| 제목 |
Individualized Prosthesis Produced by 3D Scanner and Printer in a Patient with an Amputated Thumb: |
| 소속 |
Samsung Medical Center, Department of Rehabilitation Medicine1 |
| 저자 |
Sang Jun Kim 1†, Geun ho Lee1, Dong Kyu Kim1, Sung jae Kim1* |
1. Objective
We report a case of a patient with an amputated thumb, who wore specifically shaped hand prostheses that were optimal to perform specific movements and were produced by a 3D scanner and printer and allowed and improved functioning.
2. Methods
A 67-year old man visited our outpatient department due to a right thumb amputation above the metacarpophalangeal joint in August 2015. His right hand was scanned with a 3D scanner (Artec™ Eva) at 16 frames/sec. The left hand was also scanned in the tripod grasp postures using the same scanner. This scanned data of the left hand were rotated from the left to right side to design the right thumb prosthesis. The right hand prosthesis was designed by overlapping the right amputated hand with the flipped left intact hand, subtracting the overlapped part, and adding the contacted part. All design procedures were performed using the Touch Haptic Stylus (3D SYSTEMS Corp) and Geomagic Freeform (3D SYSTEMS) software. The designed prosthesis was printed with FB9600 (TPC Mechatronics Inc) using the Fused Filament Fabrication output system, which involved stacking up melted flexible thermos-plastic elastomer filaments layer by layer. The Jebsen Taylor Hand Function Test (JTT) and the Box and Block Test (BBT) were performed to evaluate right hand function in the occupational department. The patient performed daily activities using the two prostheses for 1 month and revisited our outpatient on October 5. He underwent the JTT and BBT and was tested using the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST). The Orthotics and Prosthetics Users Survey (OPUS) was used to evaluate performance of daily activities and satisfaction with the tripod type prosthesis.
3. Results
The elapsed time and cost for designing and making the prosthesis were about 48 hours and $50 USD.
The BBT score of the patient was 17 before use of the prosthesis and 21 after application of the prosthesis. The prosthesis allowed easier grasping of the box and a faster tip pinch. The JTT results showed that elapsed time decreased for all the items except stacking checkers. Elapsed time and accuracy of writing, card turning and picking up small objects improved due to opposition and pinching movements of the thumb with the thumb prosthesis. Simulated feeding improved because the prosthesis fixed a spoon between the thumb and the second finger. The QUEST satisfaction result was 36 of a total 40 points and most items on the QUEST were “very satisfied” or “quite satisfied”. Most items except washing the face and tying a shoe on the OPUS test were marked “easy” or “very easy”.
4. Conclusion
We produced specifically shaped hand prostheses for specific movements using a 3D scanner and printer for a patient with an amputated thumb who achieved better function and satisfaction. We hope that 3D scanners and printers will be widely used to prepare hand prostheses with little time and very low cost. |
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The scanned data of the left intact hand were rotated from the left to right side and overlapped with the right amputated hand to design the prosthesis.
A right hand prosthesis was designed by subtracting the overlapped part and adding the contacted part.
A patient grasps a small box without a prosthesis (Figure 4A) and with a prosthesis (Figure 4B). The prosthesis allowed easier grasping of the box and a faster tip pinch, which increased the BBT score.
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