Tag Archives: 3D Printing

Device

Fracture Care Of The Future: Traditional Casts vs 3D-Printed Braces

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I’ve been fascinated by 3D printing for at least a decade.  Here are some examples from previous posts:

Unfortunately, practical applications have been relatively limited in the field of trauma.  But a lot has been going on in the background. The trauma research group at Erasmus Medical Center in Rotterdam recently published a systematic review on very practical work using 3D printing to produce casts and splints.

Sounds like a very mundane problem to through high tech at, right? But for those of you who look after patients with fractures that have been casted, you know the problems that can arise. Casts can be too tight. They can be ill-fitting. The patient may have soft tissue injuries that require windows cut into the side of the cast. Additional technology such as electrical stimulators may be indicated to enhance healing.

The old-fashioned way of creating a plaster or fiberglass cast seems crude. It is shaped by hand using skill and a fair amount of guesswork. If it’s just a bit too tight, serious complications may occur. If windows are not cut properly, it can destabilize the entire cast.

The Rotterdam trauma research group performed a systematic review of 12 papers that have been published on the topic of 3D-printed casts used in the treatment of forearm fractures. The authors found that most currently use a technique called fused deposition modeling with a polylactic acid substrate.

Instead of relying on subjective skill and luck to shape the brace, the uninjured forearm is scanned with a 3D scanner. The data is fed to a computer aided design (CAD) workstation and a mirror image is created and further refined. Special features such as soft tissue windows or entry points for bone stimulators can be designed into the brace at that time. Because the strength of polycarbonate exceeds that of plaster and fiberglass, it is possible to create a design with a great deal of open area so the underlying skin can be monitored. And allowances can be made for areas with swelling not present on the control extremity.

The data is then fed to a 3D printer to actually create the cast. Here’s an example:

This design is stronger that a traditional cast, is cool and comfortable, and avoids problems with hidden tissue injury or unrecognized foreign objects dropping into the cast creating major problems.

The use of 3D-printed casts and braces is relatively new and is used in only a few centers. For this reason, we do not have enough numbers to show that it is equivalent to traditional casting. Yet. But as the price continues to drop and use becomes more widespread, it’s only a matter of time before you start seeing these items in your own trauma center.

Reference: Personalize d 3D-printed forearm braces as an alternative for a traditional plaster cast or splint; A systematic review. Injury, in press, July 29, 2022. https://doi.org/10.1016/j.injury.2022.07.020

Technology

The Newest Flavor Of 3D Printing

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I’m fascinated with 3D printing, and have written a number of posts on the topic. There are numerous applications in medicine, and particularly in trauma care. We are currently able to print substitutes for bone, cartilage (trachea), bladder, skin, and more. To date, all of these use the same 2D technology found in ink-jet printers. But instead of 2D splashes of ink, three dimensional bits of plastic or metal are stacked on top of each other one layer at a time and fused by a laser.

UC Berkeley and Lawrence Livermore National Laboratory have developed a new 3D printing technology that coalesces an entire object at once using 3D information projected by shining light fro a standard LED projector into a column containing a special resin. The device has been renamed the “replicator” since it functions like the device seen in various Star Trek series. Here’s a brief video:

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Bottom line: This is new technology, so it’s still a bit glitchy. The surface definition is lower than conventional 3D printing, which will limit its usefulness in some medical applications. And currently, the size limit is only four inches. But it will allow printing over existing objects, which may give it some real advantages. I’m sure there’s more to come with this promising new technology.

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Technology

The Next Generation 3D Bioprinter For Skin

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3D printing for medical purposes (bioprinting) continues to evolve, and I’ve written a number of posts on this topic over the past 7 years. Skin bioprinting has been around for some time, but it keeps getting more and more sophisticated. Now, appropriate cell lines for the “ink” tanks can be grown in just a few days, and laid down in layers that are getting closer to real skin.

Take a look at this video to see the state of the art:

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The next step: adding hair, being able to print large sheets, and ultimately printing directly onto the body!

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New technology

The Ultimate 3D Bioprinter?

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3D printing is becoming a big deal when it comes to replacement parts for people. Substantial advances have been made over the past 5 years, and a new printer under development from a company called Aether looks more advanced than most others in the field.

Most printers have a relatively limited number of biomaterials (”inks”) that they can print at one time, and many of the actual materials are proprietary. They tend to be very expensive, sometimes $200,000 or more.

Aether has developed what I would call a great “pilot” printer to demonstrate that this can be done better and more cheaply. The printer in the 8 minute video is printing two pieces of bone connected with a tendon. In this case, the printer uses 6 “inks” including graphene for bones and stem cells to seed them as well as the tendon. The printer can actually print a mix of organic and organic “inks” with up to 10 syringes (”cartridges”). And in this case, it actually embeds two transistors and wires in the product. Printing bionic parts? And the final cost of this printer is projected to be under $10,000.

A number of other companies are out there competing in this market. They are providing tissue samples and skin for drug testing and research. So expect technology to advance and prices to fall as these printers become more sophisticated and more clinically useful.

Website: http://www.aether1.com/

I have no financial interest in Aether.

(Source: https://www.youtube.com/)
General

New Technology: 3-D Printed Casts For Fractures

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I’ve written quite a lot about the promise of medical applications for 3-D printers. Here’s another one for use by trauma professionals.

Look at the good, old-fashioned plaster cast. It’s been around for decades, and serves its purpose well. It’s easy to apply, inexpensive, and reasonably durable.

Then, along came fiberglass. It’s lighter, more durable, and a bit more water-resistant. And not a whole lot more expensive.

But both of these items have drawbacks. They are heavy. It’s best not to get them wet. Their application is very operator dependent. And probably most importantly, they are opaque. This masks any wounds or skin conditions under it for an extended period of time.

Deniz Karasahin, a Turkish student, won a design award for the development of a 3-D printed cast. It used the appearance of cancellous bone as a model, and is aesthetically very cool. A body scanner is used to scan the affected extremity so that the cast can be customized to the patient. The actual cast is printed from plastic, and can be rendered in a variety of colors. It is hinged, and locks together with a simple pin mechanism.

Bottom line: This is an interesting development in 3-D printing. However, it is not for everybody. Cheap plaster and fiberglass casts are very suitable for many patients. But for some, having the ability to inspect the underlying skin or deal with wounds will make this item much more desirable. And keep in mind, this product was developed for aesthetics. The holes can be much larger and still maintain strength and rigidity. So the cast of the future could be mostly holes, making it very light and shower compatible. Many people might be willing to pay a little more for this convenience.

Note: Ignore the LIPUS ultrasound units that can be incorporated into the one in the article. This is still unproven technology and I don’t recommend it.

Reference / photo credit: A’Design Award Competition