3D printing offers new hope for war-wounded

After seven years of war, an estimated 86,000 Syrians are coping with losing a limb to amputation, according to the World Health Organisation and disability charity Handicap International. IRIN recently spent a day in neighbouring Jordan, exploring how 3D printing technology can produce a new generation of replacement limbs that are more comfortable and adaptable than traditional prosthetics.

Patients come from Syria, Yemen, and Iraq. Many have had amputations following war injuries. Local Jordanians are also patients, some with congenital conditions.

The Medecins Sans FrontiAres (MSF) Foundation, which supports medical and humanitarian innovation and research, funds the 3D project. Its director, Clara Nordon, says she particularly values the lessons learned from real-world field testing: We see it as our duty to bring scientific evidence to what remains until now, a feeling. She says the project will only claim a product is successful when it's proven valuable by our patients.

A conventional replacement arm is heavy, and where it attaches to the stump, can become painful and sore. They can also be clunky and unsightly, and slow to deliver. Lower arms and hands produced with 3D printing, however, have offered encouraging results in terms of speedy production and comfort and ease of use for patients.

The Euros 150,000-a-year 3D pilot scheme is bringing hope of more practical alternatives to conventional artificial limbs (prostheses), ones that can be tailor-made to the client: children can have upgrades as they grow; they can be painted and coloured; extra fittings can be snapped in and out; they can be made in unusual shapes and sizes. After only its first year, the project is also reporting early benefits in using 3D printing to make face masks to ease the healing of burn patients.

The International Committee of the Red Cross, which provided prostheses to more than 22,000 conflict-affected people in 2016, sees potential in 3D printing. It already uses 3D technology to develop and field test prosthetic components, explains ICRC's innovation lead, Nan Buzard.

However, Buzard notes that before the technology can be more widely used regulatory questions must be addressed, as assistive medical devices must pass international certification in many countries. ICRC also notes that so far there are limitations in using the technology for lower-limb prostheses, which must be stronger than those manufactured for upper-limbs; 95 percent of ICRC's amputee patients have lost all or part of their lower limbs.

NGO Handicap International has tested 3D printed sockets on a few below-the-knee amputees in Madagascar, Syria, and Togo. While patients offered positive feedback, costs were higher than conventional methods. (MSF, however, reports deep cost savings on manufacturing the prosthesis.) The experimental sockets, produced by a company based in the UK, met structural and medical requirements, Handicap International reports. In a study of the technology, it suggested further evaluation of a number of issues, including a review of technical training needs; cost of raw materials and workshop space; the costs of scanners and printers; and the speed and effectiveness of fittings.

For MSF's Cordon, the technological potential of 3D imaging is even more of a game-changer than the printing: Now what is really a breakthrough is not so much the printer but rather the scanner! It opens hundreds of leads to optimise tele-expertise, remote advice, and actual remote designing.

The photos below offer a closer look at the Jordan 3D project.

Source: The New Humanitatian