Page 530 - IJB-10-2

International Journal of Bioprinting 3D printing of custom mallet splints

provision of hand therapy assessments and intervention 3. Results
(M.S.). The lead researcher (U.C.) was also present.
3.1. Participation and study completion rate
2.5. Patient interview Over a 6-month period, 16 patients were recruited, with
Initially, the patient was interviewed regarding their 10 completing the study. There were eight males and two
perception and acceptance of the 3D-printed splint females, and their average age was 58. All patients sustained
using a modified form of the Quebec User Evaluation of their injury through trauma. Two patients withdrew from the
Satisfaction with assistive Technology QUEST (Version study due to an inability to attend all scheduled appointments
2.0). The questionnaires were validated by an external as required. One patient failed to attend any follow-up
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group of experts before commencing the study (a appointments after the bespoke splint was fitted, despite
consultant in emergency medicine, an advanced nurse attempts to contact the patient and rearrange appointments.
practitioner, a research nurse, and an OT). The intention was that all patients would wear a generic
The patient’s satisfaction with the Stack splint and the Stack splint before being fitted with the 3D-printed splint.
3D-printed splint was assessed using a Likert scale and However, one patient could not tolerate the generic Stack
free-text answers. It was explained to each patient that the splint because a close fit could not be obtained. In that case,
initial splint was applied when the finger was likely to be a dorsal aluminum splint was applied. This patient’s data
most swollen. Patients were encouraged to be cognizant are not included in the results.
of this when answering the questionnaire to avoid bias
against their initial splint. On mid-trial review with the consultant in emergency
medicine, two patients were found to have osteoarthritic
The second part of the interview was conducted by the changes to their finger joints. After review by the OT and
OT with a focus on clinical outcomes and acceptance. consultant in emergency medicine, it was decided that
these were more complicated injuries. Consequently, these
2.6. Measurements patients were removed from the study and prescribed
The OT removed the splint and assessed the range of custom thermoplastic splinting and regular reviews by the
movement of the DIPj using a Rolyon finger goniometer OT. The ten patients who completed the study wearing the
®
(Smith and Nephew, London, UK). The patient’s 3D-printed splint attended the final interview with the lead
measurement was compared to the Crawford classification researcher and OT.
scale. This is the most commonly used outcome
classification tool for mallet finger treatment. 3.2. Clinical outcome
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• Excellent: No pain with full range of motion Out of the ten patients recruited, eight had successful
at the DIPj outcomes based on the OT measurements while using the
Crawford classification scale. The results showed that 40% of
• Good: Less than 10-degree extension deficit the patients scored excellent, 30% good, 30% fair, and 0% poor.
• Fair: 10–25 degrees of extension deficit with Of the two patients with unsuccessful outcomes, one
no pain abandoned the use of the splint within the first 6 weeks and
• Poor: More than 25 degrees of extension deficit or returned to participation in sporting activities; the other
persistent pain repeatedly bent the injured finger during hand washing
due to a misunderstanding of discharge advice.
If there was an extension deficit of more than 10 degrees
or poor active extension, the splint was continued for a 3.3. Clinician acceptance
further 2 weeks, followed by night splinting for a further 2 The OT was asked the following question: “Based on
weeks, as directed by the OT. your experience with this patient, would you consider a
3D-printed splint such as this to be potentially suitable for
2.7. Acceptance other patients with closed hand injuries?”
Patient feedback was collected in the free-form section
of each questionnaire to capture each patient’s detailed In all ten cases, the OT indicated they would be happy
experience of both splints. Both the patient and the OT to use a 3D-printed splint in future in place of Stack splints.
were asked if they would use the 3D-printed splint again. However, they noted the need to improve aeration and
durability to ensure the effectiveness of the splint.
2.8. Data analysis
Data from the questionnaires were tabulated and analyzed 3.4. Patient acceptance
using Microsoft Office Excel, and descriptive statistics were Analysis of the questionnaires revealed a clear patient
used to describe the data. acceptance of the 3D-printed splint (Table 2). All but one

Volume 10 Issue 2 (2024) 522 doi: 10.36922/ijb.1963