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.
