Stanford Microsurgery and Resident Training

Essentially microsurgery information, tips, and techniques from Stanford University.

The SMaRT app is a free resource for anyone who performs microsurgery, or for microsurgeons in training.  The app is organized into a simple menu that includes Preparation, Practice Models, Suturing, Intra-Operative Technique, and Study Question headings.  Despite its simplistic appearance, the information is detailed, complex, and valuable.  For example, the Preparation heading includes information about instrumentation, how to set up and adjust the microscope (with associated diagrams), and explanation of sutures.   Many photos and videos are included as well, demonstrating important topics such as adjusting proper posture.  Overall, the app is very easy to navigate, a valuable resource, free, and comes from a reliable source.  I highly recommend this app as a quick reference before any microsurgical case.

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MedTools

A unified repository of surgical implants, technique guides, comparisons, and unpackaging videos.

With so many orthopedic implant companies and device options, I am amazed it has taken so long for someone to create a central educational repository.  MedTools is attempting to do just that in the form of both a website and app.  The app itself is well organized with a side-bar menu organized by body part, and sub-menus organized by implant type.  For a generic implant type (ex: Volar Distal Radius Plates, or Total Knee Arthroplasty), the user can quickly see a collection of all available companies and device offerings.  In some cases (total joint arthroplasty) this can include well over 20 different implants from more than 10 companies.  Users can then select a specific implant to obtain product information such as technique guides, reference charts, and photographs of the surgical tray to help familiarize one’s self with the instrumentation.  The app and website have also started video taping “unboxing” of specific devices to ensure that surgeons and their operative staff are prepared and familiar with devices they plan to use.

Overall, this app seems to have been a long-time coming and reflects a significant investment in work and time.  I anticipate the breadth of implants will grow significantly in the near future, which should greatly increase its value and overall utility to surgeons.

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OrthoFlow

General orthopaedic trauma app for fracture identification, classification, and management

OrthoFlow is the first app created by MediFlow and is designed to be “your orthopaedic specialist in your pocket.”  The app has a familiar user interface which includes a skeleton for selecting a region of injury, followed by a series of lists to select the specific bone and fracture of interest.  Most fractures include a few basic questions such as the location, whether it is intra-articular, and displacement after which the app suggests operative fixation or non-operative treatment.  One of the most useful features is the “What to know for trauma meeting” which includes a high-yield and well-organized description of the anatomy, associated injuries, imaging findings, classification systems, management, surgical approaches, complications, and eponyms for the particular fracture.  The purpose is to help prepare a junior resident or medical student at morning conference.   The information provided on each topic appears to be accurate, if not somewhat generalized, for each fracture.  Classification systems are often accompanied by sketch images which I found very appealing.  Some aspects of the user interface require improvement, such as a “home” button while buried deep within in the “trauma meeting” menus.  Overall, I think the app is a very good start towards a useful trauma handbook for students and junior residents.  Since this is the first version, I anticipate that the app will only improve in functionality over time.

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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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OrthoBullets: Bullets*

OrthoBullets’ stand-alone and companion app with study material, images, questions, and quizzes

OrthoBullets has scored a home run with their new Bullets* app available from the iTunes store.  This app is can be used as a companion app to the existing OrthoBullets website, but also functions extraordinarily well as a stand-alone resource.  The app consists of 5 sections: Topics, QBank, Cases, Evidence and PASS.  The topics section includes all information on the OrthoBullets site, separated in the same familiar lists and easily searched by keyword.  I found the search and browsing to be very fast and intuitive.  Importantly, each topic includes the same figures, diagrams, and questions associated with the web version to help learn concepts through the VEPTR technique.

The QBank also integrates with your existing online login and automatically transfers over your existing TestMaster scores and personal tests.  It also allows you to create new tests which can be defined by test style, topics, number of questions, etc.  The format will be very familiar to existing OrthoBullets users.

The cases will be familiar to any OrthoBullets user, and includes a presentation, images, and the valuable comments and discussion that ensures.  One of the newest features includes the ability to select “Evidence” to support an answer to a question, greatly enhancing the validity and value of this service.  The evidence can also be searched independently, and by specialty.  All of this is seamlessly integrated into the mobile format.

Lastly, the PASS section is available to residents who already use the PASS system in their residency program.  While I could not test this section entirely, it appears to function similar to the website equivalent.

Overall, the Bullets* app is a full-featured educational tool for any orthopaedic student, resident, fellow, or attending.  With quick and easy access to the entire OrthoBullets database combined with cases, quiz access and a versatile interface – I highly recommend this free app to everyone.

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RealWorld Procedures

Video and text tutorials for common procedures

RealWorld has created another app (in addition to RealWorld Orthopaedics) with tutorials for common procedures.  Those relevant to orthopaedic surgeons include digital blocks, local anesthesia, shoulder reduction, suturing, and upper limb slings. Each tutorial has a short video (1-3 min) with a text description of the background, precautions, equipment, positioning, procedure, and complications.  Overall, the limited orthopaedic procedures are relatively well represented and can assist a junior resident or medical student prepare for a first-time procedure.

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Learning Orthopedics Quiz

A “flashcard” style app for learning orthopedic surgery

This app is designed like a flashcard stack for orthopedic questions and facts. Unfortunately, the app does not tell you how many questions are included, nor can you create quizzes from specific sets such as a particular subject or only “new questions” or “incorrect questions.”  The user selects a quiz length from the options of 25, 50, or 100 questions.  The user then answers the questions and is provided the correct answer if they answered incorrectly while a score is kept and tallied. There exists an option “send” from the quiz.  While I initially suspect this would send a score or questions/answers for review, the button merely takes a screenshot of the current screen.  Overall, not a particularly useful app based on it’s very limited functionality and unknown flashcard stack size.

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Fractures

Basic app to assist with fracture classification and management

Fractures is published by Inter-Med, a company dedicated to creating educational medical products.  The app does not provide information about whether this was created by orthopaedic surgeons.  The purpose of the app is to provide basic fracture classification and treatment recommendations for a variety of common injuries of the skeleton.  The overall organization is simple, with the option to choose fractures based on a skeleton, list, or search feature.  We like that many fractures are included and that basic information about common classification systems and general treatment principles are provided.  We also really appreciate the abundant references and pubmed links to support the recommendations and information given.  However, fracture classification apps are typically improved with images and diagrams which we could not find in this app.  Adding images would improve the functionality and educational utility dramatically.

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My Academy

AAOS Academy Meeting 2015 

My Academy is the AAOS 2015 official academy meeting app. My Academy is meant to help academy members and vendors navigate the Academy meeting. This app is a dramatic upgrade from prior academy meeting apps. I can honestly say the AAOS did it right this time. The app has features that allow you to easily search lectures and vendors, find out when and where they are and point you in the right direction with a map. The interface is friendly and easy to use. The messaging features and auto-reminders help you manage your time. The app is free with registration and will be a must have at the next Academy meeting.

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JBS Algorithms Ortho

Educational app 

Joint and Bone algorithm is an orthopedic specific app with step by step guidelines for diagnosis and treatment for a large number of orthopaedic specific issue. It was created by the Joint and Bone Science Master Center in Tehran, Iran. This app is a terrific resource to help students, residents and supporting staff through easy to read algorithms regarding basic orthopaedic problems. The strength of this app is the content and development of almost 100 musculoskeletal algorithms. I applaud the developers for the breadth of their content. While I feel the content could be presented in a more interactive manner, the content and thought that went into the algorithms is impressive. Obviously there are some serious concerns regarding the accuracy and copyright of the algorithms, outside of this major issue the algorithms are well done.

