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RESEARCH ARTICLE

3D-Printed Hand Splints versus Thermoplastic Splints: A

Randomized Controlled Pilot Feasibility Trial

Leonie Waldburger , Romain Schaller Christina Furthmüller , Lorena Schrepfer ,
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1
1
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Dirk J. Schaefer , Alexandre Kaempfen *
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1 Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Basel, Switzerland
2 Department of Hand Rehabilitation, Occupational Therapy, University Hospital Basel, Basel, Switzerland
Abstract: In this randomized controlled pilot trial, we compared three-dimensional (3D)-printed made-to-measure splints to
conventional custom-made thermoplastic splints. In a clinical setting, we evaluated their general applicability and possible
benefits for immobilization in hand surgical patients. We included 20 patients with an indication for immobilization of at least
4 weeks, regardless of the splint design. Patient comfort and satisfaction were assessed with questionnaires at splint fitting,
as well as 2 and 4–6 weeks later. The 3D splints were designed and printed in-house with polylactic acid from a 3D surface
scan. Our data suggest that 3D-printed splinting is feasible, and patient satisfaction ratings were similar for 3D-printed and
thermoplastic splints. The 3D splint production process needs to be optimized and other materials need to be tested before
routine implementation is possible or more patients can be enrolled in further studies. Validated quality assessment tools for
current splinting are lacking, and further investigation is necessary.

Keywords: Hand surgery; 3D printing; Occupational therapy; Splint quality; Additive manufacturing

*Correspondence to: Alexandre Kaempfen, Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Spitalstrasse 21, 4035
Basel, Switzerland; alexandre.kaempfen@usb.ch

Received: October 5, 2021; Accepted: November 10, 2021; Published Online: December 2, 2021
Citation: Waldburger L, Schaller R, Furthmüller C, et al., 2022, 3D-Printed Hand Splints versus Thermoplastic Splints: A Randomized
Controlled Pilot Feasibility Trial. Int J Bioprint, 8(1):474. http:// doi.org/10.18063/ijb.v8i1.474

1. Introduction those of fiberglass casts [11,12] . In healthy volunteers, the
comfort and satisfaction of 3D-printed short arm splints
Operative and conservative treatment of trauma and were rated as being superior to that of fiberglass casts .
[13]
degenerative diseases of the hand relies on immobilization Comparison of 3D-printed splints that have perforated
of the affected structures. Important features of designs to circular plaster casts seems unfair, yet we
immobilization devices include accurate fit of the impaired found only one study that compared 3D printed with
hand and preservation of the non-affected hand functions. thermoplastic splints. It showed a greater potential of the
One of the fast evolving technologies with 3D-printed splints to reduce spasticity and swelling and
interest in medical fields is the three-dimensional (3D) to improve motor function over 6 weeks of treatment in
technology. 3D scanning systems and 3D printers allow hemiparetic patients .
[14]
the fabrication of 3D physical objects with applications in Few other studies have tested 3D-printed hand
multiple medical disciplines such as orthopedics, spinal splints in a clinical setting. Two independent pilot trials
surgery, maxillofacial surgery, or neurosurgery. reported good feasibility and high patient satisfaction
The fabrication of orthoses and splints is a potentially of adults and children treated for fractures of the radius
easy application in 3D printing. Several studies and case with wrist splints made of 3D-printed polypropylene,
reports have proposed different design algorithms for polyamide, or thermoplastic-modified acrylonitrile
3D splints and assistive devices for hand surgery [1-10] . butadiene styrene [15,16] . However, we were unable to
Others have demonstrated the possibility of fabricating find suitable validated questionnaires for quality control
3D-printed splints with similar mechanical properties to assessments of custom-made temporary immobilizing

© 2021 Author(s). This is an Open Access article distributed under the terms of the Creative Commons Attribution License, permitting distribution and
reproduction in any medium, provided the original work is properly cited.
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