This workshop will examine strategies for finding material posted on the Internet (as opposed to journal articles in Medline). To give us focus we will consider Pilon Fractures as a subject.

We will use all categories of Internet searching devices - AltaVista as a representative General Search Engine, OrthoSearch, OrthoGuide and OWL. We will also use other resources as suggested in the didactic treatment of the subject.

Just to show that there is valuable information about the subject on the Internet we will start by accessing Wheeless' Textbook. Go to the Main Menu http://www.medmedia.com/med.htm and click on Fractures to bring up the Fracture Index http://www.medmedia.com/orthoo/41.htm Scroll down the list of fractures to find Pilon Fractures  and click on that to open the page entitled Tibial Pilon Fracture http://www.medmedia.com/ooa1/52.htm. This page has a comprehensive description of the injury, classification and management strategies with 25 illustrations and 18 references. Reference to Wheeless' Textbook should always be the first step in a review of an orthopaedic subject on the Internet IMHO.

From the very specific we will now turn to the most general search engine and use AltaVista and compare it with Yahoo and Excite

Click on the link to AltaVista and enter the words pilon fracture in the search box.

(Note that this illustration will not connect with the various search engines)

To run the searches, you should visit the corresponding websites.

You will retrieve over 200,000 pages. Among the first 10 are an ad for a textbook on Pilon Fractures, 3 pages from Wheeless' Textbook and a case presentation about a multiply injured man with a pilon fracture. http://www.jacobi-em.com/casemnt.html In the next 10 pages we find an AO forum on the management of Pilon Fractures http://www.ao-asif.ch/aoi/alumni/chapters/italy/forum/forum1/index.html and more pages from Wheeless (mostly abstracts of papers on the subject). The 15th page (in my collection on August 3rd) was about Cafe Pilon and thereafter the relevance of the pages falls off abruptly. Using Excite

More Search

there were only 29,000 pages found and only the first 2 were relevant. These included the Orthopaedic Trauma Association Page which has a link to a study page on " Interobserver reliability and general applicability of rank order classification over the Internet of fractures of the tibial plafond" http://www.hwbf.org/pilon/ Go to the Yahoo page and use the same search string on their site.

I found 60 sites  including many that had been found from other search engines. Among the ones that had not was a list of references from the AO on Pilon Fractures http://www.aopublishing.com/PFXM/483.htm   and the PEPID site on the Emergency Room treatment of orthopaedic injuries http://www.pepid.com/pepidce/ortho.htm which didn't have much about Pilon Fractures but was an interesting find none the less.

OrthoGuide ( http://www.orthoguide.com/ ) is a subject specific search engine that searches a diverse collection of links for the target search string. Unlike the major search engines and Orthosearch it only looks for the target in the title of the page. Enter pilon fracture in the search box and make sure that you check the radio button for match entire phrase; otherwise it will provide the addresses of 93 pages about other fractures! There are no pages specifically about pilon fractures in this search engine's database.

OrthoSearch Search Tool for the Information Age

The Orthosearch search engine is based on a database and will not work except on its own page; however the interface will be similar to the above. Go to the website, type Pilon fracture in the box and accept the default "in Teaching Resources". You will then see the page headed as above. The search is partitioned into several categories as noted. The Teaching category is the most successful, finding the Wheeless' Textbook pages. Another category which is frequently useful is Journals as the database includes a number of journal tables of contents and you can find titles and abstracts of articles. In this particular case searching in the journals category is not very rewarding.

The two main problems with Orthosearch are the difficulty of keeping it up to date and the difficulty of reviewing orthopaedic topics. The OWL collection of orthopaedic links is part of the Orthosearch database but not the Orthopaedic Topics categories. This means that many interesting orthopaedic sites are not in the Orthosearch database as yet.

OWL (Orthopaedic Web Links) is a browsable collection of links with special interest to orthopaedic surgeons. Click on the link to the front page then select Orthopaedic Topics ( http://orthogate.org/owl/ortho_surgery_topics.htm ) Click on Trauma and the Ankle to see the Internet pages on this topic in the OWL collection. There is only one of note, the AO protocol for management of Pilon Fractures from University of Alabama http://www.ortho.uab.edu/sub_spclty/trauma/trauma.html#PilonFrac Note that despite the respect and strong connections between OWL and Wheeless' Textbook the pages on this subject were not specifically linked. Like many other Internet resources OWL needs to be regularly updated and checked for dead links.

Summary

This workshop serves to emphasize two things. The first is that there is a good deal of high quality information on orthopaedic subjects on the Internet. The second is that searching needs to be multifaceted if you are to be successful finding everything of value. If you wish only to find an authoritative accounts it would be best to see what Wheeless has to offer. You can then widen the net by using the Orthosearch engine or the browsable OWL collection.These collections are the most comprehensive subject specific aids to searching the Orthopaedic Internet. However, they do not cover the ground completely. If there is still a feeling that more information should be sought then a search through a number of the major search engines should be undertaken.

Feedback

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