Orfit Industries America, Leonia, NJ, USA; Touro University, Yeshiva University, USA.
Midwestern University, Glendale, AZ, USA.
J Hand Ther. 2023 Jan-Mar;36(1):166-178. doi: 10.1016/j.jht.2021.10.005. Epub 2021 Nov 21.
Systematic Review INTRODUCTION: 3D printed orthoses are emerging as a possible option in the field of hand therapy to fabricate conventional casts and orthoses. It is unknown how this technology is currently being used to treat upper extremity musculoskeletal conditions, and if 3D orthoses are comparable to custom- made low temperature thermoplastic orthoses fabricated by hand therapists.
The primary aim of this review was to investigate the utilization, effectiveness and feasibility of 3D printed technology to manufacture custom orthoses for musculoskeletal conditions of the upper extremity.
Studies describing 3D printed orthoses or casts used in treatment with patients were included following a comprehensive literature search using CINAHL, PubMed, Medline, ProQuest, and EBSCO databases. The selected studies had to address musculoskeletal conditions of the elbow, wrist, hand and/or digits that would typically be immobilized with a cast or brace or orthotic or orthosis.
Ten studies met the inclusion criteria. Study designs included case studies, case series, and 1 randomized clinical trial. 3D printed orthoses/casts appear to be comfortable, provide adequate immobilization, and have pleasing aesthetics. However, expensive equipment, lack of appropriate software and scanning tools and lack of highly skilled clinicians are all factors preventing the implementation of 3D printed orthoses into current clinical practice.
3D printed orthoses appear to be effective at immobilization of a limb, aesthetically pleasing, and utilize lightweight and well -ventilated materials. However, the feasibility of implementing 3D printing technology in hand therapy settings remains challenging in part due to the resources required.
While 3D printing shows promise, the high cost of equipment, lack of training and skill of clinicians and the long time required for production are all factors that need to be improved to make 3D printing a viable option in the hand therapy setting.
系统评价
3D 打印矫形器作为手部治疗领域中制造传统石膏和矫形器的一种可能选择正在出现。目前尚不清楚该技术如何用于治疗上肢肌肉骨骼疾病，以及 3D 矫形器是否与手部治疗师手工制作的定制低温热塑矫形器相当。
本次综述的主要目的是研究 3D 打印技术制造用于治疗上肢肌肉骨骼疾病的定制矫形器的使用、效果和可行性。
通过全面检索 CINAHL、PubMed、Medline、ProQuest 和 EBSCO 数据库，纳入描述用于治疗患者的 3D 打印矫形器或石膏的研究。所选研究必须针对肘部、腕部、手部和/或手指的肌肉骨骼疾病，这些疾病通常需要用石膏、支具或矫形器固定。
符合纳入标准的研究有 10 项。研究设计包括病例研究、病例系列研究和 1 项随机临床试验。3D 打印矫形器/石膏似乎舒适、提供充分的固定，并具有令人满意的美学效果。然而，昂贵的设备、缺乏合适的软件和扫描工具以及缺乏高技能的临床医生，都是阻碍 3D 打印矫形器应用于临床实践的因素。
3D 打印矫形器在肢体固定方面似乎是有效的，具有美观的外观，并使用轻巧、通风良好的材料。然而，在手部治疗环境中实施 3D 打印技术的可行性仍然具有挑战性，部分原因是所需的资源。
虽然 3D 打印具有广阔的前景，但设备成本高、缺乏培训和临床医生的技能以及生产所需的时间长等因素都需要改进，以使 3D 打印成为手部治疗中的可行选择。
