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3D Printed Orthotics for Kids Reduce Production Times by 40 Percent

In a recent case study released by Moscow-headquartered Thor3D, we see how their Calibry 3D scanner made a huge difference in the production of foot orthotics for children in Germany. Phoenix GmbH & Co., an engineering company specializing in product development with 3D printing technology, was tasked with improving the creation of orthotics for a German clinic.

Employing Calibry Nest software, the Calibry 3D scanner, Geomagic Wrap software with algorithms created by Phoenix, and the Tractus 3D printer, Phoenix was able to develop a new and reproducible solution. Able to save doctors up to 40 percent in production time, the new process is so easy it can be used by orthopedists with no previous experience in wielding 3D tools.

“Before Calibry, we had to use more expensive, less user-friendly scanners to do the same tasks. This is a limiting factor in B2B scanning applications, where the user is no scanning expert,” comments Emil Wörgötter, Application Engineer 3D Scanning & Additive Manufacturing.

Even more important is the new level of comfort afforded to young patients. Historically, being fitted for a prosthetic or an orthotic could be a long and painful process for anyone, but especially a child who needs constant updates. 3D printing has already proven itself in countless instances regarding hand and arm prosthetics—helping amputees—as well as offering a much better way to fit kids for orthotics too.

Some of the greatest advantages of 3D printing are on display in this latest case study, as children are able to enjoy completely customized medical devices that can be re-sized in a matter of minutes rather than hours. They may ultimately be able to walk more comfortably (and perhaps even look forward to their visit to see the orthopedist). This is in stark comparison to the old-fashioned and highly inefficient method of creating orthotics, beginning with taking measurements and modeling the footbed. Afterward, plaster is used to mold the orthotic—this is not only messy but can be difficult when testing the patience of a child. An orthopedic specialist is required to perform the work, which can be extremely high maintenance; in fact, if one step goes awry, the entire uncomfortable process may have to be repeated all over again. Ultimately, however, the positive form is created.

The plastering process

In using the Calibry 3D scanner to create an orthotic, the Phoenix team still required a positive form from a previous fitting:

“For now, in orthosis production a traditional process of creating the initial positive form has to remain. The scan of a positive form differs from foot scan,” states the Phoenix team in the case study. “A 3D scan has a lot of anatomical details of an existing foot which needs treatment, whereas a positive form has simplified and anatomically correct geometry. Currently Phoenix develops algorithms, which will automate the creation of the initial positive form too. So, in the future orthosis production will become completely contactless.”

Scanning an existing positive form

Based on measurements, a fully automated design of a new positive form is done

The new positive form is 3D printed.

Vacuum thermoforming of the new orthosis shell

After measuring the foot and then scanning the patient’s positive form, they were able to 3D print a new one and then create a new shell with vacuum thermoforming. The patient experienced no discomfort or long wait times, and no storage is required for the forms as all of the data remains online.

Orthotics are expected to continue to evolve further via 3D printing as they are a smaller item that is easy to produce and can be made much more quickly and affordably now, with amazing customizations.

[Source: Thor3D; Images courtesy of Phoenix GmbH & Co.]

The post 3D Printed Orthotics for Kids Reduce Production Times by 40 Percent appeared first on 3DPrint.com | The Voice of 3D Printing / Additive Manufacturing.

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FDM 3D Printing & PLA: Fabrication of a Splint for Mallet Finger

Researchers from Australia and the UK are finding ways to improve treatments for injuries to the hand, detailing their results in the recently published ‘Patient-specific 3D-printed Splint for Mallet Finger Injury.’ The goal is to offer better outcomes for patients who may have experienced damage to the tendon responsible for straightening the joint found at the end of the finger (or thumb).

Mallet finger injuries most commonly occur due to trauma after being struck by an object that bends the finger or thumb tip painfully.

(A) Mallet finger fracture (Image courtesy from Sachin J Shah, MD, online), (B) anatomy of finger

While there are many injuries and illnesses far more seriously affecting lives today, losing the use of a finger or hand can be debilitating as we must use them for so many tasks—primarily at work. Many types of splints may be uncomfortable for the patient to wear, but are also labor-intensive and expensive to make, resulting in the use of excess material during production too.