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Orthopedics Patient Education by CoherentRX

Orthopedics Patient Education by CoherentRX   

Anatomy and Educational tool 

CoherentRX  has created an app to help orthopaedic surgeons and their workforce improve patient education and comprehension. CoherentRX Orthopedics has multiple features: 3-D anatomy visuals, drawing tools to mark visuals, photo and screenshot uploads as well as text and email info that is HIPAA compliant. While all of these features are powerful tools the app lacks ease to use. CoherentRX Orthopedics is very well priced $2.99/year (one of the cheaper patient educational options) however it is not the best patient educational tool on the market. While it has multiple features that are useful, the lack of disease specifics educational modules makes it difficult to actually use in practice. I applaud CoherentRX on making an Orthopedic app that has the potential to improve patient comprehension and education, however the app is still behind other players in the market.

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https://itunes.apple.com/us/app/medibabble/id355398880?mt=8

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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AAOS Access

Complete video content from the AAOS

The American Association of Orthopaedic Surgeons (AAOS) has now created a mobile app portal for access to an entire library of AAOS video content.  The AAOS Access app includes the ability to view, download, and save videos from the Orthopaedic Video Theater, previously only found on the AAOS website.  The user interface is easy to navigate, with a navigation tab on the left providing shortcuts to featured videos, special collections, or specific topics.  Videos can be downloaded for viewing, or streamed directly on the device.  Video and audio content is very good, and can be watched in full screen mode.   The current collection (March 2015) includes 414 videos, an impressive collection, and certainly more will be added in the future.  Additional features include a search function as well as a bookmark tool for easily accessing favorites.

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ICUC

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

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 (www.ICUC.net).  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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OrthoEvidence

Mobile access to OrthoEvidence, including a reading list and full ACE reports

OrthoEvidence is a new app that complements existing subscriptions to the OrthoEvidence product.  For more information, please see www.MyOrthoEvidence.com.  The premise of the platform is to provide “ACE” reports (Advanced Clinical Evidence Report) and improve evidence-based practice.  The app is an extension of the website and is very well designed and easy to use.

After logging in, the app has a home screen where recently added articles are populated in chronological order.  However, the menu allows for easy sorting by specialty as well.  When an article looks interesting to the reader, a quick “left swipe” allows for the option to add to reading list or add to favorites.  In this way, the user can easily scan new articles and select which ones should be saved for future review.  When ready to read, the reading and favorite lists are easy to access and list the selected articles. Impressively, the iPhone and iPad version sync with each other and selected readings on one device become available on the other (ie: select articles while “on the go” with your iPhone, but read them at a later time on your iPad). With one tap the ACE reports becomes immediately available.  For those who use OE, the ACE report has the same familiar appearance and includes links to the full text article (if available), a PubMed link, graphical representations of the Risk of Bias and Reporting score, and the synopsis and summary.  Added features include the ability to comment, rate the paper, and share via Facebook, Twitter, or Email.  The app also includes a robust search feature which includes a simple search (keyword) and advanced options (filter by date, score, bias, verification, or selected journals).  It is clear that the developers have taken every effort to create and intuitive, easy, and efficient app to complement their existing website.

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Xrays in MPS

Information about xray findings in patients with mucopolysaccharidosis

This app is developed by BioMarin and includes basic information about skeletal dysplasia in mucopolysaccharidosis (MPS).   The information tabs include general disease information, basic science, and images of hips, spine, shoulders, hand, and other bone deformities in the disease.

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JBJS Journals

Tablet access to all four JBJS titles.

One of the leading orthopaedic journals, JBJS, has released a fully-functional app for searching and reading content from their four journals: The Journal of Bone & Joint Surgery, JBJS Reviews, JBJS Case Connector, and JBJS Essential Surgical Techniques. The app includes the functionality that would be expected of any comparable journal app: the ability to select articles, view full-text or PDF versions, search for articles or search within articles for terms, select favorites, and share articles with colleagues.  A nice feature includes the option to “Open in…” another program, allowing for easy download and transfer of PDFs into a personal archiving system or into an annotation app for future review.  The app is simple and easy to navigate without many bells and whistles.  The version I reviewed only has the current journal editions available, but hopefully archive data will be available in future.

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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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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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PhysioMD

Physical Therapy app created by orthopaedic surgeons for specific injuries.

This app is designed to be “Rehab where you want it, when you want it.”  The app organizes therapy into different phases for different injuries, and specific therapy packages can be purchased individually for each injury.  To get started, the user selects their gender, injured area, and mechanism of injury – which presumably influences the injuries that are presented on the following page. Once an injury is selected, the exercise package can be purchased and installed for about $7.99. For shoulder instability, for example, there are 4 phases: Acute, Mobility/Strengthening, Strengthening/Limited, and Return to Sport. The app developers require the user to confirm that he/she has completed the previous objectives before advancing.  Once into each module, an extensive list of exercises are shown with images, description, and links to high-quality videos demonstrating the exercise.

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FracturED

App for learning skills needed to treat fractures in the emergency department.

Created by an emergency medicine resident, this app is organized into modules for educating residents about how to care for fractures in the emergency department. The app begins with basic information, including annotated images for demonstrating surface anatomy, bones, and nerve distributions.  The app is then organized into cases which include a brief story of the patient, appropriate xray imaging with various views, and a discussion of the pathology and treatment options.  The discussion also has an extensive list of references for additional reading.

As of this review, the app includes 20 cases for the “Hand and Wrist” including a demonstration of how to apply various splints.  However, the general “upper extremity,” “lower extremity” and “foot” sections are all marked as “coming soon.”

This app is a useful learning tool for ED residents, but is currently only limited to the upper extremity.

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Corin Resource Hub

Information about Corin orthopaedic implants for surgeons

This device company app is a resource and educational tool for surgeons who want to use or learn more about Corin products. The app is divided into solutions for the hip, knee, and “technology.”  As expected, the app includes general information about the products and marketing information.

*Requires subscription for full text access

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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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AAOS Musculoskeletal Exam – Spine

Simple app made by the AAOS to learn the spine exam

I commend the AAOS’ effort to create mobile educational material for students and trainees, which includes this simple app for learning the spine exam.  This app has a very simple structural layout in list form that presents the spine exam: standing/seated/supine/prone examination, Waddel signs, cervical spine muscle testing and cervical spine range of motion testing.  Each part of the exam includes a description, instructions and video.  In addition, references are provided for further reading. However, despite the useful information presented here, the app is bare and lacks much depth.  The user interface is unfortunately too simple and somewhat uninviting.  Overall, the content includes 46 total exam maneuvers.  At a cost of $9, this is quite a high price considering other apps that include more information and detail at a better value.  I hope that this app will be expanded upon and improved in future versions.

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Muller AO Classification of fractures-Long Bones

AO/OTA Classification app    

AO trauma has developed an app that reviews the Muller classification of long bone fractures. This app is a thorough review of the Muller classification that is traditionally used by the AO and OTA. The app has a nice feature that allows takes the user through a step-by-step guide with photos to help you identify and classify the fracture pattern you may be dealing with. Once you have identified the fracture classification you then get to see the x-ray of the particular fracture pattern. While this tool may be used to help residents/ancillary staff and Emergency Room physicians to communicate with orthopaedic surgeons this tool is not practical to the everyday orthopaedic surgeon. Overall, an easy to use app that is not that useful for everyday practice.

