4.7 Article

3D-Printing and Upper-Limb Prosthetic Sockets: Promises and Pitfalls

Publisher

IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC
DOI: 10.1109/TNSRE.2021.3057984

Keywords

Sockets; Prosthetics; Three-dimensional displays; Solid modeling; Three-dimensional printing; Casting; Tools; Additive manufacturing; 3D printing; digital scanning; amputee; upper-limb; prosthetic; socket; trans-radial

Funding

  1. Engineering and Physical Sciences Research Council (EPSRC), U.K. [EP/R004242/1]
  2. Newcastle University
  3. EPSRC [EP/M025977/1, EP/R004242/1] Funding Source: UKRI

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Limited progress has been made in modernising the way upper-limb prosthetic sockets are made, with current techniques still heavily reliant on outdated casting methods and manual labor. While digital methods such as 3D scanning and printing hold promise for improving efficiency and patient satisfaction, challenges exist in implementing them in clinical settings. There is a disconnect between technology developers and the actual needs of clinicians and patients, highlighting the need for expert knowledge to guide the use of digital tools in prosthetic socket manufacturing.
Modernising the way upper-limb prosthetic sockets are made has seen limited progress. The casting techniques that are employed in clinics today resemble those developed over 50 years ago and there is still a heavy reliance on manual labour. Modern manufacturing methods such as 3D scanning and printing are often presented as ready-to-use solutions for producing low-cost functional devices, with public perceptions being largely shaped by the superficial media representation and advertising. The promise is that modern socket manufacturing methods can improve patient satisfaction, decrease manufacturing times and reduce the workload in the clinic. However, the perception in the clinical community is that total conversion to digital methods in a clinical environment is not straightforward. Anecdotally, there is currently a disconnect between those developing technology to produce prosthetic devices and the actual needs of clinicians and people with limb difference. In this paper, we demonstrate strengths and drawbacks of a fully digitised, low-cost trans-radial diagnostic socket making process, informed by clinical principles. We present volunteer feedback on the digitally created sockets and provide expert commentary on the use of digital tools in upper-limb socket manufacturing. We show that it is possible to utilise 3D scanning and printing, but only if the process is informed by expert knowledge. We bring examples to demonstrate how and why the process may go wrong. Finally, we provide discussion on why progress in modernising the manufacturing of upper-limb sockets has been slow yet it is still too early to rule out digital methods.

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