIONS

Fracturoscopy was comparable to fluoroscopy for assessing fracture apposition during indirect reduction of simulated diaphyseal radial fractures, though reliability decreased when displacement was minimal.

CLINICAL RELEVANCE: Fracturoscopy may serve as a viable intraoperative alternative for assessing alignment during minimally invasive stabilization of simple diaphyseal fractures in dogs, particularly when fluoroscopy is unavailable, but may be less suitable for complex comminuted fractures.