A Biomechanical Comparison of Fiberglass Casts and 3-Dimensional-Printed, Open-Latticed, Ventilated Casts - PubMed (original) (raw)

Randomized Controlled Trial

. 2020 Nov;15(6):842-849.

doi: 10.1177/1558944719831341. Epub 2019 Feb 27.

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Randomized Controlled Trial

A Biomechanical Comparison of Fiberglass Casts and 3-Dimensional-Printed, Open-Latticed, Ventilated Casts

Paul Hoogervorst et al. Hand (N Y). 2020 Nov.

Abstract

Background: The aim of this study was to quantify the stabilizing properties of a 3-dimensional (3D)-printed short-arm cast and compare those properties with traditional fiberglass casts in a cadaveric subacute distal radius fracture model. Methods: A cadaveric subacute fracture model was created in 8 pairs of forearms. The specimens were equally allocated to a fiberglass cast or 3D-printed cast group. All specimens were subjected to 3 biomechanical testing modalities simulating daily life use: flexion and extension of digits, pronation and supination of the hand, and 3-point bending. Between each loading modality, radiological evaluation of the specimens was performed to evaluate possible interval displacement. Interfragmentary motion was quantified using a 3D motion-tracking system. Results: Radiographic assessment did not reveal statistically significant differences in radiographic parameters between the 2 groups before and after biomechanical testing. A statistically significant difference in interfragmentary motion was calculated with the 3-point bending test, with a mean difference of 0.44 (±0.48) mm of motion. Conclusions: A statistically significant difference in interfragmentary motion between the 2 casting groups was only identified in 3-point bending. However, the clinical relevance of this motion remains unclear as the absolute motion is less than 1 mm. The results of this study show noninferiority of the 3D-printed casts compared with the traditional fiberglass casts in immobilizing a subacute distal radius fracture model. These results support the execution of a prospective randomized clinical trial comparing both casting techniques.

Keywords: 3D printing; additive manufacturing; biomechanics; distal radius; fracture cast.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: NL reports grants and nonfinancial support from Standard Cyborg, San Francisco, California, during the conduct of the study. All other authors declare that they have no conflicts of interest.

Figures

Figure 1.

Figure 1.

Example of a 3-dimensional–printed cast.

Figure 2.

Figure 2.

Mechanical testing setup: (a) flexion-extension, (b) pronation-supination, and (c) 3-point bending.

Figure 3.

Figure 3.

Results of the radiographic parameters before and after each subsequent biomechanical testing modality. Note. 3DPC = 3D-printed cast; AP = anteroposterior; L = lateral.

Figure 4.

Figure 4.

Maximum fracture motion during the 3 biomechanical testing modalities. Note. Red = fiberglass cast; green = 3D-printed cast.

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