OrthoGuidelines

App for reviewing the AAOS Guidelines and Appropriate Use Criteria for specific diagnoses.

I applaud the AAOS for creating a very useful and intuitive app for reviewing and consulting the AAOS Guidelines and Appropriate Use Criteria for specific diagnoses.  As most orthopaedic surgeons and trainees are aware, the AAOS has committed a significant effort to developing useful guidelines and tools to help surgeons make the appropriate surgical decisions when treating a number of common conditions.  Until now, the guidelines could only be accessed in their PDF form.  This app allows anyone to review the published guidelines in a very useful format.  The app currently includes 17 guidelines (CPG) and 4 appropriate use criteria (AUC) modules.  The guidelines can be sorted by strength and stage of care.

Overall, the app is well made and a great step forward in improving access to these important tools.  I recommend the app to both trainees (for both education and testing purposes) as well as surgeons (for treatment purposes).

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Ortho10 Pro

Simple ICD-10 look-up for orthopaedic surgeons

Ortho10 is the first and only ICD-10 code look-up app specifically for orthopaedic surgeons.  The app has a very simple and intuitive interface which makes finding the proper code, and saving common codes, very easy to do.  Any user can easily find the proper code within less than 6 taps, regardless of any pre-existing knowledge of ICD-10. The app first opens to a list of body parts each on separate tiles.  Once a body part is selected, you have specific options relevant to that region, such as osteoarthritis, fracture, joint pain, sprain, etc.  As the user continues to drill down in choices they are prompted to select a more specific diagnosis, laterality of the injury or pathology, and the type of encounter (initial or subsequent, as required by ICD-10).  The user is then clearly presented with the diagnostic code and a description of the code.  At every level, there is the opportunity to move back up the selection tree and change a response.  And, once a code is selected, it can be saved in favorites for quick reference at a later time.  Overall, the app is easy to use and will be very important and useful as the mandatory transition to ICD-10 takes effect.  The app has already undergone revisions and improvements since its initial release, and we anticipate additional improvements and expansions.  There is currently a free version with all codes but limited additional features, as well as a paid version with enhancements such as “favorites” and “recently used” codes.

Free version:

Pro Version:

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MedTunnel

HIPAA-Compliant secure healthcare communication

This app is meant to remove fax and paper from cluttering your life. MedTunnel is trying to revolutionize the way the healthcare providers share and send information. This company has provided a service that protects patient privacy, but improves communication and makes your phone easy to use. Many apps already offer HIPAA compliant text or email tools via your phone. However, MedTunnel has given users the tools to make sharing information between physicians and patients more robust by giving users the ability to email or send documents. MedTunnel is one of the only HIPAA compliant messaging services that allow a user to take a photo with their phone and turn it into a pdf file and allow pdfs to be viewed and annotated, all on a phone. These two features make the app one of the best HIPAA compliant communication tools on the market. In addition the app is only a small portion of the larger desktop platform that has been created by MedTunnel. The desktop version allows users to have more control of their content and allow all files on any desktop running MedTunnel to securely be saved to the cloud. One concern about the app is you need the desktop version to set up some of the features and without setting these features the app is not the easiest to use.  For the app to be useful to you and your practice you would need the staff and other providers in your practice to adopt the app for the best use of these features. Overall an excellent HIPAA compliant communication app for healthcare professionals.

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AOTrauma Orthogeriatrics

Educational tools for the care of older adults with fractures.

AOTrauma releases another high-quality app to assist in the management of fracture patients, this time with a focus on geriatric patients.  Not surprisingly, the app’s interface is smooth and intuitive, separated into 4 categories: osteoporosis, delirium, anticoagulation, and pain management.  Each section is organized as a drill-down series of questions to help guide the treatment for these patients based on current literature. At every step, “background information” can be selected to see the evidence guiding each decision.  The app is simple, useful, and achieves the stated goals of helping surgeons manage common co-morbidities in elderly fracture patients.

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Insights Orthopedics

Orthopaedic journal and news aggregator with personalized information.

Insights Orthopedics is a comprehensive and visually stunning news and research aggregator for orthopedics.  With a recent redesign in October 2014, their interface has become even more streamlined and visually appealing. Using their specialized search engine, the app collects orthopaedic journals, videos, full-text articles, news, podcasts, images, clinical trials, and association information and presents it in a clear and functional format.  The app looks and feels like the “flipboard for orthopaedic surgery.” The initial landing page presents the various modules, including journal clubs from various institutions, leading journal articles, videos, upcoming events, bookmarks, and industry.  A simple swipe of the keyboard quickly scrolls through the various articles and videos permitting continued browsing of abstracts.  With the new features, thousands of institutional library subscriptions have been adding, permitting full access to the article for users.  The intuitive user interface includes the ability to bookmark resources for off-line browsing or share links via Twitter, Facebook, LinkedIn, email, and SMS.  One of the apps most versatile features is the Aggregator function, which works as a search and includes many pre-populated key terms as well as the ability to type in your own words.

Overall, this app has the look and feel of a “top app” with a number of useful features for any orthopaedic surgeon or trainee.

