Abstract
Background and objectiveWith significant advancement in the field of biomaterials, alternatives to conventional fiberglass casts such as customized three-dimensional (3D) orthotics have been developed. However, there is a scarcity of reported experience regarding 3D-printed orthoses. The purpose of this study was to compare radiographic outcomes and patient satisfaction with fractures treated with either conventional or 3D-printed casts.Materials and methodsWe included 23 limbs from 22 patients, who were aged between 8-18 years, and with a diagnosis of an acute nondisplaced wrist or forearm fracture. Patients were randomized into two groups: consisting of those treated with a 3D-printed orthosis and those with conventional fiberglass cast. Outcomes included X-ray alignment and healing, cast fit, the appearance of the skin, ease of care, and overall satisfaction.ResultsOf note, 10/11 (91%) in the 3D cast group healed in an excellent position, and 1/11 healed in an acceptable position. Also, 11/12 (92%) in the conventional cast group healed in an excellent position, and 1/12 healed in an acceptable position. Radiographically, 11/11 (100%) of the fractures in the 3D group and 11/12 (92%) in the conventional cast group were found to be fully healed. No differences were found in terms of skin irritation by a blinded hand therapist. Patients reported significant differences in skin irritation, comfort, satisfaction, and cast care favoring 3D casts (p<0.05).Conclusions3D orthoses offer a promising opportunity to improve patients’ experiences with upper extremity casting while also providing appropriate immobilization.
Highlights
Pediatric fractures of the forearm and wrist are common injuries, comprising 40% of all fractures in children
We included 23 limbs from 22 patients, who were aged between 8-18 years, and with a diagnosis of an acute nondisplaced wrist or forearm fracture
Patients were randomized into two groups: consisting of those treated with a 3D-printed orthosis and those with conventional fiberglass cast
Summary
Pediatric fractures of the forearm and wrist are common injuries, comprising 40% of all fractures in children. Nonoperative management through splinting and casting is an integral part of injury treatment [3,4]. Traditional casting with plaster and, recently, fiberglass has been highly regarded due to its low cost, strength, and ease of application. The cost of manufacturing three-dimensional (3D) casts is comparable to that of other orthoses. The cost of 3D casts is expected to further decrease over time. With significant advancement in the field of biomaterials, alternatives to conventional fiberglass casts such as customized three-dimensional (3D) orthotics have been developed. There is a scarcity of reported experience regarding 3D-printed orthoses. The purpose of this study was to compare radiographic outcomes and patient satisfaction with fractures treated with either conventional or 3D-printed casts
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