Clinical Assessment of Customized 3D-Printed Wrist Orthoses

Abstract

Plaster casting has been effective in fracture rehabilitation due to its immobility capability. Thermoplastic casting gains some efficiency and convenience from clinical processing but fitting and immobility are two major tradeoffs. Three-dimensional (3D)-printed braces have demonstrated improvements in innovation, customization, and appearance, but one may question their effectiveness in rehabilitation. Via a science-based data-centric approach, we evaluated the feasibility of customizing 3D-printed braces for wrist fractures after surgery. First, we established a framework for determining a proper timeframe for reliable pressure measurement for plaster casts, devised a method to evaluate the immobilization capability of the plaster casts and customized braces, and assessed changes in immobilization capability due to the clearance adjustment of customized braces. Second, we compared the customized wrist braces and plaster casts in immobilization capability and functional effectiveness in clinical trials. Thirty-three patients were recruited (9, control; 24, experimental). Both the Disability of Arm, Shoulder, and Head, and the Manual Ability Measure surveys showed significant differences between the control and experimental groups after brace wearing time frames of 2, 4, 8, and 12 weeks, and 6 and 12 months. We found that customized braces can match plaster casts in immobilization ability and can promote effective functional recovery.