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Classification apps allow users to carry knowledge in the user pockets
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.
 Matthew DiPaola |
 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.
Trauma classifications
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 also free.
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.
Next month
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 matthew.dipaola@wrightstatephysicians.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 www.TopOrthoApps.com to help surgeons and trainees find the most relevant orthopedic apps for their mobile devices. He can be reached at orrin@toporthoapps.com.
- Disclosures: DiPaola and Franko have no relevant financial disclosures.