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Touch Surgery

3-D Surgical Simulation App        

Touch Surgery is a 3-D surgical simulation app to help surgeons/assistants/students become more familiar with particular surgical procedures in their respective field. The app has recently been updated and now offers an even larger library of fundamental orthopaedic procedures that you can download onto your device. The visual clarity and upgrades have drastically improved over the last year. Once you have downloaded the procedure there is a simulation demo that takes you through a step by step demo. The simulation reviews patient set-up, incisions and which neurovascular structures to avoid as well as retractor placement using gestures you make on your device. Once you have completed the demo you can then test yourself through the procedure and see if you are improving your scores. Overall, the best surgical simulation app still out there. It has a clean interface and practical demos for learning orthopaedic residents and students. Some of the apps are 3-D modules which are better made for an iPAD. Hopefully more of the orthopaedics demo’s will be converted to a 3-D format.

In the news

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HC Chang Orthopedics

Personal practice app for Dr. Chang, Singapore

This is a personal practice app for Dr. Chang, sports medicine specialist who practices in Singapore.  The app includes the typical information, including information about calling, emailing, location, about the surgeon, and links to the website and other resources.

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California Orthopaedic Association

Conference app for the 2014 California Orthopaedic Association and QME Course

This app is created for attending the COA 2014 Annual Meeting in Monterey, CA.  Presumably, future meetings will have similar apps that will support equivalent functionality, including an agenda, speakers/evaluations, list of attendees, social events, QR reader, map, photo feed, etc

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ASSH 2013

Conference app for the 2013 Annual Meeting of the American Society of Surgery for the Hand

This app is created for attending the ASSH 2013 conference in San Francisco.  Presumably, future meetings will have similar apps that will support equivalent functionality, including a schedule, personal calendar, full program, speaker search, handout information, maps, exhibitor details, and more.

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PingMD (updated)

HIPAA compliant messaging

PingMD is a creative app to help providers securely and efficiently communicate with patients and other providers. This app creates HIPAA compliant text-messaging. If you did not know, text messaging through your phone provider does not meet HIPAA compliance guidelines. As a result, PingMD was created to fill this void. Overall the app is very user friendly and has a clean interface. Patients and other coworkers can send messages, photos and videos to help communicate with one another. The main criticism with PingMD in my prior review was that it was cumbersome to find other coworkers and patients. *PingMD has just released an update that allows users to easily find coworkers through their current phone contact list.* This update is a powerful move by PingMD. This network based app depends on other providers and patients using the app for it to be successful. Over time as more hospital systems adapt and integrate mobile health solutions this app will likely becoming an everyday part of patient and physician interactions. 

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OTA Annual Meeting 2012

Mobile App to guide OTA attendees

The OTA Annual Meeting 2012 app was created to help attendees navigate the OTA 2012 conference in Minneapolis, Minnesota. The app is thorough and impressive with the resources it gives users which include: a search feature to find a topic of interest and where it will be discussed/presented, a list of exhibitors and their locations, and a thorough schedule that users are able to add to favorite and create their own schedule.  I am impressed the OTA is using social media to help communicate with attendees (twitter and QR code reader) at the conference. While the app is thorough and a great resource for conference attendees I hope the next iteration of the app for future conferences includes more detail about presentation topics with downloadable handouts and information on the posters with that would be useful for attendees. Overall a great resource to navigate the OTA conference

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https://itunes.apple.com/us/app/ota-annual-meeting-2012/id563263168?mt=8

OrtoEscores

Easy app to calculate outcomes scores for patients

This is a great app to help staff calculate relevant outcome scores for patients. The app includes 30 different outcome measures that surgeons can use to help establish measures for how patients are progressing through their care. The app has the functionality to email this information to the patient and to the surgeon. However, a significant portion of the app is in Portuguese as it was originally made for use in Brazil. Also, the formatting of some of the surveys on the iPhone are not the best Overall a great app to calculate outcomes scores that will be more useful once fully translated and more functional on the iPhone.

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Goniometer Pro (G-Pro)

Goniometer mobile application

This Goniometer app was developed by 5fuf5 and is one of many goniometer apps in the marketplace.  Goniometer PRO uses a simple visual tool to help providers mimic a standard clinical goniometer if one is not available.  While I initially struggled using the app, a very well done you-tube video clearly taught me how easiy it is to use. The app allows users to save angle measurements in a memory bank.   Users are able to use the app in the free preview mode, but after 12 uses you are forced to buy the unlimited version which is $14.99. While the app is an excellent tool and visually stimulating at this high of a sticker price there are other apps out there which work the same.

Overall a useful goniometer app with a high pricetag

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Canadian Orthopaedic Association

Mobile Access to the Canadian Orthopaedic Association

This is a weak mobile version of the Canadian Orthopaedic Association website. The app is meant to allow members to have easy access to up to date news and event information. However the lack seems to fall short of providing more than three articles in its news column and does not organize its events calendar well on the iphone. I acknowledge the innovation of using push notifications to remind members of upcoming events, but outside of this one good feature the app itself is lacking the information and thoroughness that the website clearly provides.

