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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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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Measure Whiz

App to assist in measuring Upper Extremity range of motion from The Hand Center at the Orthopedic & Sports Physical Therapy Associates

Measure Whiz was created for use by Occupational Therapists to assist in measuring and recording upper extremity range of motion (ROM) using a mobile device. This app is intriguing as it leverages the phone’s gyroscope to measure angular differences in all three planes, but its usefulness is limited as it has minimal features, a large range of error, and is difficult to use for certain measurements. The app interface is very basic. From the home screen you can select ‘History’, ‘Range of Motion’, and ‘Assessment’. The ‘History’ and ‘Assessment’ options are just voice memos which can easily be record over accidentally.  The ROM options include Wrist, Forearm, Elbow, Shoulder, Digits with specific motion sub-options per joint. There is no option for lower extremity ROM measurements.

By selecting a specific joint and motion you can then measure the ROM live. Position the handset distal to the joint in a neutral position and press ‘Start’. Then allow the patient to move the body part being measured and then tap the ‘Finish’ Button. The ROM is displayed and updated live. The app does not lock the plane of measurement and allows ROM measurements in the X & Y plane simultaneously. This allows for different acceptable phone positions, but leads to errors in measurement with any movement out of plane. It is very sensitive & dependent on initial position when zeroed. Using the app can be difficult as you must stabilize the device against the body part being measured which can be difficult for wrist ROM and near impossible for digit ROM. It worked adequately for forearm, elbow and shoulder ROM.

A ‘New Patient’ button at the bottom of the homepage clears the app information. Multiple patient data is not supported and data is not saved for later. Data is lost when app is closed and there is no prompt when the ‘New Patient’ button is pressed, making it easy to accidentally clear the data. Overall the app is quite finicky. There are better goniometer apps out there and a real goniometer is probably better and more accurate.

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Throw Like a Pro

Baseball throwing injury prevention app released by Dr. James Andrews and Dr. Kevin Wilk

In response to the increasing rates of “Tommy John” surgery as a result of throwing injuries, this app has been released to help young baseball players prevent injuries and safely participate in sports.  The purpose of this app is to provide information about safe participation that keeps players out of the operating room.

The app includes an overview of baseball throwing injuries, statistics, and general guidelines for prevention.  The app then divides recommendations into Pre-Season and In-Season sections.  In Pre-Season, videos are included that demonstrate how to perform 5 different stretching exercises, with instructions to complete them daily.  Next, the player performs the “Throwers Ten” which includes videos of 20 more exercises that should be performed with 10 repetitions, 3-4 times/week.  Lastly, there is advice for a throwing progression with a module that talks the player through the distance and number of throws to build up.

The In-Season module includes a warm up with stretching (same videos), a thrower’s ten band workout (more videos), a throwing warm up and a pitching warm up.  The app includes a pitch-count tool which can be modified for the patient’s age, rest days, and maximum pitches desired (and advised).

Overall, the app has a very high production quality and includes important information from leading surgeons in the field of throwing injuries. They estimate a 60% reduction in throwing injuries if used properly.

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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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BoneDoc

A serious game for simulating orthopaedic surgery.

The BoneDoc app is marketed as “a serious game” and functions as an interactive and educational orthopaedic surgery tool.  The game was created by Dr. Phil Blyth from New Zealand and represents many accuracies of hip surgery.

The app layout is a list of patients that need surgery.  The first case, for example, is a hip fracture that requires fixation. The surgeon must walk through every step of the operation, beginning with setting up the traction properly.  Xrays are available as the traction is adjusted to ensure that a proper reduction is obtained. Once complete the surgeon then moves on to the incision, as well as placement of the hardware.  Xrays are used throughout the “operation” to ensure the proper alignment and orientation of hardware.  Once finished, the surgeon receives a score for every aspect of the case, and is reimbursed appropriately.

The game is very impressive due to the attention of detail that has been placed, as well as the realistic physics and challenges inherent with fixing a hip fracture.  I applaud the developers for creating a challenging and educational app for surgeon education.  I look forward to future releases with additional fracture options.

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Bone Ninja

Sophisticated app for pre-operative planning of osteotomies and limb correction.

Although it has a catchy name and cute icon, Bone Ninja is neither a toy nor a game. This is a sophisticated and serious app created by the International Center for Limb Lengthening to teach planning for limb lengthening and alignment surgery. The app was primarily used as a tool for the deformity course that they host, and I advise that anyone interested in the app either take the course or watch one of the introductory lectures.

