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Published on: February 12, 2018
Functional Assessment of 3D Printed Prosthesis in Children with Congenital Hand Differences-A Prospective
Anil K Bhat1, Vamsikrishna M1, Ashwath M Acharya1
1Division of Hand and Microsurgery, Department of Orthopaedics, Kasturba Medical College Hospital, Manipal University, Manipal, India.
Insights
3D printed prostheses offer a cost-effective solution for children with congenital hand amputations, improving grasping activities. While enhancing gross dexterity, current designs need refinement for improved pinch functionality.
Area of Science:
- Biomedical Engineering
- Pediatric Orthopedics
- Rehabilitation Technology
Background:
- Children with congenital limb differences require specialized prostheses addressing growth and psychosocial needs.
- Traditional prostheses are costly and may not meet functional demands for children.
- 3D printing presents a novel, affordable alternative for pediatric prosthetics.
Purpose of the Study:
- To evaluate the functional utility of 3D printed prostheses in children with congenital hand amputations.
- To assess the impact of 3D printed prostheses on dexterity and daily activities in a South Asian population.
Main Methods:
- Prospective observational study involving fourteen children with congenital hand amputations.
- Assessment using the Unilateral Below Elbow test (UBET), Box and Block test, and ABILHAND questionnaire.
- Evaluation conducted with and without the 3D printed prosthesis after a six-month follow-up period.
Main Results:
- The Box and Block test showed a significant improvement in gross manual dexterity (p=0.049).
- UBET (p=0.002) and ABILHAND (p<0.001) scores decreased, indicating limitations in lateral and tripod pinch.
- Patients with below-elbow prostheses demonstrated better performance.
Conclusions:
- 3D printed prostheses are a valuable, inexpensive transitional option for children with limb deficiencies.
- These prostheses improve grasping capabilities for wrist and elbow level amputations.
- Customizability and replaceability make 3D printed options ideal for growing children, though design improvements for pinch are needed.
Abstract:
Background: Children with congenital differences who require prosthesis, have special needs due to their growth and psychosocial factors. Cosmetic or body-powered prosthesis provides basic functional needs but poses a financial burden on the family. Prostheses with advanced functions need to be deferred until adulthood. 3D printed prosthesis is a novel alternative being cost-effective for children. Since limited literature is available on the functionality of 3D printed prosthesis and none in the South Asian population, this study was done to assess its utility in congenital hand amputations. Methods: Fourteen children with congenital hand amputations were selected for a prospective observational study. Unilateral below Elbow test (UBET), Box and Block test and ABILHAND questionnaire were used for assessment with and without prosthesis after six months. Results: Eleven patients completed the follow-up. Box and Block test improved from a mean score of 24 to 35 with the prosthesis implying an improvement in manual gross dexterity (p -0.049). UBET (p -0.002) and ABILHAND questionnaire (p < 0.001) showed a decrease in score with the use of a prosthesis which suggested a lack of lateral and tripod pinch in the current design of a prosthesis. Patients with below elbow prosthesis performed better. Conclusions: 3D printed prostheses are an excellent option for use as a transitional prosthesis as they are inexpensive, serves to improve needs with respect to grasping activities at both wrist and elbow level amputation and customizable according to patients' need and limb deficiency and replaceable as the child grows with age. Current designs are useful with respect to grasping activities.