Overall a weak app for an important association.

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CORE – Clinical Orthopedic Exam

CORE has set the standard for a clinical exam app.  Divided by body part, body region, alphabetical, favorites, or search – the app contains a database of over 400 clinical tests which includes a purpose, instructions, video demo, and test properties.   The most striking feature of this app, in addition to the vast collection of tests and videos, is actually the “properties” tab.  For every test, data is presented regarding the sensitivity, specificity, likelihood ratio, accuracy and other relevant statistical tests based on primary literature references.  These lists are incredibly complete.  For example, the hip impingement test lists 10 primary sources with their respective sensitivities and specificities using the impingement test to detect labral tears.  In addition, by selecting the primary references the user is directed to the full literature source with the abstract text.  This is a feature that I have not seen replicated by any other orthopaedic reference.  The videos can either be downloaded to the app or a link to YouTube can be emailed/shared with colleagues.  Tests can be marked as a “favorite” and quickly reviewed at a later time.  Unfortunately, the search feature was not ideal.  When I searched “grind” there were “no results” but when I searched “Apley” I was provided with Apley’s Grind Test.  This app seems ideal for a medical student with an interest in musculoskeletal medicine (PM&R, sports medicine, or orthopaedic surgery) or a junior resident in any of these fields.  Overall, a very complete and useful app for trainees.

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Top Ortho “App”

Download the www.TopOrthoApps.com iPhone app!  You’re already on the website, why not have on-the-go access direct from your iPhone?  This app has all of the best Top Ortho App lists that you’re used to: Top Apps, Free Apps, iPad Apps, Journals, Sports Apps, and much more!  Full reviews and screenshots are all available for free.

This app has all of the best Top Ortho App lists that you’re used to: Top Apps, Free Apps, iPad Apps, Journals, Sports Apps, and much more!  Full reviews and screenshots are all available for free.

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Knee Pain

Knee Pain is an app “course” created by Dr. Eric Gozna to teach his mnemonic for the 10 most common sources of knee pain: “four thought” on the knee.  The app is actually a narrated slideshow format that auto-advances through 55 slides of informational slides that include descriptions of the anatomy, as well as information about the pathology, the presentation, the diagnosis and treatment.  Some slides include video examples of a clinical exam, and some slides include review questions to reinforce concepts and lessons.  The concept of the app is novel.  Dr. Gozna’s credentials are listed on the site (an orthopaedic surgeon in Canada), however the information presented may be more credible if endorsed by an orthopaedic society.  Overall, the presentation is clear and may be most useful to students, non-orthopaedic providers, or patients interested in learning more about knee pain in a community-based practice.

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Tumorpedia Soft Tissue

This app is the “Soft Tissue” version in the Tumorpedia series, a collection of apps that serve as an encyclopedia of orthopaedic oncology.  This version includes over 14 orthopaedic soft tissue tumors.  Each topic is divided into general information, incidence and demographics, xrays, MRI, CT, pathology, differential diagnosis, and treatment.  The amount of information presented for each topic is variable, but generally a specific and informative overview of the topic is included.  The images are especially useful for demonstrating “typical” appearances on imaging exams and pathologic specimens.   The app also includes an “updated” feature, suggesting that the database may undergo regular updates in the future.  It appears that images are downloaded in real-time from a server, thus the app is of limited use when no WiFi or wireless data signal is available. As a result, some of the images did not load during my testing.  Overall, this series of orthopaedic tumor information is an inexpensive and useful reference for orthopaedic trainees, nurses, and other medical providers who diagnose and treat musculoskeletal tumors.  Because this is a first version, hopefully future versions will be available with improved functionality.

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Tumorpedia Lite

This app is the free version in the Tumorpedia series, a collection of apps that serve as an encyclopedia of orthopaedic oncology based on www.bonetumor.org.  This version includes a selected collection of 28 orthopaedic tumors.  Each topic is divided into general information, incidence and demographics, xrays, MRI, CT, pathology, differential diagnosis, and treatment.  The amount of information presented for each topic is variable, but generally a specific and informative overview of the topic is included.  The images are especially useful for demonstrating “typical” appearances on imaging exams and pathologic specimens.   The app also includes an “updated” feature, suggesting that the database may undergo regular updates in the future.  Overall, this series of orthopaedic tumor information is a useful reference for orthopaedic trainees, nurses, and other medical providers who diagnose and treat musculoskeletal tumors.

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Tumorpedia Foot and Ankle

This app is the “Foot and Ankle” version in the Tumorpedia series, a collection of apps that serve as an encyclopedia of orthopaedic oncology based on www.bonetumor.org.  This version includes 23 orthopaedic foot and ankle tumors.  Each topic is divided into general information, incidence and demographics, xrays, MRI, CT, pathology, differential diagnosis, and treatment.  The amount of information presented for each topic is variable, but generally a specific and informative overview of the topic is included.  The images are especially useful for demonstrating “typical” appearances on imaging exams and pathologic specimens.   The app also includes an “updated” feature, suggesting that the database may undergo regular updates in the future.  It appears that images are downloaded in real-time from a server, thus the app is of limited use when no WiFi or wireless data signal is available. As a result, some of the images did not load during my testing.  Overall, this series of orthopaedic tumor information is an inexpensive and useful reference for orthopaedic trainees, nurses, and other medical providers who diagnose and treat musculoskeletal tumors.  Because this is a first version, hopefully future versions will be available with improved functionality.

