Alturkistani Raghad, A Kavin, Devasahayam Suresh, Thomas Raji, Colombini Esther L, Cifuentes Carlos A, Homer-Vanniasinkam Shervanthi, Wurdemann Helge A, Moazen Mehran
Department of Mechanical Engineering, University College London, London, UK.
Christian Medical College Vellore, Vellore, India.
Prosthet Orthot Int. 2020 Apr;44(2):92-98. doi: 10.1177/0309364620905220. Epub 2020 Feb 26.
Partial hand amputations are common in developing countries and have a negative impact on patients and their families' quality of life. The uniqueness of each partial hand amputation, coupled with the relatively high costs of prostheses, makes it challenging to provide suitable prosthetic solutions in developing countries. Current solutions often have long lead times and require a high level of expertise to produce. The aim of this study was to design and develop an affordable patient-specific partial hand prosthesis for developing countries.
The prosthesis was designed for a patient with transmetacarpal amputation (i.e. three amputated fingers and partial palm). The final design was passive, controlled by the contralateral hand, and utilized the advanced flexibility properties of thermoplastic polyurethane in a glove-like design that costs approximately 20 USD to fabricate. Quantitative and qualitative tests were conducted to assess performance of the device after the patient used the final design. A qualitative assessment was performed to gather the patient's feedback following a series of tests of grasp taxonomy. A quantitative assessment was performed through a grasp and lift test to measure the prosthesis' maximum load capacity.
This study showed that the prosthesis enhanced the patient's manual handling capabilities, mainly in the form of grasp stability. The prosthesis was light weight and could be donned and doffed by the patient independently. Limitations include the need to use the contralateral hand to achieve grasping and low grasp strength.
Persons with partial hand amputation in developing countries lack access to affordable functional prostheses, hindering their ability to participate in the community. 3D-printed prostheses can provide a low-cost solution that is adaptable to different amputation configurations.
手部部分截肢在发展中国家很常见,会对患者及其家庭的生活质量产生负面影响。每次手部部分截肢情况各异,再加上假肢成本相对较高,这使得在发展中国家提供合适的假肢解决方案具有挑战性。目前的解决方案往往交付周期长,且生产需要高水平的专业知识。本研究的目的是为发展中国家设计并开发一种经济实惠的定制手部部分假肢。
该假肢是为一名掌骨截肢患者(即三根手指和部分手掌截肢)设计的。最终设计为被动式,由对侧手控制,采用类似手套的设计,利用了热塑性聚氨酯的先进柔韧性,制造成本约为20美元。在患者使用最终设计后,进行了定量和定性测试以评估该装置的性能。在进行了一系列抓握分类测试后,进行了定性评估以收集患者的反馈。通过抓握和提起测试进行定量评估,以测量假肢的最大承载能力。
本研究表明,该假肢增强了患者的手动操作能力,主要体现在抓握稳定性方面。该假肢重量轻,患者可独立穿戴和取下。局限性包括需要使用对侧手来实现抓握以及抓握力量较低。
发展中国家手部部分截肢的患者无法获得经济实惠的功能性假肢,这阻碍了他们融入社区的能力。3D打印假肢可以提供一种低成本的解决方案,适用于不同的截肢配置。