Abstract

BackgroundThe delay between amputation and prosthesis fitting contributes to the high rate of prosthetic abandonment despite advances in technology. Three-dimensional (3D) printing has allowed for the rapid fabrication of prostheses. Allowing individuals with amputations to interact with a prosthesis shortly after their procedure may reduce rejection chances. The purpose of the current investigation is to compare functional outcomes and patient satisfaction between a standard transradial prosthesis fitted in a clinic with a 3D-printed prosthesis fitted remotely. The standard prosthesis featured a hook terminal device, while the 3D printed prosthesis’ terminal device was a functional hand.ResultsThe main finding of this case study was that the use of a 3D printed arm prosthesis fitted remotely resulted in better functional performance, but lower overall patient satisfaction than the standard arm prosthesis. Use of the 3D printed arm resulted in improved gross manual dexterity as measured by the Box and Block test. The 3D printed prosthesis also allowed improved performance in bimanual coordination. However, the standard-hook device scored higher in patient satisfaction survey results. The patient's concerns with the 3D printed prosthesis were the durability and effectiveness of the device.ConclusionWhile durability and complex grip patterns remain a concern, the positive attributes of 3D printed prostheses include visual appeal, ease of donning, and customization of parameters to improve upper-limb symmetry offers a promising option to familiarize new amputee patients with the use of a prosthesis. Rapid manufacturing and remote fitting allows 3D printed devices to serve as postoperative transitional devices and may function as definitive devices with minimal loss of functionality if standard clinic-based prostheses are not available.MethodsThe patient was a 59-year-old male with a traumatic transradial amputation of the dominant arm. A 3D printed transradial prosthesis was remotely fitted and manufactured using photogrammetry. Assessments were performed initially with the standard-hook prosthesis and then with the 3D printed device after a 5-week familiarization period. Functional outcomes were evaluated using the Box and Block Test and Bimanual Coordination Tray Test. Patient satisfaction was evaluated using two self-reported questionnaires (the QUEST 2.0 and the modified OPUS).

Highlights

  • The delay between amputation and prosthesis fitting contributes to the high rate of prosthetic abandonment despite advances in technology

  • The Orthotics Prosthetics Users Survey (OPUS) satisfaction and functional items for the standard and Three dimensional (3D) printed arm prostheses are summarized in Tables 3 and 4

  • For activities that require high dexterity and grip strength, the standard myoelectric prosthesis resulted in higher performance

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Summary

Introduction

The delay between amputation and prosthesis fitting contributes to the high rate of prosthetic abandonment despite advances in technology. The purpose of the current investigation is to compare functional outcomes and patient satisfaction between a standard transradial prosthesis fitted in a clinic with a 3D-printed prosthesis fitted remotely. The standard prosthesis featured a hook terminal device, while the 3D printed prosthesis’ terminal device was a functional hand. By the year 2050, an estimated 3.6 million persons will be living with amputations within the United States [1]. According to the National Trauma Databank [3], 0.09% of persons hospitalized after trauma sustained a major upper-limb amputation. Despite advances in upper-limb prostheses, there continues to have a high rate of user abandonment [4]. Up to 52% of upper-limb amputees rejected or abandoned their prosthesis [2]

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