The app itself includes a library of images for practicing and learning. This includes both frontal and saggital plane views of limbs with various angular deformities. The user can also upload their own image. Once an image is selected, you enter the editing mode. The features are impressive, and include calibration and enhanced editing tools such as various select functions, linking options, the ability to free-cut the image, angular and length measurement tools and rulers, and more. It even has “hardware” icons that can be added to the images.

As stated above, this app is not for amateurs and includes lessons and resources for learning, including links to YouTube videos (Part 1, Part 2, Demo).

App website: http://www.lifebridgehealth.org/RIAO/BoneNinjaAppforiPad.aspx

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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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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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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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AAOS Musculoskeletal Exam – Knee

Simple app to learn the knee exam and special tests

I commend the AAOS’ effort to create mobile educational material for students and trainees, which includes this simple app for learning the knee exam and special tests.  This app has a very simple structural layout in list form that presents the knee 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 20 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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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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iBones

Created by Buffeln.Net, this app is an expansion of the existing online testing platform based in German.  However, the app presents information in Latin and English, as well as German, and includes options for changing the language.  The organization includes iBones, the primary review module, which includes 74 images of bones with multiple choice questions.   Only names of the entire bones are included, not more advanced bony anatomy.  Other modules include statistics and search functions, as well as “specials,” which advertises coupons for the website.  Overall, this app is a cartoon-based basic bone quiz that would be most appropriate for elementary school children who want to learn about different bones in the body.  Bottom line: consider downloading this app for your kids.

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BoneTest Miscellaneous 11

Part of an entire suite of BoneTest apps created for test review, the Miscellaneous app includes 50 questions that cover Trauma, Oncology, Basic Science, and Foot & Ankle topics.  The app is simplistically organized as a list of questions, labeled from 1-50.  There is no “test” mode or a way to randomize the question order.  Selecting any given question presents the question and answer options (standard multiple choice, true false, fill-in-the-blank, etc.) with associated images, when appropriate.  Questions and answer choices are clearly presented, but the question format does not reflect OITE or OSAS questions despite many of the questions appearing to be most appropriate for orthopaedic residents and surgeons (too advanced for students, in many cases).  One nice feature is that a brief explanation is provided for every answer choice (incorrect as well correct answers).  References have been provided for every question, but are often vague, and refer only to a book (OKU 9) without chapter or page number.  Lastly, a significant limitation of this app is that once an answer is selected, it can never be “unselected,” implying that this app is “one time use, only.”  Overall, this app is too advanced for students, but is not ideally organized for residents or surgeons by not allowing for question randomization or resetting the questions.

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Knee Pain

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

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Tumorpedia Soft Tissue

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

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Tumorpedia 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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iPrevent Running Injuries

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

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iPrevent ACL Injuries

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

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Orthopaedics Pro

This app is an attempt at an all-inclusive orthopaedics study tool.  The menu is organized into flashcards, true/fales (500 questions) and single best answer (106 questions).  The flashcards are not merely “factoids” of information, rather they are complete paragraphs of text information for every subject.  The app certainly contains a lot of information, but is also difficult to navigate at times.  The information is inconsistent, and at times impressive.  For example, the subheading “calcaneus fracture” includes reference to normal Bohler’s angle and normal Angle of Gissane.  It also includes Sander’s classification (text only), Zwipp classification, principles of fixation, reports Letournel’s results, and provides Essex-Lopresti’s subtypes.  However, the format is difficult to read and organize in one’s mind.  The true/false section is a sequential series of true/false questions that must be completed in order.  The single best answer section must also be completed in order.  Both of these sections suffer from a poor user interface, however the questions and explanations are good and very complete. Overall, the app is a good first attempt at a review/flashcard app, but would greatly benefit from an interface overhaul which is currently the apps greatest weakness.

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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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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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OITE Buzzwords

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

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OITE Tumor

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

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Scores-ODI

The developers of Scores-ODI have elegantly converted the standard Oswestry Disability Index clinical questionnaire into an intuitive and easy-to-use iPhone and iPad app. The app offers no surprises, and has the added benefit of being available in both English and French.  After entering the patient’s name, the user is seamlessly walked through each question of the survey with instructions for how to answer each question.  The results are then saved in the device and the app suggest that the data can then be emailed in a .csv file.  Unfortunately, when testing the save/email features, I found that the iPad version has a bug that did not email the actual scores, which renders the email function useless.  In addition, on the iPhone version, the email .csv file did not appear to send an accurate score.  Thus, the app could benefit from some increased functionality that would likely be useful in a research setting. Overall, the app is a very good use of technology to assist with recording patient outcomes and could have significant potential time-savings in the research settings since data is recorded and saved digitally.

