As medicine embraces 3D printing and technology at an accelerating speed, we should not forget the reality of the medical practice. The technology has numerous applications from education, surgical training, and preoperative planning to 3D-printed orthoses. By now, multiple studies show that these are effective and have high patient satisfaction rate.
But how do they fit in the context of a busy hospital? Is it even feasible for a hospital to print casts and similar devices?
Last year, we did a study in collaboration with Tel Aviv Medical Center focused on 3D-printed casts for non-displaced wrist and hand fractures. The study showed that point-of-care 3D printing for orthotics is not only feasible but is also efficient. It also confirmed that this approach brings great benefits for medical staff and their patients.
The study consisted of patients admitted to the emergency department due to wrist or hand fractures in January and February 2021. The researchers selected adults with non-displaced fractures suitable for conservative treatment with cast immobilization. These patients first received the standard treatment with either a short arm or thumb spica plaster of Paris cast, depending on their case. After a week, the researchers replaced their standard cast with a 3D-printed orthosis made in the hospital’s orthopedic clinic.
All the patients in the study recovered successfully. Moreover, the study examined the clinical feasibility of patient-specific 3D-printed hand casts, produced in-hospital. Specifically in terms of complexity and length of the procedure.
The conclusion was simple and straightforward: point-of-care production was feasible and efficient in this case.
You can access the full published paper for more details on how we conducted the study.
The primary reason for such a positive experience is the workflow that 3D-printed devices require.
In our study, the 3D printing workflow consisted of four steps, a standard in the industry. They are scanning, 3D modelling, 3D printing, and post-processing and fitting.
Orthopedic surgeon scans hand or wrists using a tablet and Spentys software. The whole process takes about 30 seconds. The result is an accurate and precise scan. When needed, the surgeon can adjust the scan afterwards.
Here is where the magic happens. The conventional procedure is complex and time-consuming. However, Spentys does most of the heavy work by automatically suggesting a model to start from. The surgeon can then modify or add to the model as needed. For example, the surgeon can manually determine the thickness of the cast, add belt hooks, adjust the model’s size, etc.
When the surgeon is satisfied with the model, the model is saved in a digital file and ready for printing.
The medical engineer takes over from here, uploading the digital file of the model to the printer. Once that is done, the printing starts, and we see the orthoses forming. On average, the printing time of a forearm cast in our Tel Aviv study was approximately 90 minutes.
Moreover, it is possible to print multiple casts simultaneously without extending the production time. In the study, the hospital printed two casts at once.
Despite technological development, some post-processing is always necessary, mainly to remove any residual resin before fitting the cast to the patient.
After ensuring everything is clean, the cast is ready to go directly on the skin, with or without a stockinet underneath, according to the patient’s preference.
Thanks to very precise measuring and production, there is a high chance the cast will fit the first time. In the study, we experienced no significant issues with fitting.
The 3D printing production is fairly simple and effective. When using software like Spentys, this becomes even easier. Over the years, we developed our solution to do the most delicate steps automatically, without requiring the surgeon and other medical staff to gain high-level of technological knowledge. Instead, they can focus on their expertise.
One of the biggest benefits of the 3D printing workflow is the time it saves.
In this study, the entire printing workflow, from scanning to finished medical devices, took between 146 and 182 minutes. We are working with our partners to reduce this lead time even more. One such way is with our new template automated 3D modeling tool Autoforma. Based on recent testing performed in other hospitals, we have been able to reduce the scanning, the correction of the scan and the modelling time to an average of 4 minutes, which use to take about 20 minutes.
If you want to dive deeper into comparing a traditional and 3D printed manufacturing process, check out this blog post.
This study confirmed what other studies have also shown in terms of clinical benefits. That is, the patients using 3D printed orthoses can fully recover from their injuries. Concretely in this study, we found 3D-printed casts efficient, with excellent clinical and radiographic results.
The patients were highly satisfied too. All of them reported the casts being comfortable, lightweight, breathable, and washable. The casts did not prevent them in daily activities and were overall easy to use.
Again, this was no surprise to us. We know from experience that a completely customized and tailored-to-patients orthosis will fit their needs better and make their experience of wearing one more pleasant.
In other words, investing in 3D manufacturing benefits both the hospital’s medical staff and patients.
It is not hard to see why hospitals embrace 3D technology, including printing orthopedic devices. As our study at the Tel Aviv Medical Center shows, it is feasible and efficient, and gives patients a more comfortable experience.
3D printing also helps orthopedic technicians, reducing their workload and helping them save on costs. Here’s a short overview of that.
Need somebody to discuss the possibilities and feasibility of 3D printing in your hospital?
Factor, S., Atlan, F., Pritsch, T., Rumack, N., Golden, E., & Dadia, S. (2022). In-hospital production of 3D-printed casts for non-displaced wrist and hand fractures. SICOT-J, 8, 20. https://doi.org/10.1051/sicotj/2022021
Graham, J., Wang, M., Frizzell, K., Watkins, C., Beredjiklian, P., & Rivlin, M. (2018). Conventional vs 3-Dimensional Printed Cast Wear Comfort. HAND, 15(3), 388–392. https://doi.org/10.1177/1558944718795291
Oud, T. A. M., Lazzari, E., Gijsbers, H. J. H., Gobbo, M., Nollet, F., & Brehm, M. A. (2021). Effectiveness of 3D-printed orthoses for traumatic and chronic hand conditions: A scoping review. PLOS ONE, 16(11), e0260271. https://doi.org/10.1371/journal.pone.0260271
Saunders, S. (2022, January 31). 2022 Predictions: Medical 3D Printing Is Disrupting Healthcare. 3DPrint.com | the Voice of 3D Printing / Additive Manufacturing. https://3dprint.com/287679/2022-predictions-medical-3d-printing-is-disrupting-healthcare/