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Tumorpedia Espanol

This app is the “Espanol” version in the Tumorpedia series, a collection of apps that serve as an encyclopedia of orthopaedic oncology based on www.bonetumor.org.  This version includes over 100 orthopaedic tumors with complete information in Spanish.  Each topic is divided into general information, incidence and demographics, xrays, MRI, CT, pathology, differential diagnosis, and treatment.  The amount of information presented for each topic is variable, but generally a specific and informative overview of the topic is included.  The images are especially useful for demonstrating “typical” appearances on imaging exams and pathologic specimens.   The app also includes an “updated” feature, suggesting that the database may undergo regular updates in the future.  It appears that images are downloaded in real-time from a server, thus the app is of limited use when no WiFi or wireless data signal is available. As a result, some of the images did not load during my testing.  Overall, this series of orthopaedic tumor information is an inexpensive and useful reference for orthopaedic trainees, nurses, and other medical providers who diagnose and treat musculoskeletal tumors.  Because this is a first version, hopefully future versions will be available with improved functionality.

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Tumorpedia Bone

This app is the “Bone” version in the Tumorpedia series, a collection of apps that serve as an encyclopedia of orthopaedic oncology based on www.bonetumor.org.  This version includes over 70 orthopaedic bone tumors.  Each topic is divided into general information, incidence and demographics, xrays, MRI, CT, pathology, differential diagnosis, and treatment.  The amount of information presented for each topic is variable, but generally a specific and informative overview of the topic is included.  The images are especially useful for demonstrating “typical” appearances on imaging exams and pathologic specimens.   The app also includes an “updated” feature, suggesting that the database may undergo regular updates in the future.  It appears that images are downloaded in real-time from a server, thus the app is of limited use when no WiFi or wireless data signal is available. As a result, some of the images did not load during my testing.  Overall, this series of orthopaedic tumor information is an inexpensive and useful reference for orthopaedic trainees, nurses, and other medical providers who diagnose and treat musculoskeletal tumors.  Because this is a first version, hopefully future versions will be available with improved functionality.

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iPrevent Running Injuries

Created by two orthopaedic surgeons, this app is a video focused on patient education regarding stretching, strengthening, and agility exercises to prevent running injuries.  The app design is simple, and includes a single video about 20 minutes long, as well as contact information for the website www.sportsipa.com (sports injury prevention academy).  The video itself is well-narrated and well-produced and demonstrates many useful stretching and strengthening activities.  In addition, narration by the two orthopaedic surgeon developers explain the purpose and motivation for developing this course.  Overall, this app can be very useful to any patient/athlete interested in preventing running injuries.  Unlike other apps, the developers are board-certified orthopaedic surgeons, thereby lending credibility to the recommendations.

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iPrevent ACL Injuries

Created by two orthopaedic surgeons, this app is a video focused on patient education regarding stretching, strengthening, and agility exercises to prevent ACL injuries.  The app design is simple, and includes a single video about 18 minutes long, as well as contact information for the website www.sportsipa.com (sports injury prevention academy).  The video itself is well-narrated and well-produced and demonstrates many useful stretching and strengthening activities.  In addition, narration by the two orthopaedic surgeon developers explain the purpose and motivation for developing this course.  Overall, this app can be very useful to any patient/athlete interested in preventing ACL injuries.  Unlike other apps, the developers are board-certified orthopaedic surgeons, thereby lending credibility to the recommendations.

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Dr. DeGroot On Line

A personal practice app for Dr. DeGroot, this provides patient information about the practice, credentials, e-mail information, location, and phone number.  No general medical information is provided.  Probably only useful for current or prospective patients in the greater Boston area.

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Shoulder Pain

Shoulder Pain is an app “course” created by Dr. Eric Gozna to teach his mnemonic for the six most common causes of shoulder pain: FACTSS.  The app is actually a narrated slideshow format that auto-advances through 71 slides of informational slides that include descriptions of each pathology, as well as information about the pathology, the presentation, the diagnosis and treatment.  Some slides include video examples of a clinical exam, and some slides include review questions to reinforce concepts and lessons.  The concept of the app is novel.  Dr. Gozna’s credentials are listed on the site (an orthopaedic surgeon in Canada), however the information presented may be more credible if endorsed by an orthopaedic society.  Overall, the presentation is clear and may be most useful to students, non-orthopaedic providers, or patients interested in learning more about shoulder pain in a community-based practice.

