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International Journal of Bioprinting 3D printing of custom mallet splints

airflow. In addition, discharge advice on how best to secure Patterson et al. report that the use of 3D printing in hand
the 3D-printed splint is essential and needs more focus. therapy is still very much in its infancy. They attribute
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this to the absence of purpose-built software programs for
4.2.2. Securing to the finger splint design. There is, therefore, a considerable learning
Although one of the goals of the initial design was to curve for healthcare practitioners to become proficient in
minimize the use of adhesive tape to secure the splint, designing splints.
patients generally preferred the additional security
provided by tape. Patients had been securing the generic There are many steps required to bring this 3D-printed
Stack splint with tape for several days before wearing the splint option to patients. The development of 3D printing
3D-printed splint and felt more secure continuing with technologies has progressed at a rapid pace since its
tape. However, the amount of tape required to secure the introduction in the late 1980s. Regulation on the use of
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3D-printed splint was notably less than that required for 3D printing for healthcare applications is often unclear.
the generic splint. It is important to consider designing However, some guidance is forming; ISO 52910 outlines
a splint that does not require any extra taping to make it guidelines on the use of additive manufacturing in product
easier to remove and reapply. design and is applicable to all products fabricated by any
type of additive manufacturing. Until this guidance is
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4.2.3. Materials clear and appropriate for medical applications, the use of
Patients also reported that the 3D-printed splint fit well 3D printing outside of research studies will be curtailed.
on initial application. However, over the 8 weeks, some Nonetheless, it is important to discuss key steps in the
patients reported that the splint began to change shape, process to help visualize a future for 3D printing for mallet
losing its form and distorting. This led to increased use finger injuries in hospitals.
of tape to ensure the splint stayed in place. The distortion One area this study highlighted as challenging is the
can be attributed to the mechanical properties of the 3D immediate need for a custom 3D-printed splint to treat
printing material and is an important finding for future a patient. Patients presenting at hospital with a mallet
design iterations. The material needs to be robust and injury require timely treatment. The procedure in this
durable enough to last the duration of the treatment. study involved first applying the generic Stack splint to
Further research is needed to determine what material each patient for a number of days to allow the research
to use. team time to coordinate the measuring, printing,

4.2.4. PIPj and fitting of the 3D-printed splint. As a measuring
It is necessary to keep the PIPj free to flex during mallet technician is not based in each unit, and the appropriate
finger treatment. Only the DIPj needs to be immobilized. 3D printer is not present in each unit, some additional
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Therefore, when designing a splint for mallet finger steps would be needed to offer an immediate 3D-printed
treatment, it is essential to allow enough clearance between mallet splint.
the base of the splint to the PIPj. Focusing on each patient’s 4.4. Discharge advice and compliance
anthropometrics as the study progressed ensured the PIPj There are many studies detailing how patients are often
had adequate clearance to move freely. discharged without a clear understanding of their discharge

In addition to some modifications needed for the advice. 33-35 This can lead to confusion, frustration, poor
3D-printed splint, the process used for this study worked compliance, and clinical complications for patients.
well as a research study but needs careful consideration Mallet injuries require patients to closely follow their
to be made logistically possible in healthcare facilities. discharge advice to support their recovery. It is therefore
Currently, generic Stack splints are the most common essential to provide clear, concise discharge advice to
offering for treatment of mallet finger injuries. One unit ensure patients can care for their injury while at home.
in the ULHG provides custom splinting from the OT team It is equally important to ensure patients understand the
on a limited basis. Although the 3D-printed splint was advice given.
found to be more acceptable to patients in this study, there
are barriers to the roll out of this service across healthcare A study conducted by Groth et al. looked at the impact
units. of compliance on the rehabilitation of patients with mallet
finger injuries. They revealed that compliant patients
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4.3. Process challenges have excellent outcomes more often than non-compliant
Based on the findings of this small pilot study, the patients (61.5% and 9.1%, respectively). Two of the patients
introduction of 3D-printed mallet splints for patients in enrolled in this study did not comply with discharge advice.
hospitals would appear to be a welcome treatment option. One removed the splint before completing their treatment,

Volume 10 Issue 2 (2024) 527 doi: 10.36922/ijb.1963