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Orthokeys

Orthokeys is an innovative orthopaedic app with a variety of tools ranging from  a thorough library of fracture classifications, a templating program based on known  classification patterns and a note section that allows you to share cases with others. The most impressive feature of the app is a clever photo tool that allows you to template fracture patterns using the injury classification library and layer it on top of the xray all on your iPhone or iPad. I applaud the developer for including both pediatric and adult fracture patterns making this one of the few apps to include pediatric fracture classification. However once you have templated the fracture pattern you are not able to template implants to help assess which size hardware you may need. Additional tools include an online Orthopaedic browser that does not have strong search capability and a surgical implant directory that lacks much needed information. Overall, this app has many useful features which could be more thorough and integrated better with the rest of the app.

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MediBabble

Medical Translator App

MediBabble is a powerful translation tool to help providers communicate with non-English speaking patients. There are many apps that provide translation tools to providers, but I have to say MediBabble is the best one on the market (and its free!). MediBabble differentiates itself with a robust database of pertinent medical phrases (including orthopaedic ones) organized in a standardized history-taking format. It does not require the user to be connected to the internet and it actually has medical phrases that are spoken to the patient from your phone. This app is probably best for intermediate language speakers who do not have the medical vocabulary to perform a complete history. Having tried the app myself I found it extremely useful as many of the phrases allow me to ask the patient close ended questions that I didn’t know ask with my mediocre spanish. Currently the app is available in Chinese, French, German Haitian Creole and Russian. Overall, a fantastic app that will help mediocre language speakers with history taking. I just wish the app would translate all that the patient was saying for me……..  but I guess that is called using translator services.

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Orthopaedics 365

Clinical daily pearls regarding the most recent and evidence-based tips for orthopaedic surgeons.

This app is a creative way to stay fresh with some of the most pertinent and evidence-based topics in orthopaedic surgery. Created by a current orthopaedic chief resident, the app has a very simple interface.  It presents itself as a calendar with “365 clinical pearls” that are delivered to the user daily via a push-notification at a designated time.  Each pearl can be shared with colleagues via text, email, or twitter and includes a reference to a relevant journal article. In addition to daily push notifications, the user can also browse through the calendar to read additional pearls.  Thus, this serves as a primitive collection of study facts or flashcards. Unfortunately, the functionality is limited since they are not sorted by topic. Overall, the app does a good job of its stated purpose, which is to deliver a new orthopaedic fact every day.

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FRAX

A digital and mobile tool for calculating the FRAX score.

This app is a very useful and free tool for calculating the WHO Fracture Risk Assessment Tool (FRAX).   Created by the International Osteoporosis Foundation and Doctot, the app is intuitive and simple to use.   The app includes a detailed section about FRAX and its purpose: to calculate a patient’s 10-year probably of fracture based on BMD – and references have been provided.  To use the actual assessment tool, select “start the test.”  The app then walks you through a series of 14 questions on the FRAX, such as age, gender, ethnicity, weight, height, history of fractures, co-morbidities (smoking, steroids, RA, osteoporosis, alcohol), type of fracture, and T-score.  The final result is a FRAX score that estimates the risk of fracture based on the validated tool.  Users can then save the score with a patient’s name. Overall, this very simple app is both validated and effective and should be highly considered for anyone who already uses FRAX in their office.

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JBJS Reviews

The Journal of Bone & Joint Surgery has added a new publication to their portfolio. JBJS Reviews is a dedicated online journal meant to publish clinical information in a mobile/web based format. As a result JBJS has created a new app meant to serve as the platform through which JBJS Reviews will be presented to mobile readers. JBJS’s  app has an easy to use interface that allows readers to search, create favorites and follow recent articles they have looked up. In addition, while I commonly give Journals a difficult time for using an inferior pdf viewer to read articles. JBJS Reviews allows the reader to download the pdf and read the article in any pdf viewer of their choosing. The interface to read the articles is a little buggy as buttons overlap one another. Hopefully with the next version of this app they will improve the article viewing options. Overall, a well made app that will definitely be used by the readership of the JBJS.

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https://itunes.apple.com/us/app/jbjs-reviews/id787553942?mt=8

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

My Knee Guide

Patient resource for those considering knee replacement

My Knee Guide is a complete resource for patients considering knee replacement surgery. I am extremely impressed with how this app personalizes the experience of knee replacement surgery to the patient. The app has creative stories of real-world patients and their experiences of undergoing total knee arthroplasty. The in-app features include: calendar with reminders of surgery specific details and checklists, email alerts to remind patients what to do and when, location based resources of local hospitals and surgeons with SCIP protocol compliance rates and many more resources. Personally my favorite part of the app is “my surgery guide” which informs patients day by day exactly what to expect before and after their surgery. This app will assist the orthopaedic surgeon to set patient expectations and help patients stay informed throughout their treatment process. My only criticize with all the resources in the app is that patients may become overwhelmed. This is an app I plan to use with my patients to help them learn more about total knee replacement.

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AJSM (American Journal of Sports Medicine)

Mobile Access to the American Journal of Sports Medicine

The American Orthopaedic Society for Sports Medicine (AOSSM) has done an excellent job producing another of its reputable journals onto a mobile platform. The American Journal of Sports Medicine app has allowed journal subscribers with easy- to-use access of the magazine in app form. The app has many advanced features such as searching for relevant topics within all issues of the publication, allowing users to save favorite articles and sharing journal articles easily through email. These up-to-date app features makes this app an excellent tool on the iPhone and iPad. In addition, the AJSM has started to build video and audio content which can become an important educational tool for viewers in the future. My only criticism that I made with other apps from the AOSSM is the reader software used to view the journal articles is slightly clunk and doesn’t allow you to make notes or easily manipulate the journal articles. However, once the developers build more video and audio content into the app it will quickly become a must have for anyone in the field.

Overall a very useful Journal application with advanced app features.

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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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AO Spine Principles

A visually impressive description of AO Spine treatment principles.

This simple and lightweight app includes basic information about the AO Spine principles.  The app is divided into 3 main sections: the home screen, principles, and details. There are 6 different classifications: trauma, tumor, deformity, degeneration, infection, and metabolic/inflammatory/genetic.  Selecting each section then includes a rotating wheel describing each of the 4 principles: stability, alignment, biology, and function.  The information provided is general and broad, and does not serve as a useful resource.  However, as a single download and review, this is somewhat interesting.

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Orthopaedic Journal of Sports Medicine

Mobile Access to Orthopaedic Journal of Sports Medicine

The American Orthopaedic Society for Sports Medicine has done an excellent job in advancing it’s journals into mobile platforms. With the Orthopaedic Journal of Sports Medicine they have provided unrestricted open access to full text in an easy-to-use format. The articles are available for download and can be viewed through the mobile app.  This app does an excellent job giving the reader up-to-date app features: search function to find journal articles, share articles to peers via email, and easily save articles to a favorite’s folder. My only criticism reading the journal articles is slightly clunk and doesn’t allow you to make notes or easily manipulate the journal articles.

Overall a very useful Journal application with advanced app features.

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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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ACUMED Version 2.0

An app that provides information for Acumed’s different fixation systems

This app is a neat resource to learn about Acumed’s different fixation solution for different body parts. The app has a beautifully done feature that allows you to visualize devices in 3D space. While the app is probably more useful for the ACUMED reps than a typical orthopaedic surgeon it is still an interesting app with lots of device information. *WARNING* to download all the features on the app is approx. 400MB of memory. So while this awesome app has some really neat 3D tools to see devices for different types of fixation. Beware it can be memory drain.