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Medscape

Medscape is a familiar name among physicians, and their well-designed app extends the functionality of their website into a mobile format.  Using the same login (free), users are provided with headlines based on their selected specialty.  For example, when logged in as “orthopaedics” the headlines include information about metal-on-metal hips, PPI and hip fracture risk, and an article on orthopaedic surgery rates – all headlines link to a full article and include audio or video, if available. The app is then divided into three sections.  The News icon expands upon the headline articles and are specific to your specialty. The Reference icon includes information about drugs, diseases & conditions, procedures, and more. The third icon is Education, includes CME approved articles which can be used to earn CME credit.  The Reference section can be especially useful; articles are incredibly detailed about a broad spectrum of orthopaedic conditions and are written by professionals in the field with references provided.  In addition, the Musculoskeletal Procedures section has an impressive collection of common orthopaedic techniques, such as splinting and joint/tendon injections.  The content of the Medscape app is an expansive collection of free information that would be useful to any provider.  The only challenge is how to find what you’re looking for.  Thankfully, the app has a great search functionality which is both accurate and incredibly fast.  Overall, the app is highly recommended for any provider, and by registering as an orthopaedic surgeon online, the news headlines become even more relevant.

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iOrtho+

An-all inclusive physical exam and special test app including images, videos, and artwork to demonstrate the proper execution of each test.

This app is a comprehensive mobile orthopaedic guide that includes physical exam tests and mobilizations.  Although the app can be downloaded for free, only a limited number of exam tests and mobilizations are available until the $14.99 in-app purchase is made.  The app includes over 200 special physical exam tests, separated by body part.  For example, rotator cuff tests are divided by muscle, and subscapularis tests include lift-off (Gerber), internal rotation lag, belly press, belly-off, and bear-hug.  Each test includes a picture demonstrating the test, a brief description of the technique and interpretation, and Stat/Ref which summarizes the clinical evidence supporting the test’s sensitivity, specificity, and +/- liklihood ratios (with references provided).  A great feature is the addition of video for many of the tests.  The mobilizations section includes over 80 techniques images and descriptions.

The app underwent a recent update which now includes medical screening tests to rule out visceral pathology, impressive dermatome artwork, deep tendon reflex testing, C-spine screens such as NEXUS and Canadian spine rules, agility-functional testing for the lower extremity, and enhanced reference list to > 1100 sources, statistical data that includes clustering of ortho tests to enhance evidence-based clinical decision making.  And, if a desired test is not available, the app includes an “add your own test” section.

Overall, the app is best designed for medical students or junior residents who are learning the orthopaedic physical exam and special tests.  The app is very high quality for the extensive information and value it provides.

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OITE Buzzwords

This app, available only for iPhone and Android, is marketed as a “buzzword” study guide for the orthopaedic in-training exam (OITE).  The app is divided into 4 sections: index, about, quiz, and contact.  The index lists 51 buzzwords, such as zebra lines, throckmorton sign, sausage digit, pancake vertebra, etc.  Unfortunately, when testing on an iPhone 4S device the content did not load for all of the content sections resulting in a blank screen.  For screens in which content did load, images required up to 30 seconds to load, and text often required 10 seconds to load.  The information provided for each topic is brief (2-5 sentences).  No references of additional information is provided for any of the  topics.  The quiz section includes a gallery of thumbnail images that can be selected. Once again, the images take up to 30 seconds to load, thereby negating the purpose of the app for quickly reviewing buzzwords.  In addition, the answers to the image pathology would not appear, and in some cases the images did not appear at all. The contact section provides a phone number, email and website: www.bonetumor.org.  Interestingly, the site appears to be an incredibly detailed, expansive, and valuable listing of bone tumors and their presentation, diagnosis, and treatment accompanied by xray and pathologic images.  Overall, this app appears to address a need among residents for OITE studying, however the implementation ranges from painfully slow to entirely non-functional, rendering this app useless at this point.  I do hope that future versions become more stable and useful since this is a great idea for OITE studying.

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OITE Tumor

This app, available only for iPhone and Android, is marketed as a “buzzword” study guide for the orthopaedic in-training exam (OITE) tumor topics.  The app is divided into 5 sections: about, index, flashcards, quiz, and contact.  The index lists 78 tumor buzzwords, such as zebra lines, PNET, Batson’s Plexus, Codman triangle, etc.  Unfortunately, when testing on an iPhone 4S device the app ran very slow and crashed at times, despite its very limited content (text and images).  For screens in which content did load, images were presented with a text description that include spelling errors at times.  The information provided for each topic is brief (2-5 sentences).  No references of additional information is provided for any of the topics.  The flashcards present a gallery of thumbnail images for selection. Once again, the images take up to 30 seconds to load, and some do not load at all, thereby negating the purpose of the app for quickly reviewing buzzwords.  In addition, the answers to the image pathology would not appear, and thus there is no way to check one’s knowledge against the real answer. The quiz section includes a listing of topics with a complete question stem and multiple choice answers and explanations.  Only 10 questions are included.  The contact section provides a phone number, email and website: www.bonetumor.org.  Interestingly, the site appears to be an incredibly detailed, expansive, and valuable listing of bone tumors and their presentation, diagnosis, and treatment accompanied by xray and pathologic images.  Overall, this app appears to address a need among residents for OITE studying, however the implementation ranges from painfully slow to entirely non-functional, rendering this app useless at this point.  I do hope that future versions become more stable and useful since this is a great idea for OITE studying.

