Background: Assessment of radiology is an integral part of fracture management in orthopaedic surgery. Mobile multimedia messaging (MMS) can be utilised in the referral process of patients with fractures. However, the reliability of using MMS in making management decisions in distal radius fractures has not been assessed. Methods: Radiographs of 20 consecutive cases of distal radius fractures managed with closed reduction and plaster, and 20 cases managed with open reduction and internal fixation (ORIF) were analysed retrospectively by two blinded orthopaedic surgeons on a computer and anApple iPhone 3GS. The interand intra-rater agreements were assessed. Results:Inter-rater agreement between the MMS group and the picture archiving and communication system (PACS) group were consistent among the surgeons (K -0.55, 0.80, p<0.001). However, the management decisions were different in seven cases (8.75%) in the study group. Conclusion: MMS x-ray pictures can be useful in formulating management plans for patients with distal radius fractures. With advancing technology smartphones will likely play a larger role in the communication process in delivering orthopaedic care.

Background: Moderate to high intensity activity is an important component in weight loss. The ability to use free technology to monitor activity would provide a useful clinical tool. Methods: Three popular pedometer mobile applications ("iSteps Lite", "Pedometer Lite" and "Lyr Free") were compared to a conventional pedometer. Outcome measures included step recording, speed estimate, distance recorded over a fixed distance and steps recorded during car travel.Results: All devices show inaccuracy in step count and speed estimate at varying intensities of activity. For measurement of 100 steps at medium intensity activity, the range of recorded step counts detected at medium sensitivity was 69.3 to 101.3. Valid and reliable results for step count were seen with the control pedometer and with one program at moderate sensitivity settings for moderate and high intensity activity. The most accurate distance recorded and estimate of speed over a fixed distance was from a program with Global Positioning System (GPS) functionality. Conclusion:It is possible to determine a step count as accurate as a control pedometer with careful selection of program and calibration. When exercising over a distance, a program with GPS functionality leads to the most accurate determination of speed estimate and distance recorded.