Digital transformation in upper extremity surgery: perceptions, applications, and future perspectives among orthopedic and trauma surgeons

Abstract Background Digital technologies such as robotics, artificial intelligence (AI), augmented and virtual reality (AR/VR), and 3D printing are reshaping orthopedic and trauma surgery. While increasingly adopted in lower extremity procedures, their integration in upper extremity surgery remains limited. Aim This study assessed perceptions, current use, and barriers to digital technologies among orthopedic and trauma surgeons specializing in the upper extremity in German-speaking countries. Methods An anonymized, cross-sectional online survey was conducted between September and November 2025 via professional societies and institutional mailing lists. The 25-item questionnaire explored usage, perceived benefits, barriers, and future expectations regarding AI, robotics, AR/VR, and 3D printing. Descriptive statistics and inferential analyses ( t tests, Pearson correlations, multiple linear regression) were performed. Results A total of 115 surgeons and trainees participated, with 91 complete responses. Occasional AI use was reported by 30.8% and regular or frequent use by 35.5%. Robotics was rated as the most transformative technology, followed by AI. Reported benefits included increased precision and reproducibility, while cost, insufficient training, and legal uncertainty were major barriers. Age correlated negatively with AI use ( B = −0.31, p = 0.022), indicating higher adoption among younger surgeons. Self-rated knowledge and management support showed positive, albeit nonsignificant, associations. Overall, 57% considered digitalization an opportunity for quality improvement, and only 4.3% expressed concern about technological dependence. Conclusion This first quantitative analysis demonstrates limited yet growing integration of AI and robotics in upper extremity surgery. Addressing financial, educational, and regulatory challenges is crucial for sustainable digital adoption.