We usually only realize how much we depend on our arms in everyday life when we can only use them to a limited extent. In the case of an upper arm fracture, it is all the more important that a patient receives an optimally fitting orthosis. Even if we don't yet explicitly offer this workflow in the Mecuris Solution Platform - with a little creativity, such an orthosis can still be made quickly.
"We need an upper-arm forearm orthosis for a patient." Jan Euerle and Michael Wille from medical device clinic Jaeger contacted us. The two master orthopedic technicians are just venturing their first steps in the field of digital orthosis creation. For this case of an upper arm fracture fitting, they wanted to test out together with our expert Ylli Binakaj how best to create one online. The goal: "To create a good product with relatively little effort - and, of course, to get the customer fitted quickly," says Wille.
Why digital instead of manual?
So why did they want to go digital in the first place instead of the traditional and handcrafted approach? Here are four reasons:
All in one solution: unlike the manual process, the orthosis can be printed directly in one piece with different features (soft tab, cushioning structures to reduce pressure, firm contact surfaces for the joints).
Cost savings: FDM printing is a cost-effective choice - especially for complex orthoses.
Hygienic solution: Since both shells consist of only one material, they are easy to clean.
Material advantage: TPU, a material popularly used in 3D printing, is dimensionally stable, durable and comfortable for the patient.
Customized orthosis in less than 2 hours
The arm, which had previously been scanned, could be uploaded directly to the Mecuris3D Modeling tool, where it was modified. Digitally, material was applied to the elbow, paddings were installed, and areas for the joints were marked. In addition, an offset was built in so that a (closure) flap could be attached later.
The process continued in the Mecuris3D Creator, the design tool: holes were set, and the orthotic shell was cut out by setting a trim line. "I think it's so nice, especially in 3D printing, that you already set the border course digitally - there's no nicer looking one, in my opinion," Jan was pleased to say.
Since we don't yet offer a complete workflow exactly suitable for upper arm forearm orthoses, Ylli showed the colleagues from the medical device clinic some tricks on how to best work here with the existing options - in this case, the hand workflow. After about an hour and a half of a joint session doing some modeling on the computer, the orthosis was ready for printing:
1. Printing a test orthosis: First, we made a test version of the orthosis, which consisted of a thin offset that we created based on the positive model. For this, we used an inexpensive material for the print so that we could fit the joints on it and do the first fitting on the patient. The fit was just right, so we could then move on to step 2.
2. Printing of the final orthosis: After we knew that the trial orthosis fit perfectly, we set about implementing the final orthosis. This was printed from TPU using the FDM printing process. FDM printing allowed us to incorporate cushioning structures in the interior of the orthosis at various points. This works very well with FDM printing because this process does not require any support structures and therefore no powder is used as a support material. This creates cavities during printing, which can be used to insert interior structures that serve as cushioning. TPU is again the ideal material for this procedure, because it makes these printed cushions comfortable for the user.
Final finishing touches
Jan and Michael took responsibility for the 3D printing and handled it through a 3D printing service provider that specializes in FDM printing. Once the finished printed orthosis blank was in house, the fine-tuning of the orthosis took place manually: The shell was cut into two halves (upper arm and forearm), sanded a bit and smoothed at the edges so that the joints could then be attached.
💡 Due to the fact that TPU forms a very strong bond to the individual layers during FDM printing, it is not a problem to cut or sand it. The surface can be smoothed very well and quickly with a flap sander, for example.
The Caroli joints were set medially and laterally and riveted to the TPU. Gluing was not necessary here, since the hollow rivets provided enough stability for this type of load. Last but not least, closures were attached and shortened to the correct length.
Et voilá - the fitting with the patient could take place. The 3D printed orthosis fit perfectly and not only the patient was very satisfied, but also the two master orthopedic technicians and our colleague Ylli: without any limitations on design, the optimal fitting could be implemented according to the patient's needs. This is an example of the flexibility of our software and what our customers enjoy most.
You.Create. is our motto, because we don't want to prescribe or restrict the work of the CPO, but rather make your ideas a reality!
Have a look at the modeling process - fast forward:
Do you want to get started working digitally? Then join CPO Richard in our on-demand webinar "How to Create an AFO Ready for 3D Printing" - this way you can get a first glimpse at how our Software works. Get the recording for free now >>
For all US-colleagues: By completing a Quiz after the video you can even earn free CEUs.
You want a personal demo of the tools on the Mecuris Solution Platform? You can see availabilities for a personal call right here.
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