Young Keaton J, Pierce James E, Zuniga Jorge M
Department of Biomechanics, University of Nebraska at Omaha, 6001 Dodge Street Omaha, Nebraska, NE, 68182, USA.
Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago, Chile.
3D Print Med. 2019 May 2;5(1):7. doi: 10.1186/s41205-019-0044-0.
Traditional prosthetic fabrication relies heavily on plaster casting and 3D models for the accurate production of prosthetics to allow patients to begin rehabilitation and participate in daily activities. Recent technological advancements allow for the use of 2D photographs to fabricate individualized prosthetics based on patient anthropometrics. Additive manufacturing (i.e. 3D printing) enhances the capability of prosthesis manufacturing by significantly increasing production speed and decreasing production cost. Existing literature has extensively described the validity of using computer-aided design and 3D printing for fabrication of upper limb prostheses. The present investigation provides a detailed description of the development of a patient specific body-powered 3D printed partial finger prosthesis and compares its qualitative and functional characteristics to a commercially available finger prosthesis.
A 72-year old white male with a partial finger amputation at the proximal interphalangeal joint of the left hand performed a simple gross motor task with two partial finger prostheses and completed two self-reported surveys (QUEST & OPUS). Remote fitting of the 3D printed partial finger began after receipt of 2D photographs of the patient's affected and non-affected limbs. Prosthetic fitting when using 3D printable materials permitted the use of thermoforming around the patient's residual limb, allowing for a comfortable but tight-fitting socket. Results of the investigation show improved performance in the Box and Block Test when using both prostheses (22 blocks per minute) as compared to when not using a prosthesis (18 blocks per minute). Both body-powered prostheses demonstrated slightly lower task-efficiency when compared to the non-affected limb (30 blocks per minute) for the gross motor task. Results of the QUEST and OPUS describe specific aspects of both prostheses that are highly relevant to quality of life and functional performance when using partial finger prostheses.
The use of 3D printing exhibits great potential for the fabrication of functional partial finger prostheses that improve function in amputees. In addition, 3D printing provides an alternative means for patients located in underdeveloped or low-income areas to procure a functional finger prosthesis.
传统的假肢制造严重依赖石膏模型和3D模型来精确制作假肢，以使患者能够开始康复并参与日常活动。最近的技术进步使得可以使用二维照片，根据患者人体测量学制造个性化假肢。增材制造（即3D打印）通过显著提高生产速度和降低生产成本，增强了假肢制造能力。现有文献广泛描述了使用计算机辅助设计和3D打印制造上肢假肢的有效性。本研究详细描述了一种针对特定患者的体动式3D打印部分手指假肢的开发过程，并将其定性和功能特征与市售手指假肢进行了比较。
一名72岁的白人男性，左手近端指间关节部分手指截肢，使用两种部分手指假肢完成了一项简单的粗大运动任务，并完成了两项自我报告调查（QUEST和OPUS）。在收到患者患侧和未患侧肢体的二维照片后，开始对3D打印的部分手指进行远程适配。使用3D可打印材料进行假肢适配时，可以在患者残肢周围进行热成型，从而获得舒适但贴合的接受腔。调查结果显示，与不使用假肢时（每分钟18个方块）相比，使用两种假肢时在箱块测试中的表现有所改善（每分钟22个方块）。对于粗大运动任务，与未受影响的肢体（每分钟30个方块）相比，两种体动式假肢的任务效率均略低。QUEST和OPUS的结果描述了两种假肢在使用部分手指假肢时与生活质量和功能表现高度相关的具体方面。
3D打印在制造功能性部分手指假肢以改善截肢者功能方面具有巨大潜力。此外，3D打印为欠发达或低收入地区的患者提供了一种获得功能性手指假肢的替代方法。
