A digital workflow for design and fabrication of bespoke orthoses using 3D scanning and 3D printing, a patient-based...

This study demonstrates the development and application of a novel workflow for designing and fabricating orthoses, using a combination of 3D scanning and 3D printing technologies. The workflow is applied to a clinically relevant translational case study in a patient with a neurological disorder and complex clinical needs. All traditional and commercial approaches to helping the patient's cervical instability and resulting 'head-drop' had previously failed, with associated progressive deterioration in the patient's clinical state and posture. The workflow was developed to design and fabricate a bespoke device for this patient with no viable alternative therapy. The workflow was developed to generate 3D printable geometry from obtained 3D scan data. The workflow includes algorithms to relax geometry, distribute material efficiently and for variational cutting of orthosis padding material. The 3D patient scan was validated against actual measurements to ensure accuracy of measurements. A total of four prototypes were produced with each iteration being improved based on patient and clinical feedback. There was a progressive improvement in subjective feedback through each iteration at sites of discomfort and overall comfort score. There was a marked improvement in the patient's posture with correction at the cervical and lumbar spine with the 3D-printed padded collar being worn for 4 hour periods. This study has implications for the rapid production of personalised orthoses which can help reduce patient waiting time, improve patient compliance, reduce pain and reduce further deterioration. The workflow could form the basis for an integrated process, whereby a single hospital visit results in a bespoke orthosis optimised and personalised for each patient.