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3D Printers Lend a Helping Hand to VA Occupational Therapists

Last year, Stratasys and the Veteran’s Affairs (VA) Center for Innovation collaborated as part of the Stratasys Corporate Social Responsibility (CSR) Program to install 3D printers in 5 Veterans Administration hospitals across the country, to use the benefits of 3D printing to improve the quality of life for veterans.

Mary Matthews-Brownell posing next to a poster describing her work on 3D printed hand orthoses. She presented at the Annual American Society of Hand Therapists in Anaheim, CA in October of 2017.

The idea of using 3D printing first came to Mary during a visit with her patient, Veteran Newton. 37-year-old Newton was referred to Mary approximately 6 years after his right pinky finger was amputated for complications from combat injuries.  He was suffering from sharp and stabbing phantom limb pain from the amputated 5th finger and muscle spasms from a 4th finger contracture which made it difficult for him to write legibly or hold tools. As a certified hand therapist, Mary was able to fabricate a hand-based orthotic for him.

In large part a labor of love, the bending and shaping of a hand orthotic takes time, skill, and an in-depth understanding of human anatomy and the needs of the patient. The custom hand orthosis allowed Newton to be pain-free while working in a warehouse distribution center 8-10 hours/day, driving his car, and taking care of his children. However, due to the physical nature of his work, the brace quickly wore out and required frequent replacements. Each time the orthotic wore out, Newton would need to make another appointment with Mary and travel a long distance back to the hospital, and Mary would need to repeat the process of bending and shaping a new orthosis for him. Newton worried what would happen if he lost or damaged the next orthotic while far from the VA hospital (he often volunteers in the Philippines). Because of the need for a custom orthotic designed by a hand therapist, he would not be able to buy an off the shelf replacement at a store.

This gave Mary an idea- to safeguard against the need for repeated clinic visits to build new orthotics, she would make a replica of the existing orthotic using a 3D printer. She recruited Ben Salatin, a rehabilitation engineer with extensive 3D printing experience, to help her. First, they created a digital copy of the existing orthotic using a 3D scanner. Ben then enhanced the digital copy by removing seams in the orthotic that were susceptible to wear and damage (a distinct benefit of 3D printing is that objects can be created as a single unified piece, without the need for seams). He also designed slots for a more comfortable strap and improved the overall aesthetic. Finally, he printed the brace on his VA-based Stratasys 3D printer out of a lightweight material with a smooth finish.

Two hand orthoses for another Veteran, printed on the Stratasys Mojo 3D Printer.

Veteran Newton has worn the new 3D printed brace for 6 months now without it breaking and he is extremely happy with it, noting the lighter weight, stronger material, and improved ability to secure the orthosis in place. More importantly, he can rest easy knowing that a replacement is literally a press of a “print” button away, and could be mailed to him wherever his travels take him, saving him the time needed to make another trip back to the VA. This also means Mary has more available clinic time to fabricate new orthotics for other Veterans in need.

Veteran Newton with his 3D printed hand orthosis.

Mary states, “3D printing can be a game changer for the chronic hand problems we see every day here at the VA.” To date, Mary and Ben have created 3D printed orthotics based on Mary’s initial custom-fabricated versions for 5 Veterans.  These 3D printed orthotics have allowed the Veterans to use the local exercise hall for the first time, continue to work and provide for family, use power tools to repair a fence, and – for one-  reach and grasp for the first time in over a year.

3D printers will never replace the need for a skilled hand therapist such as Mary. Rather, their role in this case is to act as a force multiplier for Mary and others like her, allowing her work to reach levels of sustainability and scale that are not currently possible without the technology. Innovations such as this one, fueled through VA staff creativity and 3D printing technology, are continuing to be born out of the Stratasys- VA 3D printing network project. We look forward to seeing what will come next.

 

Beth Ripley

Beth Ripley

Beth Ripley, MD, PhD, is a staff radiologist at the Seattle Division of the VA Puget Sound Healthcare System, and an Assistant Professor of Radiology at the University of Washington School of Medicine. She received her Bachelor’s degree in Art History from Stanford University and her MD and PhD in Neurosciences from University of California, San Diego School of Medicine. She completed radiology residency training and a cardiovascular imaging fellowship at Brigham and Women’s Hospital, Harvard Medical School, and a body imaging fellowship at the University of Washington.

As an innovation specialist with the VA Center for Innovation, Dr. Ripley collaborates with a talented and diverse group of physicians, orthotists, prosthetists, engineers, administrators and information technologists across the VA system who—together— are reimagining the meaning of individualized patient care. Amongst other things, the VA 3D Printing Leadership Team hopes to understand how patient-specific 3D printing can improve the safety and quality of diagnosis and interventions such as surgery and minimally invasive procedures, improve patient education, shared decision-making, and informed consent and improve how patients engage with their surroundings.

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