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OITE Strategy

This app, available only for iPhone and Android, provides free advice for orthopaedic residents taking the orthopaedic in-training exam (OITE).  The app is divided into 4 sections: topics, resources, method, and contact.  The topics include valuable information regarding the prevalence of particular types of questions based on published data. For example, the Tumor sub-heading provides the user with the most commonly tested orthopaedic tumors for the past 10 years. Other sub-headings estimate the number of questions expected to be on a given test. The resources section provides a useful list of peer-reviewed publications that address OITE-related topics, such as analyses of the most commonly tested topics, as well as the average scores for the 2009 exam. The Methods section reviews general multiple-choice techniques, and the contact section provides a phone number, email and website: www.bonetumor.org.  Interestingly, the site appears to be an incredibly detailed, expansive, and valuable listing of bone tumors and their presentation, diagnosis, and treatment accompanied by xray and pathologic images.  Overall, this app provides interesting and useful information for orthopaedic residents and provides additional resources for more information.  When testing on an iPhone, the app ran surprisingly slow and required nearly 15 seconds to initiate.  The app appears to be a “teaser” app encouraging residents to purchase other apps by the same developer, OITE Tumor and OITE Buzzwords.

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CORE – Clinical Orthopedic Exam

CORE has set the standard for a clinical exam app.  Divided by body part, body region, alphabetical, favorites, or search – the app contains a database of nearly 250 clinical tests which includes a purpose, instructions, video demo, and test properties.  The most striking feature of this app, in addition to the vast collection of tests and videos, is actually the “properties” tab.  For every test, data is presented regarding the sensitivity, specificity, likelihood ratio, accuracy and other relevant statistical tests based on primary literature references.  These lists are incredibly complete.  For example, the hip impingement test lists 10 primary sources with their respective sensitivities and specificities using the impingement test to detect labral tears.  In addition, by selecting the primary references the user is directed to the full literature source with the abstract text.  This is a feature that I have not seen replicated by any other orthopaedic reference.  In the basic version of the app, the videos are not contained within the app, but rather link to YouTube videos that can be emailed/shared with colleagues. However, for an in-app purchase of $7.99 all videos can be downloaded to the device (about 1GB of data).  Tests can be marked as a “favorite” and quickly reviewed at a later time.  Unfortunately, the search feature was not ideal.  When I searched “grind” there were “no results” but when I searched “Apley” I was provided with Apley’s Grind Test; however, this function is easily improved in a future update.  This app seems ideal for a medical student with an interest in musculoskeletal medicine (PM&R, sports medicine, or orthopaedic surgery) or a junior resident in any of these fields.  Overall, a very complete and useful app for trainees.

To learn more about this app, as well as others by the same developers, check out their website at www.clinicallyrelevant.com.

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SportsMed

SportsMed joins the series of RSS-feed apps to organize sports medicine-related abstracts into a single app.  Like other apps in this series (BoneFeed, BoneCast, HandFeed), the user can personalize which RSS feeds are presented along the home row from a list of feeds included with the app.  For SportsMed, the list includes AJSM, Arthroscopy, Sports Med Arthr, Brit J Sports Med, and a variety of other feeds.  The feeds allow the user to review an abstract, view the full text article directly from the journal website (if you have online access), post comments, or share the paper via Twitter, Facebook, or email.  Overall, this app is a simple and intuitive way to keep up-to-date with the latest sports publications.

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SugarSync

Overall: 4+
Functionality: 5
Coolness: 5

SugarSync is actually a cloud-based data back-up service that includes the use of their free apps.  But, because most surgeons are probably under-protected with regard to the security of their digital data, I strongly advocate the use of some type of auto-backup service, such as SugarSync or one of its competitors.  After paying for a subscription and installing the program onto as many computers as you would like, SugarSync will automatically back up your data in real-time both to the cloud, as well as between computers.  For example, in my home I sync my two laptops so that the data between my “home” computer and my “work” computer are always matched.  Then, I also sync specific folders (such as photos) between my computers and my wife’s computer.  Copying/transferring files with flash drives and emailing document versions have become obsolete.  Lastly, because I have the app installed on my phone and my iPad, I can access any file from anywhere, any time.  That includes photos, documents, or reading material and includes the ability to email the files directly to a colleague.  The price is competitive, and the functionality has redefined the way I manage my data.  For more information, see my FAQ section.

 Cost: Free app with subscription service.
Download Here

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JBJS Br Abstract Manager

This app is certainly a step in the right direction for peer-reviewed journals by allowing surgeons to search for and access content on their mobile devices.  The app continues to evolve into a more robust and usable form that suffers from occasional glitches.  The menu allows the user to browse abstracts in each journal edition and search for content using “watch words” or standard author/title/year/abstract search techniques.  The abstracts worked well for me, and allow for a review as well as the option to email the abstract to a colleague. However, the watch-word functionality was not working properly.  Once the kinks have been worked out, this may be a very useful app depending on how easy it will be for users to view and download material.  Until then, consider using other RSS feed apps, such as BoneFeed, to access the same content.

