The Jack Brockhoff Foundation Churchill Fellowship to gain new knowledge regarding 3D-printed hand prostheses

People with arm/hand differences have traditionally had few options for prostheses, given there has been little industry investment in research and development. 3D printing technology generates excitement in consumers and designers and provides endless opportunities for customised products at low cost. There are some risks and issues that must be considered in the largely unregulated volunteer space. The most important are: • Agencies acting in the 3D printing and design space for people with limb differences must partner with skilled prosthetists in their local area, as recipients have very specific and unique needs and prosthetists have the necessary expertise to best accommodate these. • Getting the socket fit right is the most important aspect of providing these devices. Existing downloadable designs for people with partial hands do not provide adequate sockets, and are likely to be abandoned. • For the terminal device (e.g. the “hand” or “hook”) many consumers prefer a life-like appearance, especially when using the hand in public. Task-specific devices, however, are usually more functional. • If the terminal device is to be hand-like, mechanical linkage systems for digits may be more robust than cable-driven ones. • Consumers require follow-up care with skilled health practitioners for re-fitting the device as required and training in how to use it to do the activities they want/need to do. Models of practice which involve makers/designers creating the device remotely (i.e. without working face-to-face with the consumer and their healthcare team) have been unsuccessful and are to be discouraged. // The key highlights of my Fellowship included: • The opportunity to meet with and observe the work of international designers and clinicians whose work has influenced my current research and practice in the field. All have faced the same frustrations and challenges that I have, but given they have been doing this in the US and Europe for much longer than we have in Australia, they have come up with solutions and systems that we can benefit from. • Learning about current and emerging 3D printing technologies and the exciting potential applications to my field. • Establishing formal international research and clinical collaborations with centres visited. This has led to the world-first consumer trial in Australia of the Self Grasping Hand, designed by Dr Gerwin Smit, University of Delft (Netherlands) and includes a mechanical linkage system within a 3-D printed shell. • //I have presented our work at the Australian Orthotic Prosthetic Association National Congress, the International Society for Prosthetics and Orthotics (Japan) the Australian Hand Therapy Association’s National Conference, and the Australian Assistive Technology Conference. //Our team's plan is to test a new and improved model that has been informed by the data and consumer feedback/suggestions gathered during our trial.