3D printing and additive manufacturing processes are beginning to make an impact in manufacturing of orthotics, offering benefits like greater affordability, speed in production, and best of all—total customization. Innovation around the globe has resulted in new software and improved workflow for creating medical devices like orthotics, the production of more comfortable foot/ankle orthotics, myoletric orthotics, and more.

“Mallet finger is often left untreated by patients unless severe restriction in extensor ability is present, or there is lingering pain. This injury, in the case, that there are functional shortfalls, can impede the whole hand in everyday fine motor skill tasks,” explained the authors. “Furthermore, this deformity can develop additional medical conditions in the finger and hand as overcompensation can create hyperextension of proximal interphalangeal joint, a swan neck deformity.”

“Effective use of AM may lead to a reduction in size and weight of the splint making it more comfortable for the user.”

Today, the most common splints are the prefabricated stack splint, the dorsal aluminum splint, and the customized thermoplastic splint. Generally they are worn for six to eight weeks, but with the first two choices there may be ongoing comfort issues as the splints may not fit well causing the skin to become irritated, the patient may experience added pain, and the splint itself may break due to inferior materials or manufacturing. Many patients are also unhappy with the size and style of their splints.

(A) Stack, (B) dorsal aluminum, and (C) personalized thermoplastic splints

“… customized splints, fitted to the exact dimensions of a patient’s finger, have the ability to provide successful treatment in more cases than the other two splint types,” stated the authors.

FDM 3D printing was chosen for the course of this study as the researchers made samples, noting that they would be taking advantage of the ability to fabricate complex geometries not previously possible through conventional techniques in manufacturing. More importantly is the ability to offer patient-specific treatment like never before—especially with medical devices like prosthetics and orthotics. In this study, the issue of comfort could be addressed with comprehensive customization, splints made quickly, and revised simply by changing the 3D design and printing a new one in the case of growth (these issues are common with children who may outgrow an orthotic made with conventional methods before it even arrives to them!), damage, or other requirements.

The seven measurements required to create a personalized finger splint computer-aided drawing model.

The research team used Autodesk Inventor for entering the measurements for their sample, including a built-in constraint:

“When the user clenches their fist, without this material removed, the skin of their middle phalanx finger can push into the back of the splint dislodging its correct position. The stack splint is designed with an open ventilation section above the fingernail to allow some airflow to reduce sweat when being worn and to allow limited access for washing.”

Geometry of a sample 100% mass design according to a patient’s finger.

Addressing the issue of wasted material and recycling of products later, the researchers point out that patient-specific devices like the splints they designed cannot be re-used by another individual later due to the level of customization, so they must be disposed of; however, with the use of PLA as their 3D printing material, a discarded splint can be ‘composted’ within six to eight weeks.

Schematic view of boundary conditions on a sample splint design.

One of the main objectives in the study was to develop a highly functional orthotic with topology optimization, eliminating as much material as possible while still maintaining the splint’s required volume fraction and stiffness.

Domains discretization with tetrahedral elements for (A) 100%, (B) 79.49%, (C) 71.13%, and (D) 62.51% mass

A three-dimensional-printed dog-bone poly-lactic-acid sample (A) before, and (B) after tensile test.

An Ultimaker2 Extended+ 3D printer was used for fabrication, while tensile testing was performed on an Instron 300LX.

“In FDM topology optimized and original design, finger splints were fabricated, original (100% mass), 62.51% mass, 71.13% mass, and 79.49% mass, by the same 3D printer and processing parameters used for the dog-bone specimens,” stated the researchers.

Noting that deflection results did not correlate exactly with heat dissipation, a trade-off analysis was required in choosing the best splint since the initial splint operating at 100 percent mass offered the best mechanical performance, but the 71.13 percent mass splint performed optimally in heat dissipation.

From left to right 62.51%, 71.13%, 79.49%, and 100% mass splints

“This splint is simpler to print than lower percentage mass splints that can require more printing support structures. It was found that inevitably reducing the amount of material in a load-bearing finger splint would increase the deflection of it. However, when the distribution of that material is chosen to optimize the stiffness in that situation, the deflection value was low enough to justify its use,” concluded the researchers.

