Jan 29, 2015   //   by Orrin Franko   //   Academic, All Apps, Clinical, Clinicians, Free, General Ortho, iPad Apps, Lower, Recent Reviews, Reference, Residents, Students, Study/Review, Top, Trauma, Upper  //  Comments Off on ICUC

High-quality case-based teaching tool for orthopedic trauma.

Overall: 5
Functionality: 5+
Coolness: 5

The ICUC app represents the future of surgical education.  Founded by orthopaedic surgeons and launched in 2014, the purpose of this app is to improve orthopaedic surgical education by sharing expert opinion on common cases through open and transparent commentary (  The app itself is very high quality and has an intuitive user interface.

The user begins by selecting a body region, divided by bones/joints of the upper or lower extremity.  At the time of this review, about half of the bones/joints had associated teaching files. Once an area is selected, the user is presented with a library of cases, reference cases, and expert opinions.

The ICUC Library includes continuous and complete registration of every surgical procedure performed by a group of selected surgeons during a registration period, with no possibility of changes of any type to the original data for different fracture patterns.  For this reason, there exist cases with and without errors. An overview page for each case includes the AO fracture classification, assessment of outcome, approach, and highlights.  The entire case can then be downloaded and reviewed.  The case is of very high quality and includes pre-operative imaging (XR and CT), intra-operative photographs, intra-operative fluoroscopy images, post-operative XR, and post-operative clinical function.  As an example of the level of detail, the proximal humerus case I reviewed had over 170 included images and commentary.  Of note, the comments are quite honest, and appropriately critical about imperfect techniques or non-ideal outcomes.  The amount of information here is extraordinary, with just the proximal humerus having 49 detailed cases.

The Reference Cases section includes animations representing approaches and treatment techniques.  These are usually in the form of an animation and clearly represent the theory behind treatment.

The Expert Opinion section includes recommendations for various parts of the procedure.  For example, in the proximal humerus they include X-ray tips, advice for retraction of the cephalic vein, recommendations to avoid drill-tip screws, drilling tips, etc.  These reflect the opinions of experienced leaders in the field.

The interface is easy to navigate.  When cases are selected and downloaded, they are stored in the “briefcase” for easy access and reference.  Cases can then be removed as well, if additional storage space is required.

Overall, this app represents an extraordinary advancement in surgical education and transparency.  The inclusion of a high volume of cases, combined with honest expert opinion, provides the opportunity for enhanced resident and surgeon education that is not limited by geographic barriers.  I recommend this app highly for all trainees and surgeons.

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