NEWS

UC students build 3D-printed prosthetic hands for kids

Kate Murphy
kmurphy@enquirer.com
Tue., Feb. 14, 2017: Derryn Scott, a fifth-year biomedical engineering student at the University of Cincinnati, holds a 3D-printed prosthetic that Enable UC, a student organization, produced.

College and high school students in Greater Cincinnati are using 3D printing to solve medical problems in the community.

A group of biomedical engineering students at the University of Cincinnati started a student organization in 2015 to build inexpensive prosthetic hands for local kids.

Inspired by the global organization e-Nable, Enable UC can build a custom, functional hand in its lab on campus for less than $20 – instead of thousands of dollars – and get it to the patient in about a week. Pediatric patients aren't charged a penny and are able to shake someone’s hand, catch a football or ride a bike with two hands.

These devices aren't meant to replace prostheses developed in collaboration with a medical professional. They're designed to be affordable and accessible tools for kids. The artificial hands are made out of plastic and don't use electrical sensors or robotics. Making them this way reduces the cost of supplying multiple prostheses when kids grow out of them and can be easily replaced if they break.

Tue., Feb. 14, 2017: Ishan Anand, a fourth-year biomedical engineering student at the University of Cincinnati, holds a 3D-printed prosthetic that Enable UC, a student organization, produced. Behind him, are other biomedical engineering students that are part of Enable UC. From left: Nick Bailey, Jacob Knorr, Derryn Scott, and Yosef Kirschner.

So far, in the group's less than two years of existence, students have built 42 prosthetic hands and assistive devices. And they want to do more.

"This is empowering students to have a direct impact in the life of someone with a disability," said Jacob Knorr, a 22-year-old biomedical engineering student and president of Enable UC.

The first person to receive a hand from Enable UC was a 13-year-old boy named Brody who was born with a partial right hand. It was hard for Brody to steer a bike, throw a ball or hold a lacrosse because of his disability, according to the university. Enable UC made a hand that looked like a Star Wars Stormtrooper for Brody, a huge fan of the movie franchise, so he could play with other kids his age.

The group's most recent hand recipient was 15-year-old T.J. McGinnis, a varsity football player at Rock Hill High School in Ironton, Ohio. T.J. was born a partial right hand and had never experienced using two hands before meeting the Enable UC team.

How it works

UC students find a patient or a patient finds them, often through relationships with UC Health and Cincinnati Children’s Hospital Medical Center.

To produce a prosthetic hand, students don’t need to meet with a patient. All they need is a picture of the patient’s arm that needs the prosthetic, Knorr said.

Then, the students go online and find a 3D design file of a hand or fingers from e-Nable – a global open source organization and volunteer network that provides free prosthetic hands to kids in need around the world. The organization allows anyone with access to a 3D printer to make a prosthetic hand using its design files, which inspired the creation of UC's student group. Students at Xavier University and Walnut Hills High School are also using the e-Nable program to build prosthetics with 3D printers.

The downloadable file is, in essence, instructions the 3D printer can read. The students can make adjustments and scale the file according to the patient’s disability to make sure the hand will fit.

Next, the students order the plastic materials to make the prosthetic and then load them in the printer like ink. Digital instructions are then sent to the printer and within 12 to 24 hours all the parts, including pins and hinges, are made.

The print process is slow and isn't always perfect. Imagine printing off thousands of pages at your home computer and after eight hours of waiting, there's a paper jam – it is a machine after all. Then, you'd have to reload the printer and wait for another 12 to 24 hours.

Tue., Feb. 14, 2017: The beginning stages of a prosthetic hand is 3D-printed by the Enable UC, a student organization at the university.

Once the pieces are printed, the team fits them together to make the plastic hand functional, wearable and comfortable for the patient, which takes a few hours.

Elastic keeps the hand open and a tensioned twine is tied to all the fingers, which is anchored to the wrist. So, when patients flex their wrist, the strings are pulled and the hand closes.

It takes about a week from the time the team finds a patient to having a completed product that's ready to use. The prosthetic hand costs less than $20 to build and it’s free for the patient, a cost that's completely subsidized by the university by funding costs for materials and printing. According to e-Nable, a professionally made, muscle-actuated hand can cost between $6,000 and $10,000.

