Benefits and Challenges of 3D Printing in Pediatric O&P

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 Accessibility and Flexibility for Children

3D printing offers design freedoms that are not possible with conventional manufacturing methods, such as the ability to vary thickness in specific areas to achieve targeted flexibility and performance characteristics. Essentially, it allows design of an accurate, customized upper-limb device for each of our patients.

Next, printing a device nearly completely assembled reduces turnaround time from design and manufacture to patient fitting and application. This is especially important for our pediatric patients, who are growing and require multiple devices as they mature.

Finally, having a digital 3D model of what was fitted to the patient allows O&P practitioners to make precise changes to optimize fit exactly where it is needed or as the patient grows.

In short, 3D printing allows us to make a sophisticated device personalized to each of our patients.

Antonio Dias, director of engineering, Hanger Fabrication Network, Tempe, Arizona

 Bionic technology can do incredible things for a person—give them greater ability, greater independence, help them at home, help them at work. But it also gives them a new sense of self, to add something to their body confidence, add something to their image. And at the moment, only a few select super-privileged people get to experience that.

Open Bionics is here to change that. We want every single person who has an upper-limb difference to be able to have the choice to be able to have a multi-grip arm if they want one, and not be priced out.

Samantha Payne, COO and cofounder of Open Bionics, headquartered in Bristol, United Kingdom

Although cost is certainly a consideration, it's not the only one: When considering any type of prosthetic device, numerous factors should be considered, including patient goals, functionality, aesthetics, environment, access, and cost. Discussing affordability solely in terms of cost provides an incomplete picture; affordability must be discussed in the context of value, including positive outcomes.

Bryan Lott, CP, Hanger Clinic, Durango, Colorado

 You can give an adult a device and they're going to wear it until it doesn't function anymore—until it breaks or it's no longer useful. But with a child, you need to constantly be replacing these things—or trying to plan for growth or breakage. So there's not a lot of investment in advanced types of devices for children, because generally they're not getting them. With 3D printing, we're able to start exploring these things, and change that situation.

Eric Shoemaker, MS, CPO, regional director, Ability Prosthetics and Orthotics, headquartered in Exton, Pennsylvania

Aesthetics and Sizing

The ability to mirror a patient's sound side allows us to capture their own uniqueness and create an aesthetically pleasing, perfectly mirrored device that displays symmetry similar to that seen in nature.

—Dias

This is an improvement to using off-the shelf hands in pre-established sizes, especially for children who have a wide range of hand-size presentations. It also has a cool factor. It can be fun for kids to see their hands scanned on the screen, engaging them in the process, and hopefully contributing to successful prosthetic acceptance in the future.

—Lott

Technology Cost and Clinician Education

Like any technology the price of 3D printers is going to come down; they're going to make things better and cheaper. Over time we'll either start seeing these things in the local offices or maybe more local central printer hubs that can handle printer fabrication.

—Shoemaker

 There's a big educational gap between how fast 3D technology is moving forward, compared to the lack of knowledge and practice provided for in school O&P programs. We're trying to start providing input at schools and educational institutions in the United Kingdom. But we're still a really small company, so it's difficult for us to take on the challenges of upgrading the right curricular systems to include 3D scanning and 3D modeling, so that the clinicians have more tools.

—Payne

 Orthotic Application

We're already using a company that is printing 3D foot orthoses for us. InventMedical's website features a 3D-printed AFO, a 3D-printed cranial molding orthosis. They have a line of products getting ready to hit the market in the near future. They're already out there with their foot orthosis.

Shoemaker

I am very interested in 3D-printed orthotics for the pediatric field. I think 3D printing can provide a lot of benefits; as with prosthetics, the correct approach should be to experiment with this new tool, but it needs to be done with clinical input, and it needs to be done in a co-design methodology with the users.

—Payne

 Looking Forward

I think it's really important that we start investing more in the US—and that's our plan this year. The community wants way more development and they want to have a better entree to relationships with us, so we are going to invest an awful lot more in the US this year so that we can increase our accessibility.

—Payne

 Payne noted that Open Bionics has funding available for financially disadvantaged people to apply for a Hero Arm for free at openbionics.com/sign-up/https://openbionics.com/sign-up.