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AgingSpine

AgingSpine is part of the Orca Health collection of apps that provides information for patients about various orthopaedic conditions.  Like the entire “decide” series, the user interface, graphics, and interactive anatomy modules are superb and allow the user to learn about degenerative spine anatomy while rotating, flexing, and zooming in on the images.  The conditions covered in this app include osteoarthritis, osteoporosis, degenerative disc disease, kyphosis, degenerative scoliosis, spondylolisthesis, lumbar stenosis, and cervical stenosis.  Consistent with the entire line of apps, each disease includes a plethora of xray, MRI, and CT imaging with appropriate annotations demonstrating normal and pathologic conditions.  Audio recordings are also included to narrate the text as well. Like the other apps in this series, users can search for medical providers that treat these conditions.  Overall, AgingSpine is a very impressive addition to the Orca Health “decide” series and has the potential to greatly improve patient education and comprehension about orthopaedic conditions.

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ShoulderDecide

ShoulderDecide is part of the Orca Health collection of apps that provides information for patients about various orthopaedic conditions.  Like the entire “decide” series, the user interface, graphics, and interactive anatomy modules are superb and allow the user to learn about shoulder anatomy while rotating, flexing, and zooming in on the images.  The conditions covered in this app include rotator cuff tear, bursitis, impingement, calcific tendinitis, glenohumeral arthritis, acromioclavicular arthritis, instability, proximal humeral fractures, clavicle fractures, AC separation, frozen shoulder, and biceps tendon tears & tendinitis.  Consistent with the entire line of apps, each disease includes a plethora of xray, MRI, and CT imaging with appropriate annotations demonstrating normal and pathologic conditions.  Audio recordings are also included to narrate the text as well. Like the other apps in this series, users can search for medical providers that treat these conditions.  Overall, ShoulderDecide is a very impressive addition to the Orca Health “decide” series and has the potential to greatly improve patient education and comprehension about orthopaedic conditions.

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KneeDecide

KneeDecide is part of the Orca Health collection of apps that provides information for patients about various orthopaedic conditions.  Like the entire “decide” series, the user interface, graphics, and interactive anatomy modules are superb and allow the user to learn about knee bone, tendon, meniscus, and ligament anatomy while rotating, flexing, and zooming in on the images.  The conditions covered in this app include meniscal tear, ACL tear, MCL injuries, PCL tear, patellofemoral chondrosis, tibiofemoral chondrosis, chondral lesions, advanced arthritis, lateral patellar compression syndrome, patellar dislocation, patellar tendonitis, Osgood-Schlatter disease, iliotibial band syndrome, mechanical disorders, and fractures.  Consistent with the entire line of apps, each disease includes a plethora of xray, MRI, and CT imaging with appropriate annotations demonstrating normal and pathologic conditions.  Audio recordings are also included to narrate the text as well. Like the other apps in this series, users can search for medical providers that treat these conditions.  Overall, KneeDecide is a very impressive addition to the Orca Health “decide” series and has the potential to greatly improve patient education and comprehension about orthopaedic conditions.

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SportsMed

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

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Scoligauge

Part of the goniometer series developed by Ockendon.net, scoligauge uses the iPhone’s internal accelerometer to mimic a scoliometer.  The user first calibrates the device on a level surface, and then chooses to measure the angle based on the device’s position on an object or based on the camera image. The app shows a very realistic scoliometer model during the measurement.   Overall, the app relies on the accuracy of your iPhone’s internal accelerometer, but the app does what it says and allows for precise and objective measurements when a standard scoliometer is unavailable.

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Forearm Goniometer

Part of the goniometer series developed by Ockendon.net, forearm goniometer expands upon the functionality of simple goniometer to use the iPhone’s internal accelerometer for measuring forearm pronation/supination.  Although no instructions are provided, it seems that the user should be holding the iPhone in their right or left hand. When ready, the user selects the proper hand on the screen, and then proceeds to fully supinate/pronate one direction, and then the other direction.  The app records the limits of each motion and saves the data on the screen.  Although accuracy depends on the calibration of your devices internal electronics, the app does include the ability to calibrate itself on a level surface.  In addition, motion within the hand or wrist could account for subjective variation between subjects.  Overall, the app does what it says and allows for precise and objective measurements when a standard goniometer is unavailable.