Overall a visually impressive app not for everyday use

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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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AAOS Musculoskeletal Exam – Shoulder

Simple app to learn shoulder exam and special tests

I commend the AAOS’ effort to create mobile educational material for students and trainees, the first of which is this simple app for learning the shoulder exam and special tests.  This app has a very simple structural layout in list form that presents the shoulder exam: inspection, muscles, range of motion, and special tests.  Each part of the exam includes a description, instructions and video.  The special tests include information about specificity and sensitivity and include a short reference list.  However, despite the useful information presented here, the app is bare and lacks much depth.  The user interface is unfortunately too simple, and the overall content includes only 30 total exam maneuvers.  At a cost of $9, this is quite a high price considering other apps that include more information and detail at a better value.  I hope that this app will be expanded upon and improved in future versions.

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Nerve Whiz

Extraordinary app with detailed and complete information about the brachial and lumbar plexes, including innervation, sensory distribution, and sites of compression.

Developed by Zach London, MD from University of Michigan, Nerve Whiz is one of the most useful and intuitive nerve reference resources I have come across.  The app includes complete information about the course, branches, innervation, sensory distribution, and sites of compression of the brachial plexus (C5-T1) and lumbar plexus (L2-S2).  The app has multiple sections with hidden gems.  “Chart” includes a complete listing of all data, organized by either upper or lower extremity and sorted by muscle, nerve, roots, action, trunk, or cord.  The next feature is an incredible “muscle localizer” and uses an intuitive algorithm to provide the site of injury after the user selects muscles that are injured.  For example, selecting a weak “deltoid” returns localization to either C5, C6, upper trunk, posterior cord, or axillary nerve.  The diagram section utilizes a brachial plexus diagram and highlights the selected area of interest – the diagram is both intuitive and complete.  The final section, “sensory,” allows the user to point to an area of sensory loss and returns a list of potential roots and nerves that may be injured, with associated dermatome diagrams.  Overall, this extraordinary reference app should be in the pocket of every medical student and orthopaedic, neurologic, or neurosurgical trainee.

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iSplint

A light-weight splinting reference designed for emergency department physicians.

iSplint has features not present in other splinting apps, including fully native videos demonstrating splint application.  The app was created by an emergency medicine physician at George Washington University, giving it credibility.  Unfortunately, the selection of splints is limited to thumb spica, triple S, radial gutter, dorsal hand, sugar tong (upper extremity), posterior ankle, and sugar tong (lower extremity).  Aside from non-traditional orthopaedic terminology for some of these splints, the application of splints are all demonstrated using fiberglass with minimal padding.  This is somewhat of a deviation from traditional orthopaedic splint application.  In addition to the video demonstration, there is a “discussion” for each splint which links to a table that offers an image of the applied splint, application tips, and provides very brief indications.  Overall, this app is focused more towards emergency department staff, as advertised.  However, orthopaedic providers should be aware of this application and consider recommending it to colleague for simple splint applications.

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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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Orthopaedic Patient Information

Very high-quality 3D anatomical models with video demonstrations of common anatomy, pathology, and treatments.

Orthopaedic Patient Information is part of the 3D4Medical’s suite of full-featured anatomy apps.  All of their apps follow a similar and intuitive format, but this one differs slightly. The relevant body part is presented with a video demonstrating the most common anatomy, conditions, and treatments.  These demonstrations are very high quality.   The level of detail and anatomical accuracy of all muscles, tendons, vessels, nerves, ligaments and bones is impressive.  Overall, the entire suite of 3D4Medical anatomy apps are the best anatomy models we have seen yet, and this patient information app is fantastic.

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Skeleton System Pro III

Full-featured 3D anatomy models with support for 3D rotation, various anatomy layers, cross-sectional slices, annotations, and video demonstrations.

Skeleton System Pro III is part of the 3D4Medical’s suite of full-featured anatomy apps.  All of their apps follow a similar and intuitive format. In the skeletal system, any region of the body is selected for a more focused view. The relevant body part is presented with skin covering, and different anatomical layers can then be “unwrapped” sequentially through the body.  The level of detail and anatomical accuracy of all muscles, tendons, vessels, nerves, ligaments and bones is impressive.  In addition to the different layers, the view can be manipulated freely.  All body parts can be rotated in the horizontal plan through 360 degrees rotation.  In addition, axial, coronal, and sagittal slices can be taken through various levels of each joint or body part.  The app includes “pins” which already identify every possible structure of every layer.  In addition, most of the apps in the series include videos demonstrating relevant surgical procedures or common pathologies.  These demonstrations are very high quality.  The app includes a “pen” feature for drawing on the screen, however doodles are not saved and disappear once the pen is turned off.  There is even a separate button to turn vessels on and off.  Overall, the entire suite of 3D4Medical anatomy apps are the best anatomy models we have seen yet, based on their accuracy, level of control, and video demonstrations.  Ideal for health care students and possibly even for surgical preparation.

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Spine Pro III

Full-featured 3D anatomy models with support for 3D rotation, various anatomy layers, cross-sectional slices, annotations, and video demonstrations.

Spine Pro III is part of the 3D4Medical’s suite of full-featured anatomy apps.  All of their apps follow a similar and intuitive format. The relevant body part is presented with skin covering, and different anatomical layers can then be “unwrapped” sequentially through the body.  The level of detail and anatomical accuracy of all muscles, tendons, vessels, nerves, ligaments and bones is impressive.  In addition to the different layers, the view can be manipulated freely.  All body parts can be rotated in the horizontal plan through 360 degrees rotation.  In addition, axial, coronal, and sagittal slices can be taken through various levels of each joint or body part.  The app includes “pins” which already identify every possible structure of every layer.  In addition, most of the apps in the series include videos demonstrating relevant surgical procedures or common pathologies.  These demonstrations are very high quality.  The app includes a “pen” feature for drawing on the screen, however doodles are not saved and disappear once the pen is turned off.  There is even a separate button to turn vessels on and off.  Overall, the entire suite of 3D4Medical anatomy apps are the best anatomy models we have seen yet, based on their accuracy, level of control, and video demonstrations.  Ideal for health care students and possibly even for surgical preparation.

Knee Pro III

Full-featured 3D anatomy models with support for 3D rotation, various anatomy layers, cross-sectional slices, annotations, and video demonstrations.

Knee Pro III is part of the 3D4Medical’s suite of full-featured anatomy apps.  All of their apps follow a similar and intuitive format.  The relevant body part is presented with skin covering, and different anatomical layers can then be “unwrapped” sequentially through the body.  The level of detail and anatomical accuracy of all muscles, tendons, vessels, nerves, ligaments and bones is impressive.  In addition to the different layers, the view can be manipulated freely.  All body parts can be rotated in the horizontal plan through 360 degrees rotation.  In addition, axial, coronal, and sagittal slices can be taken through various levels of each joint or body part.  The app includes “pins” which already identify every possible structure of every layer.  In addition, most of the apps in the series include videos demonstrating relevant surgical procedures or common pathologies.  These demonstrations are very high quality.  The app includes a “pen” feature for drawing on the screen, however doodles are not saved and disappear once the pen is turned off.  There is even a separate button to turn vessels on and off.  Overall, the entire suite of 3D4Medical anatomy apps are the best anatomy models we have seen yet, based on their accuracy, level of control, and video demonstrations.  Ideal for health care students and possibly even for surgical preparation.

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Ankle & Foot Pro III

Full-featured 3D anatomy models with support for 3D rotation, various anatomy layers, cross-sectional slices, annotations, and video demonstrations.

