Introduction
Over the past two years, Spentys has enabled the production of 3D-printed hand and wrist splints at Tel Aviv Medical Center. The integration of 3D-printed splints has expanded their patient services and resulted in improved outcomes. As a result, they initiated a study to assess the feasibility and effectiveness of utilizing these 3D-printed hand splints for non-displaced fractures.
The Study
The study, conducted between January and February 2021, focused on adult patients with non-displaced wrist or hand fractures suitable for conservative treatment with cast immobilization. The researchers utilized a comprehensive workflow involving rapid 3D scanning and modeling software, along with a high-speed 3D printer, all within the hospital setting.
The primary objective was to evaluate the clinical feasibility of this innovative approach, taking into account the complexity and duration of the procedure. Secondary outcomes included patient-reported impressions and radiological results.
The 3D Printing Workflow
The workflow began with a detailed 3D scan of the injured limb, taken one week after the initial injury to allow for swelling to subside. This scan served as the foundation for creating a patient-specific cast. The 3D modeling process, once a complex task, has now become semi-automated using the Spentys software, streamlining the design of the cast. The completed model was saved as a stereolithography file, which could be used for printing.
The actual 3D printing process employed Digital Light Processing (DLP) technology, which involved the layer-by-layer polymerization of liquid resin exposed to light. The average printing time for a forearm cast was approximately 90 minutes. Post-processing was a crucial step to ensure the removal of any residual unpolymerized resin before fitting the cast to the patient's limb. This step involved cleaning with ethanol and exposure to ultraviolet light to ensure that all the resin was cured.
Results and Findings
Twenty patients (16 males, mean age 37 ± 13.1 years) participated in the study. The entire printing workflow took an average of 161 ± 8 minutes. All patients showed clinical improvement and fracture union at the final follow-up, with no incidents of pressure sores or loss of reduction. Patient-reported comfort and satisfaction rates were excellent, with minimal pain reported on the Visual Analog Scale. The Disabilities of the Arm, Shoulder, and Hand (DASH) score also indicated positive outcomes, with patients experiencing improved functionality.
Discussion and Limitations
The study demonstrated the efficiency and effectiveness of in-hospital production of patient-specific 3D-printed hand casts. The technology's lightweight, breathable, and washable design contributed to high patient satisfaction and comfort rates. However, the study had limitations, including a small sample size and a relatively short follow-up period. There were no control groups, and the study focused on non-displaced fractures. Further research is needed to validate these findings with larger sample sizes and different fracture characteristics.
Conclusion
The use of 3D printing technology to create personalized casts for non-displaced wrist and hand fractures has shown great promise. This innovative approach, as demonstrated in the Tel Aviv Medical Center study, offers efficiency, excellent clinical outcomes, and high patient satisfaction. With further research and refinement, 3D-printed casts could become a standard option for fracture treatment, revolutionizing the way we approach orthopedic care.
