Disclosures: Ricardo A. Ayala-Jimenez: Nothing to disclose

Case Description: Patient underwent surgical repair and debridement after a malfunctioning firework detonated prematurely. He lost the radial half including first three digits, 4th digit up to proximal interphalangeal (PIP) joint and 5th digit up to distal interphalangeal (DIP) joint. Edema resolution and skin healing took 2 months. He received two rounds of 8 physical therapy sessions and was discharged with exercises and initial prosthesis arrangements, which never materialized. When initially met, the 4th digit was radially deviated 45 degrees and the 5th PIP had a 90 degrees flexion contracture. Atrophy of wrist flexors/extensors was noted. A body-powered prosthesis was created using a 3-Dimensional printer and adapted for his purpose.

Setting: Community Service

Patient: 37-year-old right-handed male with a left hand traumatic partial amputation.

Assessment/Results: Immediately after fitment, patient was able to grab objects with different morphologies and apply graduating levels of grip strength depending of the need. Unfortunately, it lasted around 8 months, most likely due to material selection and high concentrated stresses. Currently working on upgraded model.

Discussion: Current prostheses, particularly for upper extremities, have a steep cost/usability ratio. Highly specialized devices are prohibitive for the majority. Furthermore, 3 of 10 patients discontinue its use mostly due to discomfort, weight, and maneuverability. The device envisioned should address these issues, especially for a previously fully functional handyman. 3D printing recently became available to average users, mostly for prototyping. Due to the necessity of affordable, customizable, reproducible processes it became a viable alternative. A home-assembled Fused-Filament-Fabrication printer was used to create most of the prosthesis, completed with parts from local hardware and craft stores. Base model was sourced from a non-profit organization and customized to our patient’s anatomy. Despite its limitations, it was a foundation for improvement.

Conclusion: 3D printing is a growing alternative for custom prostheses. Its accessibility, adaptability and affordability exceed current limitations.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/affordable-prosthetics-orthotics-using-3-dimensional-printing-are-an-imminent-reality-a-case-report/