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Distal radius fracture management Using 3D printed, in-house design, production, and implementation of wrist cast/orthosis for the treatment of distal radius fractures.

Storck, K.C.G. (2022) Distal radius fracture management Using 3D printed, in-house design, production, and implementation of wrist cast/orthosis for the treatment of distal radius fractures.

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Abstract:Introduction: Distal radius fractures (DRF) are traditionally treated with plaster casts, which have disadvantages. Up to 30% of plaster casting leads to complications. The 3D-printed cast could overcome these issues: they are lightweight, waterproof, open-latticed. Literature showed no consensus about the materials, printers, design, and implementation in the clinic for 3D-printed casts. The aim was to investigate the feasibility of 3D printed casts, the implementation of 3D casts for the treatment of distal radius fractures, and to characterize the magnitude of fracture displacement during static load in human cadaver models with Colles fractures. Methods: Multiple sub-studies were performed. Material tests were conducted to select the most suitable design and material. A workflow was designed to test feasibility and implementation in the clinic. A pilot study was conducted to assess three aspects of 3D casts treatment: the feasibility of the implementation of 3D-printed casts, the clinical outcomes, and patient experiences. A final step was the human model cadaver study, where a static load was placed on the casts to see if the cast could prevent secondary displacement of the DRF in a cadaver model. Results: The material tests showed PLA was the best material to print with Fused deposition modeling (FDM).ith a semi-automated design, printable casts were created. The casts could be printed within 24-48 hours. The pilot study showed it is feasible to treat a patient within 24 hours after admission to the ER. Three children with greenstick or buckle/torus fractures were successfully treated with 3D-printed casts. The treatment scored 9.0 out of 10.0. The human cadaver model study showed displacement in the models if a static load is placed on them. Conclusion: A lightweight, water-resistant, and ventilated cast can be designed and printed within 24-48 hours. The wrist casts ensure adequate immobilization, comfort and can be implemented for greenstick and buckle/torus fractures. The human cadaver model study showed displacement after applying static loads. However, this study ignores the compensation mechanism (muscle contraction and relaxation) of the lower arm. Therefore, more research is necessary. Also, research is needed to estimate swelling more accurately to make the cast fit perfectly. In the future, 3D-printed casts for other fractures (stable and unstable fractures in the lower and upper extremities), and 3D-printed orthosis/braces in the field of orthotics should also be explored.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:44 medicine
Programme:Technical Medicine MSc (60033)
Link to this item:https://purl.utwente.nl/essays/93870
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