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J Wrist Surg
DOI: 10.1055/a-2674-3914
Special Review Article

AI-driven Technologies for Wrist Fracture Prediction: A Narrative Review of Emerging Approaches

Stefania Briano
1   Hand and Upper Limb Surgery Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
,
Maria Cesarina May 
2   Department of Integrated Surgical Diagnostic Sciences (DISC), Orthopedic Clinic, University of Genoa, Genoa, Italy
,
Giacomo Demontis
1   Hand and Upper Limb Surgery Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
,
Giulia Pachera
1   Hand and Upper Limb Surgery Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
,
Vittoria Mazzola
2   Department of Integrated Surgical Diagnostic Sciences (DISC), Orthopedic Clinic, University of Genoa, Genoa, Italy
,
Federico Vitali
2   Department of Integrated Surgical Diagnostic Sciences (DISC), Orthopedic Clinic, University of Genoa, Genoa, Italy
,
Alessandra Galuppi
1   Hand and Upper Limb Surgery Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
,
Emanuela Dapelo
1   Hand and Upper Limb Surgery Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
,
Andrea Zanirato
2   Department of Integrated Surgical Diagnostic Sciences (DISC), Orthopedic Clinic, University of Genoa, Genoa, Italy
,
Matteo Formica
2   Department of Integrated Surgical Diagnostic Sciences (DISC), Orthopedic Clinic, University of Genoa, Genoa, Italy
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Funding None.
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Abstract

Wrist fractures account for approximately 18% of all fractures and are especially common in older adults with osteoporosis and in younger patients following high-energy trauma. Predicting healing outcomes in these cases remains clinically challenging due to variability in fracture types, patient-specific factors, and treatment pathways. Although artificial intelligence (AI) systems have already demonstrated diagnostic accuracies exceeding 95% in detecting and classifying wrist fractures on radiographs, their use in prognostic modeling is still emerging.

This narrative review examines recent developments in AI-driven approaches aimed at improving clinical prognosis following wrist fractures. Advanced models—such as convolutional neural networks (CNNs), transformers, and hybrid architectures—can identify subtle imaging and clinical features associated with complications like malunion, delayed healing, or nonunion. The integration of multimodal data, including comorbidities, imaging, and even osteogenomic profiles, shows promise in enhancing risk stratification and guiding more personalized follow-up strategies.

Emerging technologies such as explainable AI, synthetic data generation, and federated learning offer potential solutions to challenges related to data availability, interpretability, and model generalization across care settings. Despite encouraging results, further validation in real-world clinical environments and standardization of outcome definitions are needed.

In summary, AI-based prognostic tools for wrist fractures could support orthopedic decision-making by identifying high-risk patients early, tailoring follow-up protocols, and improving long-term outcomes through more individualized care.

Keywords

artificial intelligence - wrist fractures - predictive modeling - deep learning - multimodal data

Authors' Contributions

All listed authors meet the ICMJE criteria for authorship. Each author contributed substantially to the conception, research, drafting, and final review of the manuscript. No writing assistance was used.


Ethical Approval

This is a narrative review article and does not involve original research with human or animal subjects. The authors have adhered to the ethical standards set by the Committee on Publication Ethics (COPE) and the International Committee of Medical Journal Editors (ICMJE). All sources have been appropriately cited to ensure academic integrity and transparency. This manuscript is original, has not been published previously, and is not under consideration for publication elsewhere.




Publication History

Received: 20 May 2025

Accepted: 31 July 2025

Article published online:
20 August 2025

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