By Forrest Harrison MD
I found myself in need of a quick reference orthopedic app that was easy to use. I had been desperately searching for fracture classification diagrams and treatment options on the internet and skimming through reference books only to become even more frustrated.
It was easy to find information if your patient had a simple boxers fracture, but what about all the other metacarpals? I needed a more concise and comprehensive source on the go, so I turned to the App store.
In my search I found two apps previously reviewed on iMedicalApps that appeared promising.
The first is an iPhone app called ortho traumapedia, and it has a price point of $9.99. This app was originally reviewed by iMedicalApps team member, Darwin Wan. The second is an iPhone/iPad app called RealWorld Orthopaedics, also with a price of $9.99. This app was originally reviewed by Dr. Yvette Ho and Tom Lewis.
Both of these apps were out of my typical discretionary money range for impulse app purchasing. A few bucks down the drain is no big deal, but $9.99 seemed like more of an investment. I felt it was worthwhile to revisit these apps due to the lack of other good resources for a quick ortho reference and also because of the investment required in purchasing one of these apps.
The Ortho Traumapedia app opens with all of the essential information easily displayed. There are a few introductory tabs initially which explain the use of the app as well as some common acronyms and basic principles of orthopedic trauma. A quick swipe of the finger brings you down to see the two main categories: dislocations and fractures. You are brought to a dedicated page for an injury by selecting a specific bone. Four tabs on the bottom of the screen allow you to quickly jump between facts, images, classification, and treatment options.
The facts section is useful, but a little wordy and would be easier to use if it was searchable or the sections in it were bolded to catch your eye. The imaging section displays the typical radiographs that should be ordered as well as an anatomic review. The app also occasionally comments on when CT or MRI might be utilized, but there are no images from theses modalities, only radiographs. You cannot zoom in on the imaging and there are no images of the actual injuries. This is a little disappointing. It should also be noted that spinal fractures are not covered in this app.
The classification and treatment sections are set up with bullet points and bolded headlines making them easier to review quickly. Illustrated diagrams are used in these sections and are typically very comprehensive. In the metacarpal section, there are only diagrams of a thumb and 5th metacarpal base fractures. More diagrams would be nice, especially in the treatment section when discussing acceptable alignment. Operative indications and general splinting options are also covered. They do a great job covering the most important information in a concise and easily readable fashion.
The RealWorld Orthopaedics:
The RealWorld Orthopaedics app for the iPhone opens with the different diagnoses categorized by body location. I use the term diagnoses because the app is geared more towards orthopedics in general as opposed to trauma. There are imaging subsections with options like bone graft, rheumatoid arthritis, or even bone tumor. There is also a quiz function at the top of the app which allows you to quickly jump to random images to test your knowledge. The layout is not conducive to quick searches and I find myself scrolling up and down frequently.
Clicking on a diagnoses takes you to 2-3 images where you have the option to add highlighted lines which demarcate fracture lines, important angles, and other significant findings on the film. You can easily bring up more detailed information on the highlighted lines describing their significance. The images are all plain films, but are easily manipulated and zoomable.
There is also a quick link to a book chapter within the app which discusses general diagnosis, classification, and treatment options. The information here is very useful, but not as concise as the traumapedia app. It is in a book chapter format with a few pictures of anatomy or various splints, but no diagrams helping to illustrate classification of the injury. It should be noted that only a few spinal fractures are covered in this app.
In terms of speed, ease of use, and comprehensiveness — Ortho Traumapedia is your best bet for a quick reference ortho app. It appears the RealWorld Orthopaedics app was designed more as a learning tool than a reference guide. Certainly the RealWorld Ortho app could be used as a reference, but is likely more useful for medical students or ER/Family/Ortho residents earlier in residency as an educational tool. Later on in residency, or as a practicing Physician, the concise information in the Ortho Traumapedia app will be incredibly helpful.
Other resources I found helpful:
- Book format: “Pocketbook of Orthopaedics and Fractures” by Ronald McRae – Nice reference book about the size of a bible that you can carry around in your backpack/briefcase.
- Orthobullets Website: Searchable website with easy to read classification and treatment information.
- Academic Life Website: Well known for their PV cards, the Ortho cards on this site are great. You can download these to your dropbox/evernote.