The intricate structure of human hands requires personalized orthotic treatments, especially with the growing aging population’s demand for accessible care. While traditional orthoses are effective, they face challenges of cost, customization time, and accessibility. Additive manufacturing, particularly material extrusion (MEX) techniques, can effectively address challenges in orthotic device production by enabling automated, complex, and cost-effective solutions. This work aims to provide engineers with a comprehensive set of design considerations for developing hand orthoses using MEX technology, focusing on applying design for additive manufacturing principles, to enhance rehabilitation outcomes. This objective is achieved by establishing design requirements for hand orthoses, reviewing design choices and methodologies across conventional and state-of-the-art MEX-based devices, and proposing an innovative approach to orthotic design. Hand orthosis design requirements were gathered through workshops with occupational therapists and categorized into engineer-, medical-, and patient-specific needs. A review of 3D-printed hand orthoses using MEX analyzes various design approaches, providing insights into existing solutions. The study introduces a modular design concept aimed at improving rehabilitation by enhancing customizability and functionality. It highlights the potential of MEX for creating personalized, cost-effective orthoses and offers recommendations for future research, to optimize designs and improve patient outcomes.