3D-Printing and Upper-Limb Prosthetic Sockets: Promises and Pitfalls

Abstract

Modernising the way upper-limb prosthetic sockets are made has seen limited progress. The casting techniques that are employed in clinics today resemble those developed over 50 years ago and there is still a heavy reliance on manual labour. Modern manufacturing methods such as 3D scanning and printing are often presented as ready-to-use solutions for producing low-cost functional devices, with public perceptions being largely shaped by the superficial media representation and advertising. The promise is that modern socket manufacturing methods can improve patient satisfaction, decrease manufacturing times and reduce the workload in the clinic. However, the perception in the clinical community is that total conversion to digital methods in a clinical environment is not straightforward. Anecdotally, there is currently a disconnect between those developing technology to produce prosthetic devices and the actual needs of clinicians and people with limb difference. In this paper, we demonstrate strengths and drawbacks of a fully digitised, low-cost trans-radial diagnostic socket making process, informed by clinical principles. We present volunteer feedback on the digitally created sockets and provide expert commentary on the use of digital tools in upper-limb socket manufacturing. We show that it is possible to utilise 3D scanning and printing, but only if the process is informed by expert knowledge. We bring examples to demonstrate how and why the process may go wrong. Finally, we provide discussion on why progress in modernising the manufacturing of upper-limb sockets has been slow yet it is still too early to rule out digital methods.

The Impact of Limited Prosthetic Socket Documentation: A Researcher Perspective

“…Prosthetists mark bony prominences and important areas on the limb and then take a Plaster of Paris cast, capturing their markings and hand sculpting the cast as it dries. The negative cast is used to produce a positive plaster replica of the limb which is then rectified (a manual process where material is added and removed to refine the fit and comfort of the socket) (14,17). The socket, or a temporary diagnostic "check" socket, is then produced and the fit is confirmed by the prosthetist (17)(18)(19).…”

Study on Properties of Automatically Designed 3D-Printed Customized Prosthetic Sockets

“…The fabrication processes may vary slightly depending on the particular manufacturer and available tools. However, there is a list of steps necessary to produce the prosthesis in a conventional manner [13], as shown in Figure 1.…”

“…This part of the prosthesis must be perfectly adapted to the patient fabrication processes may vary slightly depending on the particular m available tools. However, there is a list of steps necessary to produce th conventional manner [13], as shown in Figure 1. The problem of accessibility of limb prostheses for children is even greater than in the case of adults.…”

“…The cost of production is lower, which improves the availability of prosthetic devices [13]; they can therefore be changed more often in fast-growing children.…”

Modeling and Simulation Process via Incremental Methods of a Production-Aimed Upper Limb Prosthesis

“…The 3D model orthoses are commonly used to complement therapy and for various purposes, not only for the upper limb but also for almost all body parts [14]. Three-dimensional printing is a low-cost method of producing sockets using clinical expertise to create well-fitting prosthetics [15]. An extensive range of prostheses has been 3D printed, of which the majority are upper limb prostheses, the majority designed for children [16].…”