Ankle & Foot Pro III is part of the 3D4Medical’s suite of full-featured anatomy apps.  All of their apps follow a similar and intuitive format.  The relevant body part is presented with skin covering, and different anatomical layers can then be “unwrapped” sequentially through the body.  The level of detail and anatomical accuracy of all muscles, tendons, vessels, nerves, ligaments and bones is impressive.  In addition to the different layers, the view can be manipulated freely.  All body parts can be rotated in the horizontal plan through 360 degrees rotation.  In addition, axial, coronal, and sagittal slices can be taken through various levels of each joint or body part.  The app includes “pins” which already identify every possible structure of every layer.  In addition, most of the apps in the series include videos demonstrating relevant surgical procedures or common pathologies.  These demonstrations are very high quality.  The app includes a “pen” feature for drawing on the screen, however doodles are not saved and disappear once the pen is turned off.  There is even a separate button to turn vessels on and off.  Overall, the entire suite of 3D4Medical anatomy apps are the best anatomy models we have seen yet, based on their accuracy, level of control, and video demonstrations.  Ideal for health care students and possibly even for surgical preparation.

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Shoulder Pro III

Full-featured 3D anatomy models with support for 3D rotation, various anatomy layers, cross-sectional slices, annotations, and video demonstrations.

Shoulder Pro III is part of the 3D4Medical’s suite of full-featured anatomy apps.  All of their apps follow a similar and intuitive format.  The relevant body part is presented with skin covering, and different anatomical layers can then be “unwrapped” sequentially through the body.  The level of detail and anatomical accuracy of all muscles, tendons, vessels, nerves, ligaments and bones is impressive.  In addition to the different layers, the view can be manipulated freely.  All body parts can be rotated in the horizontal plan through 360 degrees rotation.  In addition, axial, coronal, and sagittal slices can be taken through various levels of each joint or body part.  The app includes “pins” which already identify every possible structure of every layer.  In addition, most of the apps in the series include videos demonstrating relevant surgical procedures or common pathologies.  These demonstrations are very high quality.  The app includes a “pen” feature for drawing on the screen, however doodles are not saved and disappear once the pen is turned off.  There is even a separate button to turn vessels on and off.  Overall, the entire suite of 3D4Medical anatomy apps are the best anatomy models we have seen yet, based on their accuracy, level of control, and video demonstrations.  Ideal for health care students and possibly even for surgical preparation.

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AAOS eBooks

Full-featured app for downloading and reading books in your AAOS bookshelf library. Text and images are all very clean and apps runs smoothly.

AAOS eBooks, that provides mobile access to titles purchased from their web-based store. As of writing, the store includes 8 popular titles, but is expected to increase to over 30 titles within the next few months.  Unfortunately purchases cannot be made directly through the app, but rather must be paid for on the website.  In addition, although the app asks users to log in via their AAOS username and password, this is an error and rather users must register at the AAOS eBookstore website (www.ebooks.aaos.org) to gain login information. After logging in, users can view the books they have purchased and can download them selectively, ranging in size from about 10-80 Mb.  Once downloaded, the text viewer has typical options, including the ability to change the font, change text size, adjust brightness, highlight text, make notes, and place bookmarks.  The annotation functions are primitive, at best, and even the instructions for highlighting require 4 separate steps each time.  The books themselves are of high quality, text is crisp, and images are clear, however the user cannot increase the image size, which often prevents fully appreciating many of the detailed illustrations.  Because books are downloaded to the device, they are accessible even without internet access, which is a valuable feature.  The app is still primitive in its feature set and title selection.  In addition, some books, such as OKU 10, already ship with a CD that includes a digital PDF version of the book, which is much easier to read and annotate using any of the popular PDF readers for mobile devices.

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JBJS ImageQuiz

Full-featured app including JBJS Image Quiz case reports, questions, images, and discussion about the case, the pathology, and appropriate treatment.

This app provides access to JBJS’s bi-monthly “Image Quizzes” that appear in the printed journal.  The app is well-designed and easy to navigate. All cases are presented in thumbnail format and, as of writing, the current version includes 54 cases.  Each case includes 3 sections: Question, Answer, and Discussion.  The question section includes a detailed case history as well as a number of relevant images which load quickly and clearly on the iPad.  The “quiz” appears to the left of the screen with a single question and multiple-choice options.  Interestingly, the user has the option of choosing “how others chose” to see the answers selected by other quiz takers.  This can be done either before or after making your own selection.  Once an answer is submitted, the user automatically advances to the “answer” section if correct, and is presented with a brief explanation.  Selecting “learn more in the discussion,” provides a more thorough explanation of the disease process and relevant clinical pearls.    Overall, the app is very clear and runs smoothly on the device.  At a price of $0.99, the app is somewhat of an enigma.  To those who already subscribe to JBJS, it seems odd that the journal would charge for access to these cases. While, for those who do not currently have a subscription, $0.99 for unlimited clinical cases and explanations is a phenomenal value.

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Bone and Joint

Full-featured app for reviewing and sharing JBJS (British), Bone & Joint Research, and Bone & Joint 360.

The British Editorial Society of Bone and Joint Surgery has also leapt into the mobile world with Bone and Joint, an iPad and iPhone app for viewing their collection of publications: The Journal of Bone & Joint Surgery (British), Bone & Joint Research, and Bone & Joint³⁶⁰. The app is available for free, however the full text version requires either a personal subscription or institutional access.  The reading pane includes a sidebar for browsing the current or previous issue organized by table of contents.  When an article is selected, the user can either view “abstract” or “full text.”  The full-text version appears in a condensed format, with tables and figures accessible via direct links.  In addition, all references can be directly tapped to link directly to the abstract.  The user can also choose to “download PDF” which opens the document with options for full screen viewing as well as sharing.  The share feature is surprisingly functional: the app generates an email that attaches the full-text PDF article.  Other features contained within the app include the ability to view only images and figures, select articles as favorites, full-text search capabilities, and history browsing.  All three journals named above are viewed in the same format, however users only have access to journals that are specifically included in their personal or institutional access.  Overall, very smooth integration of multiple journals and institutional access.  The ability to directly attach PDF articles to emails is a very useful feature.

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Biolox

CeramTec’s product information app about their line of ceramic hip arthroplasty products with useful animated videos.

For surgeons who already use CeramTec products, or who are interested in learning more about ceramic technology, this app includes a lot of useful information.  Four products are highlighted: the ball, insert, DUO, and OPTION.  Each section includes product information, as well as tips, handling recommendations, brochures, and news.   A number of high quality animations are included and fun to watch.   The app also includes news articles and brochures from the company, which might be useful to some surgeons, but difficult to read on an iPhone.

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OrthoRef Lite

A free version of a list-based reference of orthopaedic classification systems from the creator of NeuroMind, one of the top Neurosurgery apps.  This version only includes 60 scores for free.

From the creator of top-app NeuroMind, this app attempts to provide a comprehensive list of orthopaedic classification systems and decision support for orthopaedic surgeons and trainees.  The lite version only includes 60 scores for free, but the remaining 40 require the full version.  The app is organized into 3 sections: scores, decision support, and “other.”  Currently the app is in its infancy and is limited by the number of scores available, as well as a lack of images.  In total, this app currently contains over 100 scoring and classification systems.  The list is organized by body part, and for the most part, many of the most common systems are included.  Unfortunately, the app is limited by the fact that there are no images provided to assist with fracture descriptions, which are relatively succinct and difficult to understand if not already familiar with a particular injury scoring system.  The decision support tab provides assistive scoring tools for 9 different injuries, including SLIC, TLICS, and stroke risk in AF.  These are definitely helpful.  The “other” section includes links to a safe surgery checklist as well as the TEDx talk given by the app’s creator, Pieter Kubben.  Overall, this app is most appropriate for surgeons already familiar with a particular classification system and who need a reminder about the details.

