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van Ginkel L, Dupuis L, Verhamme L, Hermans E, Maal TJJ, Stirler V. Three-dimensional imaging of the forearm and hand: A comparison between two 3D imaging systems. PLOS Digit Health 2024; 3:e0000458. [PMID: 38635844 PMCID: PMC11025912 DOI: 10.1371/journal.pdig.0000458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 02/02/2024] [Indexed: 04/20/2024]
Abstract
The conventional treatment for distal radius fractures typically involves immobilization of the injured extremity using a conventional forearm cast. These casts do cause all sorts of discomfort during wear and impose life-style restrictions on the wearer. Personalized 3D printed splints, designed using three-dimensional (3D) imaging systems, might overcome these problems. To obtain a patient specific splint, commercially available 3D camera systems are utilized to capture patient extremities, generating 3D models for splint design. This study investigates the feasibility of utilizing a new camera system (SPENTYS) to capture 3D surface scans of the forearm for the design of 3D printed splints. In a prospective observational cohort study involving 17 healthy participants, we conducted repeated 3D imaging using both the new (SPENTYS) and a reference system (3dMD) to assess intersystem accuracy and repeatability. The intersystem accuracy of the SPENTYS system was determined by comparison of the 3D surface scans with the reference system (3dMD). Comparison of consecutive images acquired per device determined the repeatability. Feasibility was measured with system usability score questionnaires distributed among professionals. The mean absolute difference between the two systems was 0.44 mm (SD:0.25). The mean absolute difference of the repeatability of the reference -and the SPENTYS system was respectively 0.40 mm (SD: 0.30) and 0.53 mm (SD: 0.25). Both repeatability and intersystem differences were within the self-reported 1 mm. The workflow was considered easy and effective, emphasizing the potential of this approach within a workflow to obtain patient specific splint.
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Affiliation(s)
- Laura van Ginkel
- Department of Trauma Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
- Technical Medicine, University of Twente, Enschede, The Netherlands
| | - Lotte Dupuis
- Department of Trauma Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Luc Verhamme
- Radboudumc 3D Lab, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Erik Hermans
- Department of Trauma Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Thomas J. J. Maal
- Radboudumc 3D Lab, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Vincent Stirler
- Department of Trauma Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
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Stefanescu K, Timlin CL, Moy AS, Zapotoczny G. Reduced Isocyanate Release Using a Waterproof, Resin-Based Cast Alternative Relative to Fiberglass Casts. Toxics 2023; 11:1002. [PMID: 38133403 PMCID: PMC10747184 DOI: 10.3390/toxics11121002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/03/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023]
Abstract
The effects of occupational isocyanate exposure range from asthma and contact dermatitis to neurotoxicity and cancer. Respiratory sensitization due to orthopedic cast application has been well documented. This study aims to compare the safety of standard-of-care fiberglass casts and a novel waterproof cast alternative by measuring the amount of isocyanate released during off-gassing over time. A 3D-printed arm simulator with comparable casing material amounts was placed in a sealed chamber. An isocyanate-sensing color-changing (SafeAir) tag was used to measure the levels of toxic exposure. Triplicate trials were conducted across all time periods (15 min, 1 h, and 24 h) and conditions. The bare arm simulator and freshly opened tags served as negative controls. Normalized pixel intensity indexes and isocyanate release estimates in ppb were derived from ImageJ-analyzed SafeAir tag photos. Fiberglass casts exhibited greater isocyanate release than both the waterproof alternative (p = 0.0002) and no-cast controls (p = 0.0006), particularly at 24 h. The waterproof alternative and no-cast control did not statistically differ (p = 0.1603). Therefore, the waterproof alternative released less isocyanate than the fiberglass casts. Waterproof cast alternatives may be safer than fiberglass by limiting medical professionals' exposure to toxic isocyanates and, thus, decreasing their risk of suffering occupational asthma.
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Affiliation(s)
- Kristen Stefanescu
- Keck School of Medicine of the University of Southern California, 1975 Zonal Ave., Los Angeles, CA 90033, USA;
| | | | | | - Grzegorz Zapotoczny
- Consortium for Technology & Innovation in Pediatrics, Lurie Children’s Hospital, 225 E Chicago Ave., Chicago, IL 60611, USA;
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de Bruijn MAN, van Ginkel LA, Boersma EZ, van Silfhout L, Tromp TN, van de Krol E, van der Heijden BEPA, Hermans E, Stirler VMA, Edwards MJR. The past, present and future of the conservative treatment of distal radius fractures. Injury 2023; 54 Suppl 5:110930. [PMID: 37923503 DOI: 10.1016/j.injury.2023.110930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 11/07/2023]
Abstract
The distal radius fracture is a common fracture with a prevalence of 17% on the emergency departments. The conservative treatment of distal radius fractures usually consists of three to six weeks of plaster immobilization. Several studies show that one week of plaster immobilization is safe for non- or minimally displaced distal radius fractures that do not need reduction. A shorter period of immobilization may lead to a better functional outcome, faster reintegration and participation in daily activities. Due to upcoming innovations such as three-dimensional printed splints for distal radius fractures, a patient specific splint can be produced which may offer more comfort. Furthermore, these three-dimensional printed splints are expected to be more environmental friendly in comparison with traditional plaster casts.
