In this month’s column we highlight apps that feature orthopedic
classification systems. Although classification schemes help us impart valuable
information about the treatment and prognosis for specific problems, they can
be notoriously confusing. In addition, some of the more complex classification
systems are difficult to remember without a reference. The following apps allow
users to carry volumes worth of orthopedic knowledge in their pockets, and
should be useful for residents and attending surgeons alike.
Orrin I. Franko
Shoulder and spine
“Shoulder Classification” is an app developed by the founders
of ShoulderDoc.co.uk. It is extraordinarily simple and usable — two traits
that score high marks with us when we review apps. Shoulder Classification
contains a list of 13 shoulder categories such as frozen shoulder, clavicle and
rotator cuff. Selecting a topic advances the user to a further submenu of
classifications. The app appears to be comprehensive and serves as a quick
guide for any and all shoulder pathology with supporting references. This app
stands apart from a few of the apps that follow by broadly covering an entire
anatomical region, as opposed to solely trauma-related classifications. This
app is free, so ask your residents to download a copy and review it before
making that phone call in the middle of the night.
“SLIC” helps users classify sub-axial cervical spine injuries.
Vaccaro and colleagues published this system in 2007 as an improved method for
identifying and communicating the degree of pathology in sub-axial cervical
spine injuries. The app is meant to be used by the treating surgeon during
preoperative planning for a patient with a subaxial cervical spine injury.
Kudos again to the developers for keeping things simple. The app takes users
through a series of three menus for morphology, disco-ligamentous complex and
neurological status. Under each menu, users choose the description that best
fits their case. When users are finished, the app automatically produces a
score that may help with treatment decisions. This is a good app for the spine
surgeons among us. Price: Free.
The AO long bone fracture classification app was one of the first
orthopedic apps available for free. As most people know, the AO classification
system for fractures is extraordinarily comprehensive, but perhaps a bit
unwieldy for most every day use. If users have ever felt intimidated by the few
folks who could quote this classification from memory or always wanted to know
it better, worry no more. This app does the heavy lifting for users. The app
user can find a fracture type in two ways: through the “picker” menu
or through the “selector” menu. The selector menu is arguably more
useful and has pictures of the four main long bone categories: humerus, radius
ulna, femur and tibia. Press on the particular long bone, and the app will
guide users visually to a subdivided picture of the bone in question. Users can
then further drill down to categorize a particular fracture by pressing on the
segment of the bone in which the user is interested. It is all intuitive and
makes a complicated fracture classification much more manageable. This app is
OrthoClass is another nice trauma classification app. The main menu of
the app is broken down into two primary categories: adult trauma and child
trauma. Press either of these menu items, and users will be presented with a
list of classification systems ranging from shoulder and arm — all the way
to foot. The app is well populated with drawings and descriptions of a
seemingly comprehensive list of fracture classifications. Interestingly, the
authors were careful to include as many classifications as possible. For
instance, they included four different classification systems for olecranon
fractures, and typically provide references where appropriate. The references
are not hyper-linked. However, that would be a nice addition if the developers
decided to update future editions of the app. Overall, the app is useful and
contains a lot of valuable information.
The last app we will review this month is Ortho Traumapedia. Organized
by either dislocation or fracture, the app provides a comprehensive list of the
most common injuries one might encounter while on trauma call. Each subsection
is divided into facts, images, classifications and treatment. The consistent
organizational scheme was extraordinarily helpful during app navigation. During
our review, we liked the facts section, which often contained valuable pearls.
In addition, the images section includes normal and pathologic radiographs with
annotations and outlines, when appropriate. We were also impressed with the
clear diagrams in the classification section, which offered a visual supplement
to the text-based app. Overall, this app is organized similarly to one of the
most popular on-call fracture handbooks, but is a fraction of the price and
lives on the user’s phone.
Please look for our column next month, which will focus on imaging apps.
For more information:
- Matthew DiPaola, MD, is an assistant professor and shoulder
and elbow specialist in the Department of Orthopedics at Wright State
University in Dayton, Ohio. He is a writer for iMedical Apps and co-founder of
Touch Consult, a developer of team based medical software to improve signout.
He can be reached at firstname.lastname@example.org.
- Orrin Franko, MD, is a PGY3 orthopedic resident at UC San
Diego. He has an interest in promoting mobile technology within orthopedic
surgery and founded the website
help surgeons and trainees find the most relevant orthopedic apps for their
mobile devices. He can be reached at email@example.com.
- Disclosures: DiPaola and Franko have no relevant financial