Computer-aided design to support fabrication of wrist splints using 3D printing: A feasibility study

Introduction Issues contributing to poor patient compliance for splint wear include poor aesthetics, fit and performance. This paper describes a novel digitised splinting process using 3D printing in an attempt to overcome these issues. The output of the investigation was the creation of a specialised computer-aided design software workflow to support 3D printing, developed specifically for splinting practitioners in the UK, to enable them to design splints themselves for each individual patient. Method A small-scale feasibility study was done, based on the current splinting process. A thorough literature review and physical engagement in current splinting practice was performed, highlighting key requirements for successful splint fabrication. Key requirements were then replicated in a virtual software environment. Opportunities for integrating new, novel features were explored. The key requirements were then refined into a specialised software workflow to replicate the splinting process. The specialised software was then evaluated by 10 practitioners. User trials of the software were performed, followed by semi-structured interviews. Audio recordings were transcribed and then coded to establish similar trends of opinions, and areas for future research. No patients or vulnerable participants were involved in the study. Results All participants were able to use and navigate around the software prototype with relative ease. Strengths included potential simplicity in modelling more complex splints, but several areas for future research are identified, including cost analysis and materials development. Discussion The digitised splinting process shows promise for the benefit of both practitioners and their patients, provided that future research and investment can overcome current limitations.

[1]  Lucila Ohno-Machado,et al.  Medical Applications , 2020, Believing Your Ears: Examining Auditory Illusions.

[2]  Fred McBagonluri,et al.  Rapid Manufacturing in the Hearing Industry , 2006 .

[3]  Neil Hopkinson,et al.  Rapid manufacturing : an industrial revolution for the digital age , 2006 .

[4]  Richard J. Bibb,et al.  Rapid manufacture of custom‐fitting surgical guides , 2009 .

[5]  Abby Paterson,et al.  Evaluation of a digitised splinting approach with multi-material functionality using Additive Manufacturing Technologies , 2012 .

[6]  Abby Paterson Digitisation of the splinting process : exploration and evaluation of a computer aided design approach to support additive manufacture , 2013 .

[7]  Abby Paterson Evaluation of a Three-Dimensional Computer Aided Design Workflow for Upper Extremity Splint Design to Support Additive Manufacture , 2012 .

[8]  Philip Dickens,et al.  Implications on design of rapid manufacturing , 2003 .

[9]  Daniela Fischer Splinting The Hand And Upper Extremity Principles And Process , 2016 .

[10]  Kenneth Dalgarno Mass customisation of foot orthoses for rheumatoid arthritis , 2008 .

[11]  Splinting the hand and upper extremity : principles and process , 2003 .

[12]  J. Melvin Rheumatic disease: Occupational therapy and rehabilitation , 1982 .

[13]  E. Taal,et al.  Determinants of the use of wrist working splints in rheumatoid arthritis. , 2008, Arthritis and rheumatism.

[14]  R. I. Campbell Customer Input and Customisation , 2006 .

[15]  David J. Williams,et al.  Application of rapid manufacturing techniques in support of maxillofacial treatment: Evidence of the requirements of clinical applications , 2005 .

[16]  Richard J. Bibb,et al.  Rapid prototyping technologies in soft tissue facial prosthetics: current state of the art , 2010 .

[17]  Richard H. Crawford,et al.  Double-wall, Transtibial Prosthetic Socket Fabricated Using Selective Laser Sintering: A Case Study , 2000 .

[18]  Jeremy S. Lewis,et al.  A study to examine patient adherence to wearing 24-hour forearm thermoplastic splints after tendon repairs. , 2008, Journal of hand therapy : official journal of the American Society of Hand Therapists.

[19]  Richard J. Bibb Medical Modelling: The application of advanced design and development techniques in Medicine , 2006 .

[20]  J. Melvin Rheumatic Disease in the Adult and Child: Occupational Therapy and Rehabilitation , 1989 .

[21]  Kenneth W. Dalgarno,et al.  Mass Customization of Foot Orthoses for Rheumatoid Arthritis Using Selective Laser Sintering , 2010, IEEE Transactions on Biomedical Engineering.

[22]  Neri Oxman,et al.  Variable property rapid prototyping , 2011 .

[23]  E. Stern Wrist extensor orthoses: dexterity and grip strength across four styles. , 1991, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.