Objective <p>Accurate rotational reduction following tibial shaft fracture fixation is absent in up to 36% of cases yet may be critical for lower extremity biomechanics. The objective of this cadaveric study was to compare the results of freehand methods of reduction with software-assisted reduction.</p> Methods <p>Four fellowship-trained orthopaedic trauma surgeons attempted rotational correction in a cadaveric model with fluoroscopic assistance (without radiographic visualization of the fracture site) using (1) their method of choice (MoC) and (2) software assistance (SA). After correction, deviation from baseline rotation was calculated.</p> Results <p>The mean difference between the two methods (MoC–SA) was − 0.2° which was not statistically significant. There was no difference in variability between methods. The rate of clinically relevant rotational deformity (&gt; 15°) was 28% using MoC and 31% using SA.</p> Conclusion <p>Rotational assessment of diaphyseal tibia fractures in this cadaveric model was not significantly different when compared between method of choice and software augmentation.</p>