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Understanding Disease: Orthopedics

Overall: 2+
Functionality: 3
Coolness: 2

This app is part of a series of apps titled “Understanding Disease: XXXX.”  The “Orthopedics” version is free to download, however in-app purchases are required to view information about the subjects that are included: osteoarthritis, osteoporosis, postmenopausal osteoporosis, psoriatic arthritis, and rheumatoid arthritis.  The app is clearly marketed to patients and is likely of little use to students, trainees, or surgeons with the exception of providing material for patients to review while in a waiting room.  The limited number of subjects available for review limits the app significantly; however, an expansion could make this a potentially useful and informative app for patient education.

Cost: Free for the app; in-app purchases of $9.99 for each subject or $39.99 for all 5.
Download Here

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Ortho Traumapedia

Quick reference for on-call trauma related to fractures and dislocations
 

This app is the ideal complement to any student, resident, fellow, or attending taking general orthopaedic trauma call.  The app has a simple and intuitive user interface separated into either dislocations or fractures and organized by bone, joint, or region.  Each topic is then divided into the same four sub-topics: facts, image, classify, and treat.  With an easy-to-read bullet format, the user can quickly glean the most critical facts about a particular fracture, answer common “pimp” questions, understand how to interpret the radiology, and review various classification systems for a particular injury.  One of the most useful features are the images which include very clear lines, arrows, and circles overlying normal and injury radiographs to teach the user how to evaluate and interpret injury films.  Overall, the material appears to be consistent with most other orthopaedic trauma texts, although no references are provided.

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Google Translate

Overall: 5
Functionality: 4
Coolness: 5+

Leave it to Google to creat one of the most creative, useful, and free apps available.  This app does everything you would expect from a translator: 1) It allows the user to speak into the phone and it performs voice-recognition and converts the speech to text, 2) It then translates the text into one of over 40 languages and displays the translation on the screen in the native alphabet, and 3) For many of the languages it can then speak the translated phrase back to the patient!  If this is not impressive technology, I don’t know what is.  In addition to the ingenious functionality, the app runs very fast, the dictation function is accurate, and I have yet to encounter a language that I need but do not have available.  For anyone who works in a hospital with an international patient population but where translators are not always readily available, this app is certainly one of the coolest and most useful I have ever encountered.

Cost: Free
Download Here

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MedCalc

Overall: 3
Functionality: 3
Coolness: 2

Everyone needs a good medical calculator on their smartphone, and MedCalc is my personal favorite based on the plethora of built-in equations.  The app has a very intuitive interface that can be easily navigated by users with any level of experience.  In addition, equations are organized by subject, alphabetically, and allows the user to easily mark his or her “favorites” for quick reference.  Some of the most useful tools that I have found include the opioid conversion tool, the dermatome distribution map, and the ISS calculation.  The app is also offered as MedCalc Pro for iPad and includes a full-size HD version with additional resources.  At $0.99 or $4.99, this app is a good option for someone that does not yet have their favorite medical calculator app.

Cost: $0.99 for MedCalc (iPhone); $4.99 for MedCalc Pro (iPad)
Download MedCalc (iPhone) Here
Download MedCalc Pro (iPad) Here

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Dragon Dictation

Overall: 4
Functionality: 3+
Coolness: 5

These days most surgeons are aware of commercially available voice dictation, such as Dragon and other brands, however few know that Dragon Dictation makes a free app for the iPhone.   That’s right: completely free.  Not only that, but even without voice training (as is required for the full computer-based version), this app has impressive recognition capability the first time you use it.  The app is limited by the fact that you can only dictate within the Dragon app, thus you cannot dictation directly into an email, text message, or note.  Of course, this is a limitation created by Apple which prevents one app from running “within” another app.  In addition, Dragon limits each dictation to 30 seconds.  However, because you can perform multiple dictations within a single document, and because the app allows you to easily copy, email, or text message your text – these limitations are easily overcome.   A great feature is that words that Dragon knows it may have mis-interpreted can be selected and the user is presented with similar alternatives.  From my experience, Dragon is accurate about 90% of the time, and if you include the alternative options, accuracy increases to >95%.  For someone who writes emails from their phone, this app has the potential to save you much time, frustration, and iPhone-related spelling errors.  I cannot think of a reason not to download the app.

Cost: Free
Download Here

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BoneCast

From the same makers of Bone Feed and Hand Feed, two apps that present RSS text feeds, this app is the cool older brother than instead summarizes and presents audio feeds (podcasts) and video feesd (vodcasts) from the most popular orthopaedic sources.  This includes JBJS Am, JBJS Br, AOSSM, Brit J Sp Med, HSS Ortho and others.  The app allows you to stream high-quality video and audio directly to your device with a nearly non-existent lag or delay, depending on your internet connection speed.  Functionally, this app is limited by the fact that podcasts usually require you to insert headphones to adequately listen to the presentation; however the fact that you can stream orthopaedic video directly to your device is certainly going to “wow” your colleagues.

