IOA 2022

3D–Printed Patient-specific Casts for the Treatment of Non-Displaced Wrist and Hand Fractures: A Pilot Study

Shai Factor 1,2 Eran Golden 1 Netta Rumack 1 Franck Atlan 2 Tamir Pritsch 2 Solomon Dadia 1
1Surgical 3D Printing Innovation Center, Tel Aviv Medical Center, Israel
2Hand Surgery Unit, Department of Orthopedic Surgery, Tel Aviv Medical Center, Israel

Purpose:
3D–printed orthopaedic casts are personalized and have been shown to improve patient’s comfort and satisfaction. The aim of this study was to examine the clinical feasibility of workflow for in-hospital production of patient-specific 3D-printed casts for the treatment of non-displaced wrist and hand fractures.

Methods:
A prospective study was conducted for patients who admitted to the emergency room (ER) due to wrist or hand fractures, between January and February 2021. Inclusion criteria were adult patients with non-displaced wrist or hand fractures. One week after ER visit, patients underwent conversion of the standard cast into a 3D-printed cast. Follow-up examinations were performed about the second, sixth and twelve weeks after the application of the 3D–printed cast. The primary objective was to examine the clinical feasibility of in-hospital production of patient-specific 3D-printed hand casts in terms of complexity and length of the overall procedure. Secondary outcomes were patient reported outcome as well as radiological results.

Results:
Twenty patients (80% males) were included with a mean age of 37 (SD 13.1). The mean time of the entire printing workflow was 161 minutes (SD 8.5). At follow-up, 3 months after the injury, all patients demonstrated excellent clinical improvement and fracture union. No loss of reduction was found in all participating patients. Pressure sores were not present in any patients. Patient comfort and satisfaction rate were excellent. The mean VAS was 0.9 (SD 1.1) and 0.6 (SD 1) and the mean DASH scores was 18.7 (SD 9.5) and 7.6 (SD 7.6) at 2 and 6 weeks after application of the 3D-printed cast, respectively.

Conclusion:
The workflow for in-hospital production of 3D-printed casts was found to be feasible and efficient with excellent clinical and radiographical results as well as high patient satisfaction. Our medical center now performs this treatment routinely.