A start-up project to create customised 3D-printed hand prostheses affordable in developing countries
Rafael R. Torrealba, Samuel B Udelman, Arturo J Rivas, Fernando J Carvalho
Purpose: Prosthetic devices are expensive in developing countries, regardless of whether they are for lower or upper limbs. However, in the latter case, the prostheses are not much demanded in structural terms and that is why 3D-printing using common polymeric materials as PLA or ABS may be used to produce these in a clean, relatively fast and affordable way. In particular, the present paper is aimed at creating customised 3D-printed hand prostheses at an affordable price in Venezuela, a developing country. The idea is to approach this task by combining the designs of some similar initiatives abroad, and the authors' know-how in the P&O field, as well as in mechanical design and 3D-printing. Method: In general terms, this work looks to give a holistic statement of the problem, presenting an ongoing local initiative to solve it, and sharing some concluding remarks on the outcomes of this work besides a prospective on what the near future might bring. For this, the paper was structured in accordance with the methodology applied, covering the following issues: research introduction, background contextualisation, mechanical design and manufacturing of the hand, a case study, cost analysis, alternatives to give sustainability to the project, and finally, conclusions and prospective view. Results: A complete customised 3D-printed prosthesis was created, consisting of both arm and hand, for a 13-year-old male child disarticulated at the elbow. This allowed, on the one hand, to present the process of design and manufacturing of the prosthesis, furthermore involving the P&O criterion of qualified technicians to fit and evaluate its performance preliminarily, and on the other one, to analise the resulting cost structure of this initiative in a developing country, such as Venezuela, at the time that several alternatives are introduced in order to make this start-up viable. Conclusions: Some changes in the design of the hand prosthesis developed so far are needed, in order to make it really functional, and to automate the process of adapting the hand design to a particular patient requirements, until the subsequent manufacture and mounting of the device. Using 3D-printing for creating hand/arm prostheses brings affordability to this kind of devices in a significant measure, but it is made clear that the use of such technology by engineers to create prostheses must be accompanied by the skilled job of prosthetists. Likewise, several alternatives, such as making alliances with healthcare institutions, launching community service programs through universities, besides looking for private investment and public funds, must be explored in order to raise the budget required to make this start-up sustainable in time. Finally, as a prospective conclusion, it is remarked that the development initiated with this work is able to incorporate future advancements in the technology of artificial hands.