为桡骨远端和肩胛骨骨折开发 3D 打印腕部夹板

Pub Date : 2024-02-02 DOI:10.1055/s-0044-1779053
Bernadette Tobler-Ammann, Frédéric Schuind, Loïc Voillat, Théophile Gentilhomme, E. Vögelin, Noé Murith, Bernard Masserey
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引用次数: 0

摘要

研究背景 本研究旨在从舒适度、骨折稳定和预防石膏并发症等方面优化桡骨远端和肩胛骨骨折的保守治疗。技术描述 增材制造技术的进步使得患者特异性解剖支架(PSAB)的开发成为可能。我们的具体目标是开发一种适用于骨折护理的 PSAB 模型,评估健康志愿者是否能很好地耐受这种支架,并确定其与传统腕部固定方法相比的机械性能。材料和方法 机械工程师根据外科医生和手部治疗师的临床专业知识设计了几种三维打印夹板原型。这些实验性支架在一项临床前研究中进行了测试,有 10 名健康志愿者参与,对舒适度、满意度和活动度进行了评估。最终原型与传统石膏和预制夹板进行了机械比较,测试了不同的闭合系统。此外,还创建了一种数学算法,可根据患者的解剖结构自动调整 PSAB 的最终模型。结果 最终原型的总体满意度为 79%,重量不到 90 克,由聚酰胺制成,使用钩环带固定。PSAB 的硬度介于 0.64 和 0.99 牛米/度之间,超过了传统石膏模型和预制夹板的性能。结论 用于骨折治疗的最终腕部 PSAB 模型轻巧、舒适,并能提供解剖学上的控制。与传统石膏相比,该模型目前正在用于治疗稳定的桡骨远端和肩胛骨骨折。
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Developing 3D-Printed Wrist Splints for Distal Radius and Scaphoid Fractures
Background The purpose of this study is to optimize conservative treatment of distal radius and scaphoid fracture, in terms of comfort, fracture stabilization, and prevention of cast complications. Description of Technique Advances in additive manufacturing have allowed the development of patient-specific anatomical braces (PSABs) which have the potential to fulfill this purpose. Our specific aims were to develop a model of PSAB, adapted to fracture care, to evaluate if this brace would be well tolerated by healthy volunteers and to determine its mechanical properties as compared with conventional methods of wrist immobilization. Materials and Methods Several three-dimensional-printed splint prototypes were designed by mechanical engineers based on surgeons' and hand therapists' clinical expertise. These experimental braces underwent testing in a preclinical study involving 10 healthy volunteers, assessing comfort, satisfaction, and activities. The final prototype was mechanically compared with a conventional cast and a prefabricated splint, testing different closing systems. A mathematical algorithm was created to automatically adapt the final PSAB model to the patient's anatomy. Results The final prototype achieved an overall satisfaction score of 79%, weighing less than 90 g, made from polyamide, and fixed using hook and loop straps. The PSAB stiffness varied between 0.64 and 0.99 Nm/degree, surpassing the performance of both conventional plaster casts and prefabricated splints. Conclusion The final wrist PSAB model, adapted for fracture treatment, is lightweight, comfortable, and provides anatomical contention. It is currently being tested for the treatment of stable distal radius and scaphoid fractures in comparison to conventional plaster cast.
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