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Hand Feed

Similar to its close relatives, BoneFeed and SportsMed, this app is an RSS reader for orthopaedic hand-related publications.  The user can customize the feeds that are presented, including JHS American, JHS European, Hand Clinics, Techniques in Hand, JBJS Br Upper Extremity, HAND, and others.  The feeds allow the user to review an abstract, view the full text article directly from the journal website (if you have online access), post comments, or share the paper via Twitter, Facebook, or email.  Overall, this app is a simple and intuitive way for hand surgeons to keep up-to-date with the latest publications 24-hours a day.

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Epocrates

Overall: 4
Functionality: 4
Coolness: 2+

Epocrates continues to be the gold-standard for mobile drug-reference applications.  The app provides free medication information including dosing (both adults and pediatrics), interactions, contraindications, as well as a “pill identifier” to match a pill with its name according to shape, color, imprint, etc.  For anyone who cannot always remember the dosing and frequency of every medication, this app belongs in your pocket.  Unfortunately, Epocrates also insists on updating frequently and prompting users with “news” information that some may not find useful.  Thus, functionality is limited by the time it takes to occasionally update the app.  Otherwise, this app is a “must have” for any provider.

Cost: Free for drug reference, requires subscription for Essentials Plus with added features.
Download Here

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AAOS Now

The American Academy of Orthopaedic Surgeons has created this lightweight app to view AAOS Now, the monthly print publication sent to all Academy members.  Unfortunately, the app only presents articles in their full form which requires a significant amount of zooming/panning when viewing on a small mobile device such as a smartphone.  However, the app does have additional useful features such as podcasts and videocasts available as a streaming feed directly to the mobile device.  Although its uses are limited for reading articles, the media casts and the fact that this app is free may warrant download for any Academy members that may want access to when “on the go.”

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Multiplier

Calculator for predicting height and bone length in children.

Designed to help surgeons predict leg-length discrepancies at maturity, this app has expanded the use of Paley’s Multiplier tables to allow for the prediction of height, upper extremity length, and timing of epiphysiodesis.  The app itself is published by Sinai Hospital of Baltimore and includes a variety of references from their institution.  In addition to an intuitive user interface, there are useful resources including a complete multiplier table as well as the Elbow Scoring System to determine skeletal age.  The app also includes additional information such as AP and lateral foot measurements, as well as diagrams for measuring limb alignment. Overall, the app is certainly a requirement for any medical student, resident, fellow, or attending working with pediatric orthopaedic patients.

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AAOS Code X-Lite

Overall: 3+
Functionality: 3+
Coolness: 3

Developed by the American Academy of Orthopaedic Surgery, this app is a light version of the Code X software already available to members who pay for a subscription.  Anyone with a Code X subscription can request a login name/password for its use.  Strengths of the app include the ability to search by body site or keyword, as well as the ability to save favorites and email a list of codes.  However, the app could benefit from a better search function, integration between ICD-9 and CPT codes, and an improved user interface.

Cost: Free for the app, but requires subscription to AAOS Code X ($535-699)
Download Here

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BoneFeed

Similar to its close relatives, HandFeed and SportsMed, this app is an RSS reader for orthopaedic-related publications.  The user can customize the feeds that are presented, including JBJS-Am, JBJS-Br, CORR, JHS-Am, Spine, JPO, and many more.  The feeds allow the user to review an abstract, view the full text article directly from the journal website (if you have online access), post comments, or share the paper via Twitter, Facebook, or email.  Overall, this app is a simple and intuitive way for orthopaedic surgeons to keep up-to-date with the latest publications 24-hours a day.

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AO Muller Classification

Overall: 3
Functionality: 3-
Coolness: 3

Created by the AO Foundation, this classification app allows a user to determine the Muller classification of long-bone fractures by selecting the bone, the segment, and the fracture morphology. In addition, radiographs are included to demonstrate true images of fracture patterns as a supplement to the figures provided. Once a particular fracture is selected, the user can save cases as “favorites” with a memo, a tool that could be valuable for a resident needing to keep track of fracture types while seen on call. The app also includes a “glossary” section that offers supplemental notes such as classification terminology and instructions for identifying fractures. Lastly, all data lives on the device thereby allowing for rapid access and use even without a data access signal.

Cost: Free
Download Here

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AO Surgery Reference

Overall: 4+
Functionality: 4
Coolness: 3+

Created by AO and released in No­vember 2010, the AO Surgery Refer­ence app has set the bar for orthopae­dic reference apps. The data mirrors information which has been previ­ously existed at www.aosurgery.org but is formatted specifically for the smartphone. The app has an intuitive interface that walks the user through the diagnosis, decision process, prepa­ration, surgical approach, reduction, fixation, and aftercare of fractures. Additional information can be found by selecting the “info” icon next to an option, and reference articles are provided on every page. Some of the most valuable aspects, in addition to the text, are the abundance of images demonstrating fracture patterns, pa­tient positioning, and anatomy/surgi­cal approaches. Ideally, this app can serve as a quick reference while treat­ing a patient or prior to a surgery when no other references are available for review. The greatest limitation to this app is that all data is pulled from the internet in real-time, and thus a data connection (3G or WiFi) is required for the app to function. In addition, some fractures are still not available, but the app suggests that future updates will be included.

Cost: Free
Download Here

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