Article
3D print orthesis for mallet finger. Digitalisation for digits: A pilot study
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Published: | February 6, 2020 |
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Outline
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Objectives/Interrogation: In this study, we introduce an innovative and new approach to the production of 3D printed orthesis in hand surgery on the example of a mini orthesis for mallet finger.
Frequent problems in the therapy of mallet fingers are prefabricated finger ortheses, that lead to insufficiant results. Since individualized thermoplastic orthesis are not available in every setting, a new approach is software assisted planning of individualized orthesis and 3D printing. We have developed a new design for a DIP orthesis and present a pilot study.
Methods: We treated 10 patients with fresh or old (<6 months) extensor tendon rupture (Zone 1) or after failed treatment in a prefabricated orthesis. Patients received a preliminary thermoplastic orthesis, that was individually fitted with the aim of a mild overextension in the DIP joint (-10°). A hand laser scan was performed of the affected digits. 3D mesh-software customization of the orthesis was performed according to the fingerscan and 3D printing with PA12 executed. A thermoplastic orthesis was kept by the patient as a backup. After 8 weeks and 12 weeks, ROM was measured and patient feedback for haptic, comfort and restrictions of daily use was inquired.
Results and Conclusions: After 8 weeks, all patients in the ongoing study reached an extension deficit of 0° to 10°. The haptic experience was graded 8,5 (1-10), comfort was graded 7(1-10). 3 patients complained of pressure problems which required the printing of new modified orthesis. In total patients wore 70% of the time the 3D print orthesis, but changed back to the thermoplastic orthesis for 30%. All patients would undergo the treatment with the 3D orthesis again.
Patents with prior treatment with a confection orthesis graded the 3D orthesis as very superior to the prefabricated orthesis. When directly compared to the thermoplastic orthesis, patients rated the experience comparable.
We demonstrate the therapeutic ability of individualized 3D printed orthesis for Zone 1 extensor tendon injuries. Advantages are comfort, haptic experience, waterproofness and long-term stability of the orthesis. Treatment goals were achieved, even after unsuccessful treatment as a second line therapy. Patients reflected a comparable rating and feedback as thermoplastic orthesis from our specialized hand therapists. Therefor 3D printing could offer an individualized treatment, even if - as in many hospitals or practices -there is no specialized occupational therapy with a broad orthesis experience.