Comparison of the Effects of Augmented Reality and Computed Tomography in the Assessment of Intra-articular Distal Humerus Fractures According to Years of Expertise

Abstract

Objective: The aim of this study was to compare augmented reality (AR) and computed tomography (CT) in terms of diagnostic accuracy (DA), response time (RT), and surgical planning time (SPT) during the assessment of intra-articular distal humerus fractures by orthopedic and traumatology specialists and to evaluate the influence of specialist experience on these outcomes.

Materials and Methods: A total of 28 orthopedic and traumatology specialists from a single public training and research hospital were included in this comparative observational study. Participants were categorized according to experience after completion of specialty training: ≤5 years (Junior specialists (JUN), n=14) and >5 years (Senior specialists (SEN), n=14). Seven intra-articular distal humerus fracture cases classified according to the Jupiter and Milch systems were evaluated using CT images and CT-derived AR models. The cases were presented in randomized order within each modality; CT assessment was performed first, followed by AR assessment. Participants identified the fracture type and planned the surgical approach. DA, RT, and SPT were recorded and compared between modalities and experience groups.

Results: Mean DA was 86.8% with CT and 90.4% with AR, with no statistically significant difference (p=0.257). Mean RT was significantly shorter with AR than with CT (61.8±13.1 s vs. 77.0±21.4 s; p<0.05), whereas mean SPT did not differ significantly (197.0±63.8 s vs. 182.0±88.4 s; p=0.244). The SEN group demonstrated higher DA and shorter RT than the JUN group with both modalities. SPT with CT was shorter in the SEN group, whereas SPT with AR did not differ between experience groups.

Conclusion: AR produced no statistically significant difference in diagnostic accuracy compared with CT and was associated with a shorter response time. Because CT was always assessed before AR, the findings should be interpreted as the additional value of AR after standard CT review rather than as evidence of the independent superiority of AR. AR may serve as a complementary assessment tool, particularly for less experienced specialists.

Keywords

• Augmented reality
• computed tomography
• distal humerus fractures
• diagnostic accuracy
• surgical planning
• orthopedic education

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