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Affiliation(s)
- Marcel A N de Bruijn
- Department of Trauma Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Laura A van Ginkel
- Department of Trauma Surgery, Radboud University Medical Center, Nijmegen, The Netherlands; Faculty of Science and Technology - Technical Medicine, University of Twente, Enschede, The Netherlands
| | - Emily Z Boersma
- Department of Trauma Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lysanne van Silfhout
- Department of Trauma Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Tjarda N Tromp
- Department of Trauma Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Erik van de Krol
- Department of Trauma Surgery, Radboud University Medical Center, Nijmegen, The Netherlands; Military Health Organisation, Ministry of Defence, Kromhout Kazerne, Utrecht, The Netherlands
| | - Brigitte E P A van der Heijden
- Department of Plastic Surgery, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Plastic Surgery, Jeroen Bosch Ziekenhuis, 's-Hertogenbosch, The Netherlands
| | - Erik Hermans
- Department of Trauma Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Vincent M A Stirler
- Department of Trauma Surgery, Radboud University Medical Center, Nijmegen, The Netherlands; Military Health Organisation, Ministry of Defence, Kromhout Kazerne, Utrecht, The Netherlands
| | - Michael J R Edwards
- Department of Trauma Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
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Steck P, Scherb D, Witzgall C, Miehling J, Wartzack S. Design and Additive Manufacturing of a Passive Ankle-Foot Orthosis Incorporating Material Characterization for Fiber-Reinforced PETG-CF15. Materials (Basel) 2023; 16:ma16093503. [PMID: 37176385 PMCID: PMC10180110 DOI: 10.3390/ma16093503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/20/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023]
Abstract
The individualization of patient-specific ankle joint orthoses is becoming increasingly important and can be ideally realized by means of additive manufacturing. However, currently, there are no functional additively manufactured fiber-reinforced products that are used in the field of orthopedic treatment. In this paper, an approach as to how additively manufactured orthopedic products can be designed and produced quickly and flexibly in the future is presented. This is demonstrated using the example of a solid ankle-foot orthosis. For this purpose, test results on PETG-CF15, which were determined in a previous work, were integrated into a material map for an FEA simulation. Therewith, the question can be answered as to whether production parameters that were determined at the test specimen level can also be adapted to real, usable components. Furthermore, gait recordings were used as loading conditions to obtain exact results for the final product. In order to perfectly adapt the design of the splint to the user, a 3D scan of a foot was performed to obtain a perfect design space for topology optimization. This resulted in a patient-specific and stiffness-optimized product. Subsequently, it was demonstrated that the orthosis could be manufactured using fused layer modelling. Finally, a comparison between the conventional design and the consideration of AM-specific properties was made. On this basis, it can be stated that the wearing comfort of the patient-specific design is very good, but the tightening of the splint still needs to be improved.
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Affiliation(s)
- Patrick Steck
- Engineering Design, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91058 Erlangen, Germany
| | - David Scherb
- Engineering Design, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91058 Erlangen, Germany
| | - Christian Witzgall
- Engineering Design, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91058 Erlangen, Germany
| | - Jörg Miehling
- Engineering Design, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91058 Erlangen, Germany
| | - Sandro Wartzack
- Engineering Design, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91058 Erlangen, Germany
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Vilela FB, Silva ES, de Lourdes Noronha Motta Melo M, Oliveira RMP, Capellato P, Sachs D. Polymeric Orthosis with Electromagnetic Stimulator Controlled by Mobile Application for Bone Fracture Healing: Evaluation of Design Concepts for Medical Use. Materials (Basel) 2022; 15:8141. [PMID: 36431627 PMCID: PMC9698363 DOI: 10.3390/ma15228141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/28/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
Background: The occurrence of bone fractures is increasing worldwide, mainly due to the health problems that follow the aging population. The use of additive manufacturing and electrical stimulators can be applied for bioactive achievements in bone healing. However, such technologies are difficult to be transferred to medical practice. This work aims to develop an orthosis with a combined magnetic field (CFM) electrostimulator that demonstrates concepts and design aspects that facilitate its use in a real scenario. Methods: A 3D-printed orthosis made of two meshes was manufactured using PLA for outer mechanical stabilization mesh and TPU for inner fixation mesh to avoid mobilization. A CFM stimulator of reduced dimension controlled by a mobile application was coupled onto the orthosis. The design concepts were evaluated by health professionals and their resistance to chemical agents commonly used in daily activities were tested. Their thermal, chemical and electrical properties were also characterized. Results: No degradation was observed after exposure to chemical agents. The CMF achieved proper intensity (20-40 µT). The thermal analysis indicated its appropriate use for being modelled during clinical assessment. Conclusion: An orthosis with a coupled electrostimulator that works with a combined magnetic field and is controlled by mobile application was developed, and it has advantageous characteristics when compared to traditional techniques for application in real medical environments.
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Affiliation(s)
- Filipe Bueno Vilela
- Centre for Studies and Innovation in Biofunctional Advanced Materials, Institute of Physics and Chemistry, Unifei-Federal University of Itajubá, Av. BPS, 1303, Itajubá 37500-903, MG, Brazil
| | - Eduardo Serafim Silva
- Centre for Studies and Innovation in Biofunctional Advanced Materials, Institute of Physics and Chemistry, Unifei-Federal University of Itajubá, Av. BPS, 1303, Itajubá 37500-903, MG, Brazil
| | | | - Rochelly Mariana Pedroso Oliveira
- Centre for Studies and Innovation in Biofunctional Advanced Materials, Institute of Physics and Chemistry, Unifei-Federal University of Itajubá, Av. BPS, 1303, Itajubá 37500-903, MG, Brazil
| | - Patricia Capellato
- Centre for Studies and Innovation in Biofunctional Advanced Materials, Institute of Physics and Chemistry, Unifei-Federal University of Itajubá, Av. BPS, 1303, Itajubá 37500-903, MG, Brazil
| | - Daniela Sachs
- Centre for Studies and Innovation in Biofunctional Advanced Materials, Institute of Physics and Chemistry, Unifei-Federal University of Itajubá, Av. BPS, 1303, Itajubá 37500-903, MG, Brazil
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