“The results of this project would pave the way for the medical industry to utilize superior advanced manufacturing and minimum materials that have been shape optimized to better serve their purpose while improving patient comfort.”

What do you think of this news? Let us know your thoughts! Join the discussion of this and other 3D printing topics at 3DPrintBoard.com.

[Source / Images: ‘Patient-specific 3D-printed Splint for Mallet Finger Injury’]

The post FDM 3D Printing & PLA: Fabrication of a Splint for Mallet Finger appeared first on 3DPrint.com | The Voice of 3D Printing / Additive Manufacturing.

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Create O&P Co-Founder Jeff Erenstone Resigning to Bring More 3D Printed Prosthetics to Developing Countries

3D printing orthotic and prosthetic manufacturer Create O&P, based in New York, is responsible for creating the first medical-grade 3D printed arm for a survivor of the Haiti earthquake. Soon after this feat, it introduced the Create 3400: the first and only fully integrated medical-grade 3D printer for orthotic and prosthetic devices. The company’s mission is to manufacture cost-effective 3D printed prosthetics that are easily accessible around the world, and not just in the US. It’s safe to say that Create O&P has used 3D printing to do a lot of good in the world.

Jeff Erenstone, the co-founder and Chief Technology Officer of Create O&P, is a certified prosthetist-orthotist. He already had his own clinical practice, Mountain Orthotic and Prosthetic Services, when he launched the company in late 2014 after seeing the potential of using 3D printing to increase productivity in the orthotic and prosthetic care industry. Now, he’s decided to move on in order to continue advancing and improving clinical and prosthetic care in the developing world, and this week announced his resignation as the company’s CTO.

“I am very proud to have co-founded this business and work with hundreds of clinic owners to improve care for their patients and enhance efficiency at the same time. I am excited to take the lessons we learned here and improve care in the developing world where this technology will allow for clinical care in areas where it otherwise is currently unavailable,” Erenstone said.

Erenstone will be continuing his work in the orthotics and prosthetics field by expanding the use of applied 3D printing solutions in clinical work in developing regions of the world through his non-profit organization, Operation Namaste, which he also co-founded. This is a pretty inspiring move, in my opinion.

“I am very proud of the products we developed at Create O&P, which today includes 3D printers, software, education and other tools with which O&P clinicians can produce a whole range of products. With Create O&P’s capabilities, clinicians in the United States and throughout the world have seen drastic improvements in the efficiency of their practices,” said Erenstone. “I am glad to be leaving this company in competent and energetic hands.”

The heartwarming Operation Namaste organization wants to ensure that amputees all around the world can have easy access to 3D printed prosthetic care. Its mission is “to provide a continuum of prosthetic care and related rehabilitative services to the people of Nepal” and other developing countries as well, such as Haiti.

Some of the projects that Operation Namaste has worked on include a summit on prosthetics and orthotics, Camp Namaste for Nepalese children with limb differences, and the Nepal Warrior Trek, where a team of amputees (including an Ohio police officer) and business owners journeyed to the country for a long trek with the purpose of raising awareness and financial assistance for victims of the 2015 Nepal earthquake.

“We will very much miss Jeff at Create O&P and wish him the best of luck as he brings 3D technology to places where patients too often don’t receive care. Jeff’s contributions to this company are immeasurable,” stated Create O&P’s CEO Cecilia “Cissi” Schaffer. “As a clinician, practitioner and visionary, Jeff saw the challenges domestic clinics face, particularly as they relate to net margins. He knew that 3D printing was the only solution that would both improve efficiency and improve clinical care.”

Erenstone was the company’s first CEO, and oversaw the development of two generations of its 3D printers, which includes its current series that makes it possible to manufacture diagnostic sockets, hands-free, in less than three hours. In addition, he also created Create O&P’s Rapid Plaster software, digitally replicates the processes that clinicians use in order to design sockets, as well as other devices, for their patients.

[Image: Create O&P]

“It was an honor to co-found this company with Jeff. We are implementing Jeff’s vision, which he himself tirelessly pursued for over four years,” said Create O&P Co-Founder and Chief Financial Officer Dan Kelleher. “I am grateful to Jeff for the opportunity to help him pursue this digital future since 2014.”

