Influence of additional intra-articular arthroscopic visualization on surgeons’ assessment of reduction adequacy in distal radius fractures : A survey-based observational study
- 1Department of Orthopaedics and Traumatology, University of Health Sciences, Balıkesir Atatürk City Hospital, Balıkesir, Turkey
- 2Department of Orthopaedics and Traumatology, Balıkesir Atatürk City Hospital, Balıkesir, Turkey.
Abstract
This study investigates whether additional intra-articular arthroscopic visualization alters experienced orthopedic surgeons’ assessment of reduction adequacy and their image-based consideration of revision during intraoperative evaluation of intra-articular distal radius fractures compared with fluoroscopic assessment alone. Rather than evaluating clinical outcomes, the study aimed to determine whether direct visualization of the articular surface influences surgeons’ interpretation of the conventional fluoroscopic reduction criteria. Intraoperative fluoroscopic and corresponding wrist arthroscopic images from 2 purposively selected, surgically treated intra-articular distal radius fractures (AO/ASIF type 23-C2) were evaluated by 196 orthopedic surgeons with at least 10 years of post-residency clinical experience. For each case, participants first assessed fluoroscopic images and answered standardized questions regarding reduction adequacy and whether they would consider revision surgery. The same questions were subsequently answered after reviewing the corresponding arthroscopic images. Paired categorical responses were compared using the McNemar test, with statistical significance set at P < .05. For case 1, the proportion of surgeons considering the reduction acceptable decreased from 94.4% (185/196) after fluoroscopic evaluation to 10.2% (20/196) following arthroscopic assessment (P < .001). Arthroscopic evaluation also significantly increased consideration of revision surgery (P < .001). In case 2, reduction acceptability did not differ between imaging modalities (P = 1.00); however, arthroscopic visualization significantly increased the proportion of surgeons indicating that they would consider revision surgery (P < .001). In this exploratory survey based on 2 purposively selected intra-articular distal radius fracture cases, additional static arthroscopic visualization altered experienced surgeons’ image-based assessments of reduction adequacy and their hypothetical consideration of revision. These findings reflect changes in interpretation after additional intra-articular visual information and should not be considered evidence of diagnostic superiority, improved anatomical reduction, or clinical benefit.
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BibTeX
@article{gok2026influence,
title = {{Influence of additional intra-articular arthroscopic visualization on surgeons’ assessment of reduction adequacy in distal radius fractures : A survey-based observational study}},
author = {Murat Gök and Mücahit Çelik and Özgün Karakuş},
journal = {Medicine},
year = {2026},
month = oct,
doi = {10.1097/md.0000000000051447},
url = {https://europepmc.org/article/PMC/PMC13727216},
note = {CC BY},
}
RIS
TY - JOUR
TI - Influence of additional intra-articular arthroscopic visualization on surgeons’ assessment of reduction adequacy in distal radius fractures : A survey-based observational study
AU - Murat Gök
AU - Mücahit Çelik
AU - Özgün Karakuş
PY - 2026
DA - 2026/10/30
JO - Medicine
DO - 10.1097/md.0000000000051447
UR - https://europepmc.org/article/PMC/PMC13727216
AB - This study investigates whether additional intra-articular arthroscopic visualization alters experienced orthopedic surgeons’ assessment of reduction adequacy and their image-based consideration of revision during intraoperative evaluation of intra-articular distal radius fractures compared with fluoroscopic assessment alone. Rather than evaluating clinical outcomes, the study aimed to determine whether direct visualization of the articular surface influences surgeons’ interpretation of the conventional fluoroscopic reduction criteria. Intraoperative fluoroscopic and corresponding wrist arthroscopic images from 2 purposively selected, surgically treated intra-articular distal radius fractures (AO/ASIF type 23-C2) were evaluated by 196 orthopedic surgeons with at least 10 years of post-residency clinical experience. For each case, participants first assessed fluoroscopic images and answered standardized questions regarding reduction adequacy and whether they would consider revision surgery. The same questions were subsequently answered after reviewing the corresponding arthroscopic images. Paired categorical responses were compared using the McNemar test, with statistical significance set at P < .05. For case 1, the proportion of surgeons considering the reduction acceptable decreased from 94.4% (185/196) after fluoroscopic evaluation to 10.2% (20/196) following arthroscopic assessment (P < .001). Arthroscopic evaluation also significantly increased consideration of revision surgery (P < .001). In case 2, reduction acceptability did not differ between imaging modalities (P = 1.00); however, arthroscopic visualization significantly increased the proportion of surgeons indicating that they would consider revision surgery (P < .001). In this exploratory survey based on 2 purposively selected intra-articular distal radius fracture cases, additional static arthroscopic visualization altered experienced surgeons’ image-based assessments of reduction adequacy and their hypothetical consideration of revision. These findings reflect changes in interpretation after additional intra-articular visual information and should not be considered evidence of diagnostic superiority, improved anatomical reduction, or clinical benefit.
SN - 0304-5412
SN - 1536-5964
SN - 0025-7974
ER -