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OrthoRef

A list-based reference of orthopaedic classification systems from the creator of NeuroMind, one of the top Neurosurgery apps.

From the creator of top-app NeuroMind, this app attempts to provide a comprehensive list of orthopaedic classification systems and decision support for orthopaedic surgeons and trainees.  The app is organized into 3 sections: scores, decision support, and “other.”  Currently the app is in its infancy and is limited by the number of scores available, as well as a lack of images.  In total, this app currently contains over 100 scoring and classification systems.  The list is organized by body part, and for the most part, many of the most common systems are included.  Unfortunately, the app is limited by the fact that there are no images provided to assist with fracture descriptions, which are relatively succinct and difficult to understand if not already familiar with a particular injury scoring system.  The decision support tab provides assistive scoring tools for 9 different injuries, including SLIC, TLICS, and stroke risk in AF.  These are definitely helpful.  The “other” section includes links to a safe surgery checklist as well as the TEDx talk given by the app’s creator, Pieter Kubben.  Overall, this app is most appropriate for surgeons already familiar with a particular classification system and who need a reminder about the details.

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EBSS.live

An orthopaedic spine trauma literature search tool for finding articles about spine surgery, full abstracts, and levels of evidence.

AO Foundation has created a unique and useful tool that is a great resource for residents, students,  and orthopaedic surgeons alike who perform spine surgery.  The app is organized by subtopic: Trauma, Tumor, Deformity, Degeneration, Infection, and Metabolic/Inflammatory/Genetic spine diseases.  In total, the app includes over 3800 peer-reviewed clinical articles applicable to spine surgery.  The user can also search by key word, and can presumably find relevant articles related to very specific topics.  The search algorithm appears to apply to the title, as well as the abstract.  In addition, the app easily identifies the level of evidence for each article, provides the full abstract, and links to the Pubmed abstract.  Overall, while smart phones are typically not the platform of choice to browse the literature, this app is certainly worth a look.

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Traumaline

An orthopaedic trauma literature search tool organized by body part and published by the AO foundation to organize peer-review articles and evaluate levels of evidence.

AO Foundation has created a unique and useful tool that is a great resource for residents, students,  and orthopaedic surgeons alike.  Organized by body part (with a familiar appearance to those who use the AO Surgery app), this app has classified over 5500 peer-reviewed articles applicable to the treatment of orthopaedic fractures.  The user can search by body part as well as key word, and can presumably find relevant articles related to specific trauma topics.  The search algorithm appears to apply to the title, as well as the abstract.  In addition, the app easily identifies the level of evidence for each article, provides the full abstract, and links to the Pubmed abstract.  Overall, while smart phones are typically not the platform of choice to browse the literature, this app is certainly worth a look.

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Ombro e Cotovelo

A Portuguese-language iPhone app for orthopaedic shoulder and elbow pathology.

Unfortunately, I do not speak Portuguese and cannot evaluate this app based on its merits.  However, from playing around with the menus, this app appears to offer a significant amount of general information about shoulder and elbow pathology… in Portuguese.

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OrtoClass

A Portuguese-language iPhone app for orthopaedic trauma classification systems.

Unfortunately, I do not speak Portuguese and cannot evaluate this app based on its merits.  However, from playing around with the menus, this app appears to closely mimic the English-language “OrthoClass” app that received very high reviews.  The only difference is that this one is in Portuguese.

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TumorOsseo

A Portuguese-language iPhone app for musculoskeletal tumors.

Unfortunately, I do not speak Portuguese and cannot evaluate this app based on its merits.  However, from playing around with the menus, this appears to be a very functional tool that includes a plethora of information about musculoskeletal tumors.  …and it’s in Portuguese.

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Mobile Coder Foot and Ankle

This is a useful coding app designed specifically for surgeons who perform foot and ankle surgery.  The app download is free and allows the user to view all sections, however the complete 12-section download require an in-app purchase of $49.99. The taskbar is organized into four sections.  The “patients” tab allows the user to add patient records and includes information such as facility, date/time, patient info, assistant, and comments.  That record can then be associated with the second section: CPT.  CPT codes are organized by body region and separated by the usual CPT categories.  A search function is available, and the user can identify favorite codes to save time during future entries.  The codes themselves include options to include modifiers and the interface is easy to navigate.  The third tab is a patient history section, and the fourth tab is a configuration tab where the user can enter facilities and surgical assistants.  The program includes help alerts for every screen that are initially informative, but must be turned off in the configuration tab because they quickly become bothersome.  Overall, the app is one of many coding apps available and will appeal to many surgeons, however there does not appear to be support for ICD-9 codes if that is an important feature to you.

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Orthopaedic Surgery Board Review Manual

This app is a journal reader for issues of the Orthopaedic Surgery Board Review Manual by Hospital Physician. At the time of review (March 2012), the app includes 6 issues: Patellofemoral Pain, Thermal Injuries in the Extremities, Osteonecrosis of the Femoral Head, etc.  Each “issue” reads like a regular journal with advertisements, a table of contents, and full journal contents.  However, because each issue is on a single topic, the contents include an introduction, anatomy, pathogenesis, presentation, diagnosis, treatment, etc.  The app is clear, quick, and easy to navigate.  The articles are easy to read and include a plethora of useful information.  Although it is not clear whether this will remain free in the future – it is currently available at no cost and supported by advertising.

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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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RealWorld Orthopaedics

Created by physicians and medical students at the Universite de Sherbrooke, this is one of the best musculoskeletal radiology apps available. The app is organized into subheadings: Medical, Technical, and Chapters.  Although not intuitively named, each section contains an abundance of information medical and radiology information.  For example, the Medical section includes a listing of about 150 radiographic fractures and dislocations, with each topic including 1-2 different patient cases.  Selecting a patient includes high-resolution images of the named pathology.  The most valuable and impressive part of the app, however, is the “eye” icon which overlays colorful highlighting directly over the radiograph with associated annotations (“glasses” icon) to explain the important radiographic findings.  This feature, alone, is impressive.  An information icon also links directly to reading material found in the Chapter section.  The Technical and Chapter sections include the same library of patients and images, but organized in a different way.  The most notable feature this app lacks is a “search” function that can quickly search for a fracture or dislocation of choice.  Overall, a very well-made and impressive app that would be useful to any medical student, intern, or junior resident that needs to learn about musculoskeletal radiology.

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CCJR Mobile

Based on the Current Concepts in Joint Review (CCJR) live meetings, this app serves as a mobile version of the conference with information about speakers, topics, and the ability to download full videos.  From the home screen, the user can select a talk from an extensive list of speakers and topics (about 125 lectures) from the 2011 Spring meeting.  Selecting a particular lecture includes an abstract summary of the talk, as well as the option to immediately download the full video (WiFi not required).  Most videos appear to be 6 min in length and download in 1-2 minutes using 3G.  The other modules in the app reorganized the data by Topic, as well as by Speaker.  The app also includes a search feature, which appears to only search the titles of individual lectures, but not the associated abstracts.  Overall, there are few negative remarks that one can make about this well-made, well-organized app that offers over 100 brief lectures on relevant topics by leaders in the field. Currently, this app is offered for free, and would be useful to any surgeons, residents, or fellows who perform total joint arthroplasty.  The App Store summary suggests that future updates will offer premium modules with expanded information at a price.