Discuss this news and other 3D printing topics at 3DPrintBoard.com or share your thoughts in the Facebook comments below. 

[Images: Operation Namaste unless otherwise noted]

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Crispin Orthotics Purchases HP 4200 from Europac 3D for 3D Printing Orthotic Devices

In 2016, 3D printing, scanning, and inspection business Europac 3D, headquartered in the UK, was named a UK Channel Partner for HP, which means that it’s responsible for the sales and servicing of all of HP’s 3D printing equipment in the country. Recently, Crispin Orthotics contacted Europac 3D in search of a new 3D printing and CAD software package that would be able to keep up with the demand for orthotic devices, while also speeding up production and lowering 3D printing costs, and the company suggested HP’s 4200 Multi Jet Fusion 3D printer for the job.

“The HP Multi Jet Fusion 4200 is able to accurately mass produce bespoke orthotic devices, which in turn can cut costs and speed up production times,” said John Beckett, the Managing Director and Founder of Europac 3D. “Crispin Orthotic’s use of the HP’s Multi Jet Fusion printer is indicative of how additive manufacturing is revolutionising the orthotics industry.”

[Image: Sarah Goehrke for 3DPrint.com]

Crispin is a top HCPC registered clinic specializing in producing and maintaining orthotic devices, and has already worked with HP in the past. By making a further investment in its MJF technology, Crispin is able to produce parts that are strong and flexible enough to be made into orthotics that can endure a human’s everyday movements.

HP’s 4200 MJF can produce parts up to ten times faster, and at a 50% cost-per-part reduction, when compared to other SLS 3D printing systems. This reduced cost and increased speed means that Crispin will be able to 3D print hundreds of personal, customized orthotics in just 12 hours.

Crispin tested out its new HP 3D printer by pairing it with Siemens NX CAD software, featuring topology optimization, so its technicians could add strength to important areas and make designs more lightweight. In addition, the software is also capable of organizing multiple 3D parts so they nest, or perfectly fit, together on the print bed. This capability decreases the number of print jobs, which also lowers cost and increases speed.

“3D scanning and printing has revolutionised the speed and quality of parts we’re able to produce for clients.  Having the ability to create a bespoke devise that is lightweight, durable and accurate to 0.2mm has obvious benefits to the user. The business also benefits from the speed of 3D printing parts as well as cost savings of approximately 40% on each part by removing the need for multiple components in the supply chain and assembly,” said Mark Thaxter, Managing Director of Crispin Orthotics.

“Using 3D scanning and printing also provides greater freedom on the design of products particularly those with complex geometry.  Having the ability to vary the thickness of the device in certain parts also allows us to produce devices not possible with current methods of manufacturing.”

Crispin used its new HP MJF 3D printer, and its Siemens NX CAD, during a recent project. The combined technologies made it possible for the company to create a 3D printed arm orthotic with an integrated elbow joint and an attachment at the end, which makes it possible to pair up prosthetic devices with it. The device was 3D printed in a single part out of a durable but lightweight nylon material.

The sample parts that Crispin 3D printed on its new HP 4200 MJF system passed all of the necessary tests. But even more impressive is that the parts all had homogeneous strength in the three separate build axes, which just goes to show that build orientation does not have any negative impacts on the quality or strength of 3D printed parts.

Discuss this news and other 3D printing topics at 3DPrintBoard.com or share your thoughts in the Facebook comments below.

[Images provided by Europac 3D, unless otherwise noted]

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NAMIC and Wiivv Sign MoU for Developing High Performance, 3D Printed Biometric Insoles

This week, the National Additive Manufacturing Innovation Cluster (NAMIC), which is on a mission to increase Singapore’s adoption of additive manufacturing technologies and is behind much of the country’s 3D printing activity, signed a memorandum of understanding (MoU) with Wiivv, one of the worldwide market leaders in 3D printed insoles.

“It’s a great honour to be in this partnership,” said Shamil Hargovan of Wiivv. “We are proud to have this opportunity to bring Wiivv’s groundbreaking technologies and products to the Singapore market. We look forward to a long and productive partnership.”

