Victoria Hand: Providing 3D-Printed Prosthetics to Amputees in Developing Countries
At the University of Victoria, a team of engineers, designers, and volunteers are working hard to provide 3D-printed prosthetics to amputees in the world's poorest regions. This is a challenging, yet very unique, undertaking. They are the Victoria Hand project, and today we will tell their story.
Adaptive Grasp
In the late 1990s, Dr. Nikolai Dechev was working on his PhD project, creating a prosthetic hand with groundbreaking technology, which he called the Adaptive Grasp. The Adaptive Grasp allowed fingers to conform around objects as the hand closed. At the time, the hand was designed to be welded onto a CNC machine. This high-cost manufacturing method was an unwise choice. And it was precisely at this point that 3D printing found its niche. Seeing the potential of this technology, Dechev and his colleague Joshua Coutts modified the design and began the Victoria Hand project.
Due to limited resources, restricted access to rural areas, lack of specialized knowledge, and high costs, prosthetics are often difficult to obtain in developing countries. 3D printing offers a solution to these problems, enabling the team to reduce costs and print and assemble locally in each country. With a 3D printer and the right materials, clinics can print personalized medical devices or replacement parts, even in remote areas. For example, in Nepal, a team of engineers travels with their 3D printer to create medical devices and replacement parts for machines. This method is easier and cheaper than transporting specific parts and large boxes.
They needed a printer that could provide high-quality finished products with strong adhesion between each plastic layer. The Ultimaker 2 was ideal. Due to the high quality of the Ultimaker 2, it is an easy-to-use 3D printer with available resources for maintenance and troubleshooting.
How the Ultimaker 2 Works
First, a prosthetist assesses the amputee. A mold of the residual limb is created, and then the prosthetist creates an interface between the device and the human body. The Victoria Hand project team captures the prosthetist's skills through a customized 3D scan of the plaster mold. This scan is then used to create a customized 3D-printed socket for the amputee.
The hand and wrist components take approximately 48 hours to print, then are assembled and connected to the custom socket. The final step is to paint the prosthetic to match the natural skin tone. This aesthetic touch helps amputees feel more confident.
Training is provided to all 3D printing lab staff, as well as prosthetists and clinicians.
Challenges of 3D Printing
In 2014, the Victoria Hand project team researched different 3D printers and found the Ultimaker 2 to be best suited for the task. Initially, they also ordered an SLA 3D printer, but it led to many print failures and did not provide the required clean environment. The parts were also too fragile for practical use. This proved that Ultimaker was easier to use, which meant that clinicians and prosthetists could quickly learn how to operate them.
There were still some issues along the way, but Ultimaker's guides and forums helped them learn how to use and maintain the 3D printers. The printing quality improved, and the manufacturing process accelerated. Over the years, the team gained valuable experience using 3D printers and was able to provide technical services to other clinics. They personally trained medical workers to ensure they knew how to assemble and fit the prosthetics. This encouraged closer relationships among clinic staff.
The team also learned that 3D printing in clinics was different from printing in the University of Victoria's lab. For example, in Nepal, there are daily power outages. Without a UPS, sockets cannot be printed. In other clinics, it is hot and humid, which can change the properties of the materials. In Kathmandu, the air is dusty, meaning the heated bed needs to be cleaned more frequently, making the process more expensive. Additionally, shipping and import fees make replacement parts expensive, even for tiny nozzles.
Material Selection
Sometimes, knowing the best print settings can be challenging. Using the Ultimaker 2+ printer, the Victoria Hand team tested print speed and layer thickness to find the optimal settings and tested different materials such as PLA, ABS, nylon, and PET. Engineering student volunteers conducted tensile tests and failure analysis in each case. These tests allowed the Victoria Hand project to refine their designs.
The students found black PLA to be the best. It is strong and requires less pre-processing time. Other materials were harder to print; for example, although ABS is also strong, it does not adhere firmly to the heated bed. This is problematic for inexperienced 3D printer users (such as clinic staff). PLA provides excellent quality and is easy to use – so it is the ideal 3D printing material.
From Guatemala to Cambodia and Beyond
After receiving the Grand Challenges Canada award, the Victoria Hand project collaborated with a sports program in Guatemala. Short-term and long-term trials were conducted, which confirmed the urgent need for high-quality prosthetics without the cost. Designer Joshua Coutts recalled his third visit, when he realized the local potential of 3D printers.
Before that, he focused on developing hand function. In the third trial, both function, ease of use, and aesthetics were improved, which made a world of difference. It felt as if their hard work had finally paid off, and they were finally delivering life-changing results.
Since then, the Victoria Hand project has partnered with other clinical partners in Nepal, Haiti, Cambodia, and Ecuador. Clinics find amputees, print and assemble the hands, and fit the prosthetics. The Victoria Hand project team sets up equipment, trains local staff, and provides support and ongoing follow-up.
Sponsors and Supporters
This project would not have been possible without several generous donations. Grand Challenges Canada funded the initial development and trials and expanded their support to help establish more clinics. Ultimaker donated four Ultimaker 2+ 3D printers, which are a critical component of the operation. The Enable Community Foundation funded clinics in Haiti, and other donations were raised through crowdfunding and fundraising.
Although the Victoria Hand project has collaborated with E-nable, the design team is now separate. E-nable operates an open-source model, allowing people to download designs and print them anywhere with a 3D printer. The Victoria Hand project only provides STL files and G-code files to collaborators. This ensures the excellent quality of the 3D-printed prosthetics and maintains a good reputation.
New Devices
In addition to 3D-printed hands, the team has started using 3D printing to develop other medical devices; for example, adjustable ankle-foot orthoses, ankle braces, and finger splints. They use the same hardware and materials, so new designs emailed to clinics can be printed immediately.
Since PLA is a thermoplastic, parts can be thermoformed using a heat gun or hot water. When the material softens, it can be formed around the limb; then, when it cools, it becomes rigid and provides support.
Future
The Victoria Hand project aims to further improve the system for amputees, raise funds, and establish more partnerships worldwide. Raising awareness and obtaining financial support are key factors in achieving this goal. Watch this space to learn more about this amazing project!
Original text:https://ultimaker.com/en/stories/23486-victoria-hand-providing-3d-printed-prosthetics-to-amputees-in-the-developing-world
[3D Printing News] Victoria Hand 3D Printed Prosthesis
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