The UC students are also using 3D printing to build other assistive devices for the occupational and physical therapy programs at Touro University in New York. They aren't prosthetic hands, but tools that patients use to carry out everyday tasks they normally couldn't.

They built a device for a patient who had suffered a traumatic brain injury so that he would be able to drink independently at the dinner table. Students have also created devices that help patients to open a bottle of nail polish and play the violin.

“We’re trying to help people live their lives a bit easier," Knorr said.

The future of 3D printing in prosthetics

Christine Geeding, the clinical director at the Corryville-based J.F. Rowley Prosthetic and Orthotics Lab, said the innovation of 3D printing could make prosthetics more accessible and affordable.

“3D printing is going to have a really good place in prosthetics, it’s just not there yet,” Geeding said. "Once they start perfecting it and making it strong, then it will trickle down to being more affordable to us."

Printers need to be able to use stronger material and print faster, she said. When that happens, it could bring down the whole price as manufacturers are able to make the parts people can use cheaper.

Geeding has been a prosthetist for more than 20 years. Her office specializes in pediatrics and she said they rarely see patients looking for prosthetic hands or fingers because the human body adapts and compensates for the loss. Often, the loss doesn’t become a concern for a patient until adolescence when it becomes more of a cosmetic issue.

When a patient does come in, she works closely with parents to identify the child’s needs and goals.

Geeding casts the limb that needs the prosthetic, creating a mold. She customizes the device to the exact size and shape of the patient to make sure it’s comfortable. Geeding makes a prosthesis in her office in about two hours, and the prices vary, but the bill is usually covered by insurance.

She said making a hand for one patient would cost her about $1,000. That includes the crafting the device itself and the socket where it attaches to the body, plus office visits. One of her recent patients had a prosthetic from the shoulder down and the insurance company paid $3,800.

Geeding makes prosthetics made out of titanium, which is light, and reinforced with a combination of carbon, the synthetic fiber Kevlar and glass.

She said that material combination makes prosthetics durable enough for kids to play on the playground or a baseball field without worrying about it breaking.

Students at UC, beyond invested in helping others 

Knorr has worked as a co-op student and undergraduate researcher at Cincinnati Children's in the plastic surgery division since 2014. His research is focused on craniofacial abnormalities in children. He uses 3D printing to create tissue-engineered “scaffolds” used to grow bones to repair cleft lip or palate bone defects.

With that experience, he saw the opportunities his university could provide for other students and patients through 3D printing.

Knorr saw a news story about a civil engineer who made an inexpensive prosthetic for a veteran who had lost his fingers. He thought "this would be a cool thing to bring to UC."

Knorr and some of his engineer friends formed Enable UC, which became a formal student organization in October 2015. The group was awarded grants from the College of Engineering and Applied Sciences Alumni Association to buy the 3D printer. The university provides the materials and lab space on the Victory Parkway campus in East Walnut Hills. The University Funding Board and UC's Student Activities and Leadership Development also help fund the organization.

Now, the organization has about 30 students as members, a 12-member executive board and a faculty adviser, James Lin from UC's biomedical engineering program.

"Here, we can actually do something that’s similar to what a professional would do," Knorr said. "It's giving students very valuable skills that will help them do this type of work later in life."

Knorr said students in the organization also want to address new medical problems by collaborating with Cincinnati's medical community.

For example, Enable UC is working with a seven-year-old girl at Cincinnati Children’s to develop a hand that will help her overcome a nerve injury in her arm. She isn’t missing any part of her arm, but she can’t close her fingers.

They’re building her a brachial plexus arm, the first of its kind, that will incorporate a glove design to help her grasp things.

“Our idea is to develop it on the basis of this one patient and then make it available to the open-source community so that other institutions can use the device we’ve created to help people with similar medical conditions,” Knorr said.

At Xavier, the university has a "human-centered making" major where students learn "design, product engineering and critical thinking skills with an emphasis on empathy." Those students used a 3D printer to build a myoelectric hand that offers more control and dexterity than the plastic prostheses. Those devices have electrical sensors in the socket that are connected to the patient's arm and sense when the muscle is flexing to open and close their hand.

Geeding, who is a professional consultant to the Xavier students, has referred some interested patients to Xavier's e-Nable program.

She said the e-Nable movement is raising awareness of "an issue that a lot of people don’t pay much attention to" and patients are getting access to something they're going to use every day.