NAMIC is a pan-national initiative supported by Singapore’s National Research Foundation and led by NTUitive, which is the innovation and enterprise company of Nanyang Technological University. Wiivv, based in both Vancouver and San Diego, creates solutions that allow for the mass customization of high-performance lifestyle products, such as insoles and sandals.

Supported by the terms of the MoU, NAMIC and Wiiv will work together to develop high performance biometric insoles. Wiivv will work to develop its next generation of customized, 3D printed biometric insoles that enhance customers’ individual performance, and will be supported by NAMIC and its wide network of strategic partners and research performers.

The ceremony for signing the MoU was held at NAMIC’s ongoing Global Additive Manufacturing Summit, in conjunction with Industrial Transformation Asia Pacific (ITAP). The Wiivv brand was represented at the ceremony by the company’s co-founder and CEO Shamil Hargovan, and guest of honor Dr. Lam Pin Min, the Senior Minister of State in both the Transport and Health Ministries, and Ms. Choy Sauw Kook, the Assistant Chief Executive and Director-General of Quality and Excellence for Enterprise Singapore, both witnessed the signing.

This collaboration seems like an interesting pairing for NAMIC, especially considering that two of the more recent agreements it signed have to do with developing maritime applications related to digitalization and advanced manufacturing…not much in common with 3D printed footwear and orthotics.

But, NAMIC does want to increase Singapore’s competitiveness in the evolving landscape of digital industrialization, and works to nurture and help promising AM startups and technologies, such as Wiivv. The initiative acts as a connector between public agencies, researchers, and industry, and is moving beyond the industrial sectors, which have mainly embraced 3D printing, to hedge its bets on 3D printed footwear and wearables, because of the ever increasing desire and need for mass customization in our daily use products.

“Wiivv exemplifies how new businesses should aspire to be, riding on market trends like hypermobility, mass customization and wellness needs, building personalized and highly desirable solutions enables by technologies like cloud computing, artificial intelligence and 3D printing,” said Dr. Ho Chaw Sing, NAMIC’s Managing Director. “We are excited and honoured to be partnering with Wiivv to support their growth plans in Singapore.”

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Father Takes Up 3D Printing, and Founds New Company, to Create Son’s Custom Orthosis

Some of the most heartwarming aspects of the 3D printing industry involve the people who do everything they can to develop and provide affordable 3D printed prosthetics to people who need them the most. Just in time for Father’s Day, Formlabs has shared a beautiful story about a dad who worked tirelessly to help his young son walk on his own…and ended up helping others along the way.

Cerebral palsy (CP) causes more than 17 million people around the world to have limited control of their own bodies. Seven years ago, Nik, the son of Matej and Mateja Vlašič, was born one month early, and due to difficulties during childbirth, suffered brain damage that led to the diagnosis of CP, and an inability to stand or walk on his own.

To help CP patients walk, many doctors will prescribe standard orthoses meant to correct spine and limb disorders. Patients can purchase pre-made orthotics, and some can even be slightly modified to better fit the patient, but it’s not easy to use one device to help with several symptoms, and they can even lead to skin irritation and pain.

Custom orthoses, CNC machined based off of a plaster or foam box impression, generally fit better, but the cost can be astronomical, even with insurance, and delivery can take weeks. On top of that, children outgrow them quickly.

Matej, who has an engineering background, said, “Based on my knowledge, I knew that a piece of plastic could not cost so much money.”

Matej has worked hard all of Nik’s life to help him move on his own, even using ski boots to stabilize his ankles when he got older.


“When you’re looking at your child, you instinctively know what to do in order to help him. When Nik was unable to turn on his side, I decided to build a ramp so that he could easily flip on his belly. When he found out that this was fun, he was trying to do it all by himself,” Matej said.

“He instantly felt confident, and you could see it in his eyes that he loved it and that he wanted to progress. This is what kept us going.”

Unfortunately, Nik’s short Achilles tendon and low muscle tone kept him on his toes.

“He was afraid of walking because his feet were in a really bad position,” said Petra Timošenko, Nik’s physiotherapist. “If he had tried to walk longer like that, he would have injured the bones and the joints.”

Matej knew he had to find a better way to help his son.

