There are a wide range of medical apps available today. Some are patient focused providing specific information related to a condition, others are reference handbooks which have been helpfully converted into electronic form. One area which is not so populated are apps used in the preoperative stages of surgery. IOS Fixator, developed by shows the potential role mobile medical technology could play in the future.

Designed as a reference for the benefit of surgeons and physicians, IOS fixator contains a simple straightforward guide to the use of the STORM (Staffordshire Orthopaedic Reduction Machine) and the Intelligent Orthopaedic Services (IOS) External fixator for the treatment of tibial fractures.


The app can also be used in the preoperative planning stages when planning external fixation using the specific IOS device. The app uses the camera on either the iPhone, iPod Touch or iPad to take a picture of an X-ray (XR) of a tibial fracture. The use of a scaling ball is important to reduce the errors associated with magnification during XR and the first step in the pre-op planning stage is calibrating the size. Intuitive touch gestures make calibration straightforward.


The user then selects the part of the tibia that has been fractured and artificially reduces it using further touch gestures such as pan and rotate.


However, the ‘reduction’ of a fracture on XR can only be an estimate. There is no way to compensate for rotational deformity, for example, on a 2 dimensional projection. Finally, the user can now position a scaled IOS fixator device and make observations regarding placement. Use of a scaling ball means that the IOS device should be accurately represented. Both antero-posterior and lateral views are available to aid in the tempting stage.


The user is then presented with an option to save the templated image along with a patient ID. It is anticipated that the final templated image will be available in theatre, as a reminder of positioning and alignment as well as the particular fixator variant that was selected pre-op.


If your hospital uses the IOS device for external fixation, then this app is certainly very useful in the pre-operative planning stages. If this is not the case, then this app is of very limited use. However, the key point is not so much the particular app itself but the way in which this app has demonstrated that mobile medical technology can be used and successfully integrated into a surgical workflow. It does not take much to imagine a time where apps like IOS Fixator exist to help plan a whole range of surgical procedures. These apps may even be able to integrate with EHR’s and DICOM images to further improve surgical management. IOS Fixator paves the way for further apps to be developed which can integrate into medical and surgical workflows.


  • A fantastic demonstration of the power of mobile medical technology when applied to medicine
  • Clever use of augmented reality assists surgeons


  • Use of this app is highly limited unless the users hospital uses the IOS and STORM devices when treating tibial fractures.

Overall Rating:

  • IOS Fixator successfully demonstrates the capabilities of mobile medical technology within a healthcare environment.
  • Surgeons who use the IOS device will find the app assists their pre-operative planning whilst others will hopefully appreciate the positive impact that such an app could have if applied to their particular specialty.

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