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J Wrist Surg 2024; 13(05): 390-397
DOI: 10.1055/s-0044-1779053
Special Review: Custom 3D-sprint for the wrist

Developing 3D-Printed Wrist Splints for Distal Radius and Scaphoid Fractures

Bernadette Tobler-Ammann 
1   Department of Orthopaedic, Plastic and Hand Surgery, Inselspital Bern, University of Bern, Bern, Switzerland
,
Frédéric Schuind
2   Department of Orthopaedics and Surgery, Université Libre de Bruxelles, Brussels, Belgium
3   Swibrace Ltd, Fribourg, Switzerland
,
Loïc Voillat
3   Swibrace Ltd, Fribourg, Switzerland
,
Théophile Gentilhomme 
4   R&D Department, Idiap Research Institute, Martigny, Switzerland
,
Esther Vögelin 
1   Department of Orthopaedic, Plastic and Hand Surgery, Inselspital Bern, University of Bern, Bern, Switzerland
,
Noé Murith
6   Department of Mechanical Engineering, HES-SO University of Applied Sciences, Fribourg, Switzerland
,
Bernard Masserey 
6   Department of Mechanical Engineering, HES-SO University of Applied Sciences, Fribourg, Switzerland
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Abstract

Background The purpose of this study is to optimize conservative treatment of distal radius and scaphoid fracture, in terms of comfort, fracture stabilization, and prevention of cast complications.

Description of Technique Advances in additive manufacturing have allowed the development of patient-specific anatomical braces (PSABs) which have the potential to fulfill this purpose. Our specific aims were to develop a model of PSAB, adapted to fracture care, to evaluate if this brace would be well tolerated by healthy volunteers and to determine its mechanical properties as compared with conventional methods of wrist immobilization.

Materials and Methods Several three-dimensional-printed splint prototypes were designed by mechanical engineers based on surgeons' and hand therapists' clinical expertise. These experimental braces underwent testing in a preclinical study involving 10 healthy volunteers, assessing comfort, satisfaction, and activities. The final prototype was mechanically compared with a conventional cast and a prefabricated splint, testing different closing systems. A mathematical algorithm was created to automatically adapt the final PSAB model to the patient's anatomy.

Results The final prototype achieved an overall satisfaction score of 79%, weighing less than 90 g, made from polyamide, and fixed using hook and loop straps. The PSAB stiffness varied between 0.64 and 0.99 Nm/degree, surpassing the performance of both conventional plaster casts and prefabricated splints.

Conclusion The final wrist PSAB model, adapted for fracture treatment, is lightweight, comfortable, and provides anatomical contention. It is currently being tested for the treatment of stable distal radius and scaphoid fractures in comparison to conventional plaster cast.

Keywords

3D printing - additive manufacturing - patient-specific anatomical brace - distal radius fracture - scaphoid fracture

Statement of the Location Where the Work Was Performed

The idea to design a patient-specific anatomic brace (PSAB) originates from Swibrace Ltd, 2 route de la Fonderie, CH-1700 Fribourg, Switzerland, as well as the organization of the project and foundation of the research consortium who collaborated in this project.


The mechanical testing of the PSAB was performed at the Department of Mechanical Engineering, HES-SO University of Applied Sciences, Fribourg, Switzerland.


The mathematical algorithm for the automatic adaptation of the final PSAB model to the patients' anatomy from the scanned limb geometry was developed at the R&D Department, Idiap Research Institute, Switzerland.


The development of the ARSEQ, the preclinical testing of the different 3D prototypes, and recruitment of volunteers were conducted at the Hand Therapy Research Unit, Inselspital Bern, University of Bern, Switzerland.


Supplementary Material



Publikationsverlauf

Eingereicht: 18. Oktober 2023

Angenommen: 27. Dezember 2023

Artikel online veröffentlicht:
02. Februar 2024

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