“The lack of comfort and high price combined with all the cons were enough that I decided to do something about it. I didn’t have the solution at that time, but I wanted to find a better way to design it,” Matej said. “I was just trying to help my son the best possible way.

“I didn’t know how orthoses are produced currently, so I was able to look outside of the box.”

He had heard of 3D printing, and after conducting some research, determined that the technology was accurate enough to create a properly-fitted orthosis. One of the benefits of 3D printing, especially in the healthcare field, is its ability to design customized products at a more affordable cost, and Matej was confident he could create a custom, 3D printed orthosis that would give Nik the correction and support he needed.

After a few attempts, Matej successfully digitized Nik’s feet, learned 3D modeling, and spent the next six months researching and experimenting, and eventually developed an innovative workflow, which starts with placing the patient’s feet, in the corrected, standing position, on a vacuum bag.

An iPad-mounted structure scanner scans the footprints from the bag, while the feet are also 3D scanned from above, and the data is merged and cleaned up into an accurate representation. The custom orthosis is designed right on the 3D scanned foot in CAD software, and then 3D printed in high resolution on a Form 2 3D printer with Durable Resin.

The first 3D printed prototype reached almost to Nik’s knee and kept him from walking freely, so Matej got to work on the second iteration, creating a prototype that fit inside a regular shoe. Finally, a successful prototype was created.

“In two or three days he was walking, and we were not needed to take care of him so that he doesn’t fall anymore,” Matej said. “The change was immediate, it was unbelievable.”

Nik’s orthosis is barely visible.

Just how braces align teeth, the 3D printed orthosis keeps Nik’s foot in the corrected position. It’s best to use orthoses at a young age, as children’s bodies can adapt while they grow. Physiotherapy also helps to strengthen ligaments and muscles.

“When he’d been using the orthosis for two or three months, for the first time, I saw Nik smiling,” said Timošenko. “After four or five months, he started to become faster and faster. His steps became longer, and his walking more smooth. He actually started to dance.

“Now I can do much more sophisticated exercise with him. We can run on a treadmill, we can jump, because I know that his feet are in the right position and I can’t cause any deformation to his bones or joints, that might, on the long term, require an operation to correct. If he didn’t have this orthosis, his feet would be in danger.”

Matej created four versions of Nik’s 3D printed orthosis.

“The first version gave him confidence and stabilized him. The second version improved his overall walking smoothness,” Matej explained. “Then the third helped him get better posture, and that’s when he really started to enjoy the walking and started to play around. The fourth orthosis corrected his right foot that was off the center of his body, so now he’s able to stand with his feet together in a straightened, upright position.”

After looking at the workflow, and measuring Nik’s feet with and without his 3D printed orthoses, certified orthotist and prosthetist Dejan Tašner knew that Matej had created a novel solution. He is able to make an affordable custom orthosis in less than 24 hours, and the devices are also comfortable.

“3D printing allows us to create orthotics with different thicknesses in different areas. We can apply a more thick area where it’s needed and minimal thickness to the areas where correction is not required,” Matej explained. “This is not possible with current solutions.

“Orthoses don’t need to hurt, only without pain can the children accept them.”

Matej and his wife decided to certify the workflow, which is now patent-pending, so the process and components will meet standard requirements for medical devices and allow for clinical trials. Matej quit his job to focus on 3D printed, patient-specific 3D printed children’s orthotics full-time and, together with Mateja, Tašner, and Timošenko, formed a new company called aNImaKe.

“At the moment, we are testing with several patients with different pathologies from age three to 11,” Tašner said. “We already see improvements in terms of biomechanics, which is the main goal. But also, crucially, a positive change in sentiment that the parents see in the daily life of their children because they need to feel comfortable to use the orthosis often enough to improve their walking.”

aNImaKe hopes to expand the technique to other parts of the body, such as a hand brace that helps young CP patients spread their fingers.

“We want to enlighten others in the medical industry about the tools that are available today to provide better options to the children,” Matej said. “Orthotics should be built for a person, and should treat only the symptoms, not be standardized solutions that put them in boxes.”

Discuss this and other 3D printing topics at 3DPrintBoard.com or share your thoughts below. 

[Source/Images: Formlabs]