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iJoints

This app has taken images from the Visible Human Project ™ to recreate axial, coronal, and sagittal slice images of a cadaveric hip, knee, ankle, shoulder, elbow, and wrist.  The app was created by a board certified radiologist, and the functionality is strictly limited to anatomy identification (no added information about anatomical origins, insertion, or inervation).  Navigation is intuitive from the main menu, with joints separated by the types of slices.  Each section includes about 9-12 slices for each joint.  After selecting a slice, options include mirror image (left/right), adding/removing labels, labeling muscles, bones, vessels, or “other,” and advancing a slide. The images are very clear, and all relevant anatomy is labeled. In addition to reviewing by joint, a search function allows for the user to enter any structure and will return every slice that includes the named structure. Lastly, a quiz function also exists that is organized by joint/slice. The quiz shows an image with labelled anatomy and asks you to identify a particular structure (multiple choice). If incorrect, the user is shown the correct answer, as well as the name of the structure that was incorrectly selected. Overall, this app seems most appropriate for students learning anatomy, and especially with regard to radiology-oriented slices for 3D imaging (coronal, axial, and sagittal).  Thus, the app would be greatly beneficial for improving CT and MRI identification, but how this may transfer to surgical anatomy is not as clear.

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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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Dragon Medical Search

Nuance has expanded their collection of voice dictation apps with a free app designed specifically for searching medical sites with speech.  The format is similar to the Dragon Search app, however after speaking a search phrase, the app simultaneously presents search results from Google, Medscape, Medline, drugs.mobi, and IMO.  Most providers are familiar with these sites, and when searching a phrase such as “femur fracture” the search engines returned relevant sites, articles, and information.  When searching a drug name, information from drugs.mobi was very useful with regards to dosing, side effects, and interactions.  The IMO search tab was incredibly useful for searching ICD9 codes and returned a complete list of relevant diagnostic codes for any pathology named.  Once again, Nuance has created a free app that can be of great value.  The app is limited by the fact that an internet is always required, however the utility of searching ICD9 codes from your phone is well worth the price (free).

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Orthopedics Encyclopedia

This app attempts to serve as a limited orthopedic encyclopedia.  In that regard, it accomplishes its goal as a first-stop overview for a variety of broad orthopaedic conditions and diseases.  The app includes 21 topics, such as the human skeleton, clubfoot, orthotics, knee, tendon, rheumatoid arthritis, etc.  One immediately recognizes that the selection of included topics and joints seems quite arbitrary.  Selecting any individual topic, however, returns an incredibly detailed and complete description of any particular topic with a series of sub-headings and associated images.  For example, the topic “Muscle” includes subheadings such as embryology, muscle types, anatomy, physiology, nervous control, exercise, disease, atrophy, strength, efficiency, and evolution.  The data presented includes very specific information, such as the precise density of muscle or skeletal muscle metabolism at rest.  However, despite this impressive collection of data, the unusual organization of the topics and the document-like format of the information prevents easy reference of information.  Without a search function, this app offers little more  than the title suggests: a single-use orthopaedic encyclopedia, but cannot function as a versatile reference.  Overall, the app may be useful to a student interested in musculoskeletal medicine interested in reading a brief overview of a variety of orthopaedic topics.

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eSplint

This app is clearly a must-have guide for any primary care, urgent care, or emergency care provider by providing simple step-by-step instructions for splint application.  In addition, junior residents in musculoskeletal medicine fields, such as orthopaedic surgery or podiatry, may also find this to be a useful refresher for the application of splints.  The app is very simply organized into headings such as Splint Technique, Coaptation, Sugar Tong, etc. and provides a text and image guide for the application of each splint type.  The guide briefly lists a few indications for that particular splints, includes a text description with associated images, provides a very good brief video demonstrating application of the splint, and even includes patient education instructions for splint care!  Overall, this application is very useful to a variety of practitioners.  At such a great price, I cannot think of a reason why anyone who might need to apply a splint would not download this very simple and useful reference tool.

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Shoulder Classification

This app is likely to be overlooked and under-rated, but I believe it is a hidden gem.  Someone (no developer or contact information is provided) has compiled an incredibly comprehensive list of injury and disease classification systems about the shoulder with their associated primary literature reference.  The app is organized into list format, and the main list tree includes conditions such as AC joint, Acromion, SLAP, Calcific Tendonitis, etc.  Then, upon selecting a particular condition or injury, you see multiple different classification systems that have been published for that particular topic.  This list is very comprehensive and utilizes the most common classification systems, as well as those less frequently employed.  Each description includes a reference to the primary literature source, a brief description, and typically includes an associated image when appropriate.  Overall, the developers of this small, simple, and free app have done a phenomenal job of compiling classification systems for shoulder pathology.

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Campbell’s Operative Orthopaedics

Campbell’s is the first orthopaedic text book that has transitioned to the digital age!  The app is not the complete 4-volume text, rather this is “core techniques,” which includes brief summaries of 242 common surgical and bedside procedures accompanied by images and videos.   The app is divided into the four volumes of the full book with their corresponding subheadings.  For example, the app includes 26 surgical approaches, such as removal of iliac bone graft, anterolateral approach to the humerus, and z-plasty.  Most descriptions are brief with 2-5 images, and would serve as a “refresher” for a senior resident or surgeon familiar with a procedure, or as an introduction for a medical student or junior resident who needs a quick orientation before a case.  However, in addition to the many brief entries, some topics are reviewed completely with 20-30 images and videos up to 15-20 minutes in length.  These videos are incredibly detailed and review how to perform full surgical procedures.  Examples of “complete” entries with videos and images include femoral nailing, ACL reconstruction, SLAP repair, rotator cuff repair, chevron osteotomy, compartment syndrome fasciotomy, shoulder hemiarthroplasty, and carpal tunnel release – I counted a total of 23 videos within the app.  Unlike many other apps that offer videos, all media is completely contained within this app and downloaded to the device, which explains the download size of over 800mb, but also has the great benefit of full access 100% of the time (i.e. review surgical techniques on an airplane).  Lastly, the app has a very good search feature that scans all topic titles and text within the app.
Overall, Campbell’s Operative Orthopaedics is the first orthopaedic text to “go digital” with an incredibly useful reference app that is ideal for junior orthopaedic surgery residents.  Although considered an expensive app at $100, compare this to list price of nearly $800 for the 4-volume print version. Of course, the app is not the complete text, but is most useful to trainees who may frequently use the app as a “refresher” between operative cases.  The interface is well designed, the images and text are clear, and the search function is invaluable.  In addition, consider that the purchase price includes ownership for life with all associated updates.  Campbell’s is a very highly recommended app for those who can afford it.

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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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Mobile Coder Hand & Wrist

This is a useful coding app designed specifically for surgeons who perform hand surgery.  The app download is free and includes 2 sections, however the complete 14-sections download require an in-app purchase of $49.99. The taskbar is organized into four sections.  The “patients” tab allows the user to add patient records and includes information such as facility, date/time, patient info, assistant, and comments.  That record can then be associated with the second section: CPT.  CPT codes are organized by body region and separated by the usual CPT categories.  A search function is available, and the user can identify favorite codes to save time during future entries.  The codes themselves include options to include modifiers and the interface is easy to navigate.  The third tab is a patient history section, and the fourth tab is a configuration tab where the user can enter facilities and surgical assistants.  The program includes help alerts for every screen that are initially informative, but must be turned off in the configuration tab because they quickly become bothersome.  Overall, the app is one of many coding apps available and will appeal to many surgeons, however there does not appear to be support for ICD-9 codes if that is an important feature to you.

