Ranaldo Davide, Zonta Filippo, Florian Simone, Lazzaro Jacopo
Private Hospital Villa Maria Padua, Italy.
Playcast Padua, Italy.
J Clin Orthop Trauma. 2023 Jun 24;42:102206. doi: 10.1016/j.jcot.2023.102206. eCollection 2023 Jul.
Closed fractures of distal radius and ulna are one of the most common skeletal injuries, occurring at all ages. Temporary arm immobilization through cast is part of the standard treatments. However, traditional casting procedures are time consuming, operator's skill dependent and do not always guarantee a satisfactory outcome. From a clinical perspective, casts are often considered uncomfortable and can be associated to skin lesions. To overcome these limitations, the recent growth of 3D technologies has enabled new standardized casting procedures: additive manufacturing (AM) is a technique that creates highly customized cast models from anatomical 3D data by using digitally controlled and operated material laying tools. Compared with conventional casts, those produced with AM technique could potentially reduce skin complications and satisfy both mechanical and clinical requirements of functionality, comfort, and aesthetics. The objective of this study is to describe the new practical methodology to produce a 3D printable cast for upper arm immobilization. The parametric modelling tool, employed to develop a semi-automatic design system for generating the printable cast model, reduces the complex process of orthosis design to a few minutes and all the manufacturing operations remain unaffected by CAD skills of the operator. Specific hardware and software tools (3D scanner, modelling software and FDM technology) were chosen to mitigate design and production costs while guaranteeing suitable levels of data accuracy, process efficiency and design versatility. To highlight the effectiveness of the proposed solution, a finite element analysis simulation was performed on models with different geometry, highlighting the mechanical strength of generated structures. The final result is a personalized 3D printed cast with a highly ventilated structure that is lightweight but still maintains a high level of strength and provides hygienic benefits, reducing the risk of cutaneous complications, potentially improving treatment efficacy and increasing patient satisfaction.
桡骨远端和尺骨闭合性骨折是最常见的骨骼损伤之一，各年龄段均可发生。通过石膏进行临时手臂固定是标准治疗方法的一部分。然而，传统的石膏固定程序耗时，依赖操作者的技能，且并不总是能保证令人满意的结果。从临床角度来看，石膏通常被认为不舒服，并且可能与皮肤损伤有关。为了克服这些局限性，3D技术的最新发展催生了新的标准化石膏固定程序：增材制造（AM）是一种通过使用数控和操作的材料铺设工具，从解剖学3D数据创建高度定制的石膏模型的技术。与传统石膏相比，采用增材制造技术生产的石膏可能会减少皮肤并发症，并满足功能、舒适度和美观性方面的机械和临床要求。本研究的目的是描述一种用于生产上臂固定用3D可打印石膏的新实用方法。用于开发生成可打印石膏模型的半自动设计系统的参数化建模工具，将矫形器设计的复杂过程缩短至几分钟，并且所有制造操作不受操作者CAD技能的影响。选择了特定的硬件和软件工具（3D扫描仪、建模软件和熔融沉积成型技术）来降低设计和生产成本，同时保证适当的数据准确性、过程效率和设计通用性水平。为了突出所提出解决方案的有效性，对具有不同几何形状的模型进行了有限元分析模拟，突出了所生成结构的机械强度。最终结果是一个具有高度通风结构的个性化3D打印石膏，它重量轻但仍保持高水平的强度，并具有卫生优势，降低了皮肤并发症的风险，有可能提高治疗效果并提高患者满意度。
