3D printing of casts used to fix broken bones improves patient outcomes

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ActivArmor’s 3D printing process enables the production of a wide range of custom casts and splints for people of all shapes, sizes and ages. Image: ActivArmor

Fans of the NFL’s Jacksonville Jaguars football team will be happy to learn that there’s a new, improved way to deal with broken bones and sprains that players sometimes experience. North Florida high school and college athletes who have injured themselves while playing sports will also be thrilled, as will anyone else with a broken bone who visits Dr. Kevin Kaplan, orthopedic surgeon at Jacksonville (Florida) Orthopedic Institute and the Jaguar core team. doctor.

“I was looking for a better treatment option for my athletic patients,” he said. “Traditional casts have all kinds of problems in terms of sweat, dirt and itching. And when trying to heal a fracture or broken bone, removing a cast to assess the healing process, while often necessary, isn’t the best thing to do.

“That’s where I met Diana.”

Kaplan talks about Diana Hall, founder and CEO of ActivArmor, based in Pueblo, Colorado, and the 2022 recipient of the Colorado Manufacturing Woman of the Year award.

Building Solutions

In 2014, Hall started offering the best treatment option that Kaplan was referring to. A chemical engineering graduate from the Colorado School of Mines, Hall was running a mentorship program for poor children when she, like Kaplan, began looking for an alternative to plaster casts. Having had previous experience with 3D printing at various Fortune 500 companies, it didn’t take him long to find a solution.

Said Hall: “Children like to play. They get their casts dirty, they get them wet, and for that reason we need a hygienic, washable alternative to immobilize broken bones. I quickly realized that if we could additively manufacture a cast from biocompatible plastic, it would provide a custom-fitted, disinfectable orthosis that would lead to a much better result.

ActivArmor has since 3D printed tens of thousands of these casts across the United States and has established an ever-growing number of partnerships with companies in Canada, Australia, Greece, the Middle East and elsewhere. Hall has also collaborated with additive manufacturing technology companies such as Denmark’s Create it REAL, which makes the cutting software used by ActivArmor, and Twikit, a Belgium-based design-automation software developer.

She is also a dedicated user of FFF (fused filament fabrication) printers. Several dozen FFF-style machines of varying sizes from Fusion3, Greensboro, NC, sit on ActivArmor’s Pueblo production floor. Most of them have been equipped with special hot nozzles and other features to maximize printing speed.

Printing process

Hall and the ActivArmor team have developed an end-to-end workflow that ensures compliance with FDA regulations. Its casts and splints are made of ABS and have been thoroughly tested for any microporosity that may lead to fluid absorption and bacterial growth, as well as biocompatibility and mechanical strength. The result is an efficient and repeatable process that allows ActivArmor to deliver custom orthotics to its medical partners within four days. (Rush orders are shipped in a shorter time.)

When a patient in need of a cast arrives at a medical facility participating in the ActivArmor program, the attending physician scans the injured limb with a cell phone equipped with the ActivArmor Scan app. Next, the doctor takes some measurements of the injured limb and answers a series of questions posed by the app, then forwards the results to ActivArmor for processing.

additive manufacturing

ActivArmor can deliver finished 3D printed casts in four days or less.

While waiting for the cast to arrive, patients are fitted with a temporary splint – also 3D printed by ActivArmor – which gives the edema (swelling) common to broken limbs some time to dissipate. It’s also an easy-to-use process, so much so that ActivArmor will soon begin renting preconfigured 3D printing cells to participating clinics for use in their facilities, further expediting patient care.

Click here to learn more about the program.

Rethinking castings

One clinic eagerly awaiting the rollout of the print cell is Motion Is Medicine, a sports and family medicine in North Richland Hills, Texas, founded by Dr. Daniel Clearfield.

“Anyone who has worn a cast knows the experience. They itch, smell and are uncomfortable,” said Clearfield, who is also the team doctor for USA Wrestling and USA Judo. “With the 3D printed casts, my patients can do all the activities they are used to.” He’s laughing. “I started referring to ActivArmor casts as ‘summer savers’. ”

Dr. Laurence “Laudi” Laudicina of ABQ Orthopedics in Albuquerque, NM, agrees. He said patients knew “something special was going on” when he started scanning their wrist or ankle with his smartphone. “And when I take this colorful 3D printed cast out of the box, the response is always, ‘That’s so cool.’ What’s even cooler is that they can jump in the shower, play sports and jump in the pool with their friends.

Hall is clearly thrilled to have pulled off a 3D circuit board stunt, but she’s even happier that people of all ages now have an affordable alternative to the “smelly, irritating” braces of yesteryear. She said the cost of one ActivArmor cast is about the same as the two casts it replaces. (A cast must be cut and replaced for each examination and x-ray.)

And because an ActivArmor cast eliminates common annoyances with a cast, like rolling a coat hanger inside to scratch an itch, patient compliance is better. This significantly improves results, Hall said.

She expects the plaster casts to eventually follow the iron lung path.

“Casts make it difficult for anyone to practice basic hygiene like washing their hands, especially children,” Hall said. “You have people in the food service and medical industries who wind up on short-term disability because they can’t sanitize their hands, so workers’ compensation providers love ActivArmor.

“Additive manufacturing has changed all that. It’s become a tool to improve people’s quality of life, and now it’s available to all fracture care providers around the world,” Hall said.

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