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Knee Goniometer

Part of the goniometer series developed by Ockendon.net, knee goniometer expands upon the functionality of simple goniometer to do exactly what it says: it uses the iPhone’s internal accelerometer to mimic a goniometer for clinical measurements.  The app includes prompting the user to select which side is being tested and the side that the examiner is standing on.  The app only has three functions: set, hold, and reset.  Although accuracy depends on the calibration of your devices internal electronics, the app does what it says and allows for precise and objective measurements when a standard goniometer is unavailable.

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Simple Goniometer

Part of the goniometer series developed by Ockendon.net, simple goniometer does exactly what it says: it uses the iPhone’s internal accelerometer to mimic a goniometer for clinical measurements.  The app only has three functions: set, hold, and reset.  Although accuracy depends on the calibration of your devices internal electronics, the app does what it says and allows for precise and objective measurements when a standard goniometer is unavailable.

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HandDecide

HandDecide is part of the Orca Health collection of apps that provides information for patients about various orthopaedic conditions.  Like the entire “decide” series, the user interface, graphics, and interactive anatomy modules are superb and allow the user to learn about hand anatomy in different regions of the hand and wrist while rotating, flexing, and zooming in on the images.  The conditions covered in this app include carpal tunnel syndrome, wrist injury, TFCC, thumb base arthritis, de Quervain’s tendonitis, skier’s thumb, ganglion cyst, mallet finger, dupuytren’s contracture, trigger finger, and flexor tendon injury.  Consistent with the entire line of apps, each disease includes a plethora of xray, MRI, and CT imaging with appropriate annotations demonstrating normal and pathologic conditions.  Video and audio recordings are also included to narrate the text and demonstrate surgical procedures. Like the other apps in this series, users can search for medical providers that treat these conditions and this particular app expands the selection to include a physical therapist, plastic surgeon, and manicurist.  Overall, HandDecide is a very impressive addition to the Orca Health “decide” series and has the potential to greatly improve patient education and comprehension about orthopaedic hand conditions.  At only $1.99 this application is a great value for the amount of information included.

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FootDecide

FootDecide is part of the Orca Health collection of apps that provides information for patients about various orthopaedic conditions.  Like the entire “decide” series, the user interface, graphics, and interactive anatomy modules are superb and allow the user to learn about foot anatomy in different regions of the foot and ankle while rotating, flexing, and zooming in on the images.  The conditions covered in this app include Achilles tendonitis/Haglund’s deformity, ankle and subtalar arthritis, peroneal tendonitis/tear, bunionette (taylor’s bunion), Morton’s neuroma, hammer toe, interdigital callus, metatarsalgia, tarsometatarsal arthritis, stress fracture/reaction, ankle sprain, second MTP instability, bunion (hallux valgus), plantar fasciitis, and posterior tibial tendinosis.  Consistent with the entire line of apps, each disease includes a plethora of xray, MRI, and CT imaging with appropriate annotations demonstrating normal and pathologic conditions.  Audio recordings are also included to narrate the text as well. Like the other apps in this series, users can search for medical providers that treat these conditions and this particular app expands the selection to include an orthotist, cobbler, and pedicurist.  Overall, FootDecide is a very impressive addition to the Orca Health “decide” series and has the potential to greatly improve patient education and comprehension about orthopaedic foot conditions.

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SpineDecide

SpineDecide is part of the Orca Health collection of apps that provides information for patients about various orthopaedic conditions.  Like the entire “decide” series, the user interface, graphics, and interactive anatomy modules are superb and allow the user to learn about spine anatomy while rotating, flexing, and zooming in on the images.  The conditions covered in this app include cervical bulge, cervical herniation, cervical stenosis, spondylolisthesis, lumbar bulge, lumber herniation, lumbar stenosis, degenerative disc disease, kyphosis, and scoliosis.  Consistent with the entire line of apps, each disease includes a plethora of xray, MRI, and CT imaging with appropriate annotations demonstrating normal and pathologic conditions.  Audio recordings are also included to narrate the text as well. Like the other apps in this series, users can search for medical providers that treat these conditions.  Overall, SpineDecide is a very impressive addition to the Orca Health “decide” series and has the potential to greatly improve patient education and comprehension about orthopaedic conditions.

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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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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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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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BoneCast

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

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BoneFeed

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

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