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Bones, Joints & Muscles

Bones, Joints & Muscles is a patient-education resource designed for patients to learn about diseases as they relate to the musculoskeletal system.  The app has a simple design that consists of a list of pathologies in alphabetical order.  Each topic includes 1-5 brief paragraphs that include general information about each disease.  The app does not include images or video, and does not include contact information for providers that can take care of the diseases, a feature available in other similar applications.  The user does have the option to email the information.  Overall, the app can provide very basic and general information to patients, but other apps provide similar information with the assistance of images, video, and greater depth.

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Synthes

Overall: 4+
Functionality: 4+
Coolness: 4

Like many other device company apps, the Synthes app can serve as a library and educational resource for surgeons and trainees with regards to Synthes products.  The app is not exclusively for orthopaedic surgeons, and also includes CMF and Vet products, in addition to their Trauma and Spine product lines.  The app comes in both iPad and iPhone versions, which each have navigation interfaces designed specifically for the size of each device. On the iPhone, navigation is simple and consistent with other Synthes product websites by allowing the user to view Key Technologies, Browse by Anatomy, Synthes Solutions, Clinical Resources, and General Resources.  As the user advances through the drill-down navigation screens, more information and more options are provided including images, AO classification systems for the relevant body part, and case studies demonstrating use of their products.  The app is clearly designed for providers, not patients, and hosts a wealth of information that ranges from general tips and techniques to useful images and guides for specific products.  Useful features include in-app links to the Synthes Resident program, Synthes Surgeon.com, and the ability to search the app for a particular product. One limitation of the app is that it requires updates on a weekly basis, which can be frustrating when trying to access information quickly.  Otherwise, the app is well-made, complete, and provides useful information to any surgeon who uses Synthes products.

Cost: Free
Download Synthes Here

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Leg.Fractures

Overall: 2+
Functionality: 3
Coolness: 2

This app was designed by physicians for providers treating lower limb injuries in the UK.  The app has 7 sections: patients, standards-1, standards-2, arterial supply, surface markings, fasciotomies, and pinning of tibia.  The first three sections describe which patients these guidelines apply to, and the “standards” section essentially lists the guidelines that should be performed for these types of patients.  The next 4 sections provide visual aids to inform the reader of the relevant anatomy in regards to the arterial supply, surface landmarks of the leg, cross-section of the leg for fasciotomies, and safe locations for ex-fix pin placement using cross-sectional slices.  Overall, the information presented is very brief yet can serve as a quick refresher for a trainee or surgeon already familiar with the procedure(s).  However, this app does not provide enough information for a student to learn much about the treatment of acute leg trauma.  This small app has valuable information but only at a superficial level and is therefore ideal as a quick reference in only very specific situations.

Cost: Free
Download Leg.Fractures Here

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inMotion

Overall: 4+
Functionality: 4
Coolness: 5

This app is created by Stryker and is an impressive patient education tool with regard to the two advertised devices: a total knee and a total hip arthroplasty.  What makes this app unique, however, is the integration of computer animation, video, and audio that includes a highly realistic anatomical model with the options to select anatomic structures and make them transparent or hide them during the demonstration.  This is truly the future of medicine.  For example, you might show a patient hip motion after a total hip arthroplasty procedure, and during the video the user can “hide” any overlying muscles or bones to reveal the implant, or you can add them back one-by-one to demonstrate the relative anatomy.  Overall, this app should be downloaded for the coolness factor alone.  It would make a great resource for a waiting room, but of course this is probably most useful to surgeons using Stryker’s products.

Cost:Free
Download inMotion Here

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OpTech Live

Overall: 4
Functionality: 4
Coolness: 2+

This app is part of Stryker’s library of applications and, like other device company apps, provides the user with a library of device and implant user guides.  The interface is well-organized by topic and lists PDF guides according to specialty or body part.  Selecting an item quickly downloads the PDF surgical technique guide which can then be saved in a library on the device (for referencing later) or a link to the document can be emailed.  Browsing for topics is very easy with essentially no delay.  For access to Stryker’s line of technique guides, this app does everything it should.

Cost: Free
Download OpTech Live Here

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Eponyms

Overall: 4
Functionality: 4
Coolness: 2+

This app does exactly what it advertises: it organizes and defines medical eponyms based on specialty.  The user can view all eponyms, or you can choose to sort by topic.  Orthopedics has its own heading with about 150 common eponyms for diseases, fractures, signs, and clinical exam tests.  This app may not be particularly useful to a orthopaedic provider, however for a medical student rotating on an orthopaedic service, this can be a very handy reference guide.  Explanations are very short and do not provide much detail.  However, there is a good search feature that searches the eponym title, as well as its description.  For example, searching for “supra” returns the Hawkin’s sign because the definition notes that it tests for supraspinatus tendon impingement.  The user can also mark eponyms as “favorites.”  When not limiting the search to orthopedics, the app has over 1700 eponyms!  While not the most useful to residents or surgeons, this app would be very useful to medical students or interns.

Cost: Free (for students) or $1.99
Download Eponyms Here

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NeuroMind

Overall: 2+
Functionality: 3
Coolness: 1

This app was designed for neurosurgeons, however the content includes spine and spine trauma information that would also be valuable to orthopaedic trainees and spine surgeons.  The interface is nothing more than a listing of classification systems roughly organized by specialty such as general, motor, spine, spine trauma, tumor, and vascular.  For spine and spine trauma there are about 18 classification systems listed and selecting a topic provides the user with a text description of the classification table and a reference. There is no fancy interface design, no graphics, and no ability to save “favorites” for quick reference.  But, for someone who needs access to a list of spine classification tables, this is a free and light app to keep in your pocket.  Overall, this is probably useful to only a select group of individuals.

Cost: Free
Download Here

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Mobile Coder Orthopedics

Overall: 3+
Functionality: 4+
Coolness: 3

This is a useful coding app designed specifically for orthopaedic surgeons.  The taskbar is organized into four sections.  The “patients” tab allows the user to add patient records and includes information such as facility, date/time, patient info, assistant, and comments.  That record can then be associated with the second section: CPT.  CPT codes are organized by body region and separated by the usual CPT categories.  A search function is available, and the user can identify favorite codes to save time during future entires.  The codes themselves include options to include modifiers and the interface is easy to navigate.  The third tab is a patient history section, and the fourth tab is a configuration tab where the user can enter facilities and surgical assistants.  The program includes help alerts for every screen that are initially informative, but must be turned off in the configuration tab because they quickly become bothersome.  Overall, the app is one of many coding apps available and will appeal to many surgeons, however there does not appear to be support for ICD-9 codes if that is an important feature to you.

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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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SLIC

Overall: 3+
Functionality: 4
Coolness: 2

This app uses decision-tree diagrams to assist surgeons with the treatment of various trauma-related spine pathology including burst fractures, central cord syndrome, facet fracture dislocation, facet subluxation, and hyperextension injury.  Each topic provides a flowchart as well as a decision-support interface to walk the user through the treatment algorithm.  The data appears to be peer-reviewed and closely mirrors charts from published articles on the topic, however no references are provided.  Overall, this may be useful to individuals taking spine-trauma call.

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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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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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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OrthoEvent

Overall: 3+
Functionality: 4
Coolness: 3+

This free app is useful for any orthopaedic practitioner who attends or is planning to attend any orthopaedic-related conference. The app is designed to compile information regarding nearly all professional orthopaedic conferences worldwide, as well as organize conferences according to specialty. Once a conference is selected, the app provides dates, locations, abstract deadlines, and links to meeting websites. The app is limited by the fact that information is inconsistent, and that the majority of the app text is in French with no other languages available. Overall, the application is a creative and very helpful way to search for conferences that you might not otherwise be aware of.

Cost: Free
Download Here

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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