IEEE Trans Neural Syst Rehabil Eng. 2021;29:527-535. doi: 10.1109/TNSRE.2021.3057984. Epub 2021 Mar 3.
Modernising the way upper-limb prosthetic sockets are made has seen limited progress. The casting techniques that are employed in clinics today resemble those developed over 50 years ago and there is still a heavy reliance on manual labour. Modern manufacturing methods such as 3D scanning and printing are often presented as ready-to-use solutions for producing low-cost functional devices, with public perceptions being largely shaped by the superficial media representation and advertising. The promise is that modern socket manufacturing methods can improve patient satisfaction, decrease manufacturing times and reduce the workload in the clinic. However, the perception in the clinical community is that total conversion to digital methods in a clinical environment is not straightforward. Anecdotally, there is currently a disconnect between those developing technology to produce prosthetic devices and the actual needs of clinicians and people with limb difference. In this paper, we demonstrate strengths and drawbacks of a fully digitised, low-cost trans-radial diagnostic socket making process, informed by clinical principles. We present volunteer feedback on the digitally created sockets and provide expert commentary on the use of digital tools in upper-limb socket manufacturing. We show that it is possible to utilise 3D scanning and printing, but only if the process is informed by expert knowledge. We bring examples to demonstrate how and why the process may go wrong. Finally, we provide discussion on why progress in modernising the manufacturing of upper-limb sockets has been slow yet it is still too early to rule out digital methods.
现代上肢假肢接受腔的制作方法进展有限。今天在诊所使用的铸造技术类似于 50 多年前开发的技术,仍然严重依赖手工劳动。3D 扫描和打印等现代制造方法通常被视为生产低成本功能性设备的即用型解决方案,公众的看法在很大程度上受到表面媒体报道和广告的影响。承诺是,现代接受腔制造方法可以提高患者满意度、缩短制造时间并减少诊所的工作量。然而,临床社区的看法是,在临床环境中完全转换为数字方法并不简单。据传闻,目前开发假肢设备的技术与临床医生和肢体差异人士的实际需求之间存在脱节。在本文中,我们展示了一个完全数字化、低成本的跨桡骨诊断接受腔制造过程的优缺点,该过程由临床原则提供信息。我们介绍了志愿者对数字创建的接受腔的反馈意见,并就数字工具在上肢接受腔制造中的使用提供了专家意见。我们表明,使用 3D 扫描和打印是可行的,但前提是该过程得到专家知识的支持。我们展示了一些示例,说明流程可能出错的原因和方式。最后,我们讨论了为什么现代上肢接受腔制造的进展缓慢,但现在排除数字方法还为时过早。