Is 3D Prosthetic Printing in the Future for FTM?6/14/2017
After a recent remodel, the prosthetics clinic located at the ILAC mission in the Dominican Republic looks ahead to advanced technologies like molded plastics, 3D printing, and CAD design to increase their patient volume.
Made from a shipping container that Dr. Tessier used to send the original prosthetic tools from Florida to the Dominican Republic two years after the Haitian earthquake (2011), the prosthetics clinic no longer looks like it just arrived by truck. When the prosthetic lab was established there was no other functional prosthetics clinic for the ten million people who live in the DR not to mention those who live in Haiti and travel to the DR for healthcare.
Since then, a few other prosthetic clinics have been established on the island, but Ranvier, the prosthetist who runs the clinic, believes this is the only reasonable option for those who can’t afford the services of a private clinic.
Before the recent improvements to the clinic at ILAC, Ranvier had to meet with patients outside for assessments because he simply did not have any space inside. Likewise, any therapy they needed as they learned how to use their new device had to be outside. This meant that when it rained, which is fairly often in the DR, Ranvier couldn’t meet with patients. The new improvements include private assessment rooms, an indoor physical therapy area, a new workshop and a much needed storage area with a new roof that protects the original container as well as the newly constructed areas (see video at bottom).
With the improvements Ranvier has doubled the number of people he can see from one hundred patients the year before the remodel to an expected two hundred patients this year.
Here is a video made before the improvements.
With the new remodel, Ranvier now has room to add physical therapy to the potential services the clinic could offer. This would be a tremendous help to the patients and allow Ranvier to concentrate on prosthetics production. To do this, Ranvier has set his sights on improving his processes to shorten the time it takes to make each prosthetic. This could include 3D printing of prosthetic parts, using a plastic molding machine, and possibly a 3D scanner in conjunction with an animation program.
This is a short video of a 3D printer working on a brain tumor model.
The most time-intensive part of making a prosthetic is the multistep process of forming the socket. This is the piece that fits over the residual limb. It takes the weight and is the point of control for the prosthetic. If the fit is too tight it will cause pain and discomfort, if the fit is too loose there is a lack of control. Think of trying to use a fork with a gummy-worm handle. Forming a good socket has often been described as an art form. Ranvier can sometimes spend up to three days making a mold of the residual limb and forming a socket that fits well.
Below are some pictures of finished prosthetic devices.
There are ideas in incubation that can be developed or tested in beta during the next mission in 2018. One idea is that a 3D printer and scanner might be able to assist in making a socket. There are fairly inexpensive combinations of scanners and printers that could make a mold of the residual limb just by taking a few pictures of it. Once Ranvier has a mold of the limb, he can then use a special oven to heat a plastic blank up to 300 degrees F and, while it is still hot, place the blank over the mold and suck the air out of the space between the mold and the plastic. When the plastic cools, he would have a socket that only requires small adjustments for a good fit.
Ranvier has worked in more advanced clinics in other countries so he has the knowledge and experience to utilize the more advanced systems. For now, the obstacles are twofold. One is deciding on a system that is fairly rugged and self-contained, and two, developing a plan to invest and implement that system. FTM is working on partnering with a prosthetics clinic in the US to share their technology with the clinic at ILAC in the DR.
Below is a short video of some of the improvements.