Safety and Efficacy of Casting During COVID-19 Pandemic: A Comparison of the Mechanical Properties of Polymers Used for 3D Printing to Conventional Materials Used for the Generation of Orthopaedic Orthoses

Document Type : SHORT COMMUNICATION

Authors

1 Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Hand Surgery Division, Rothman Institute, Philadelphia, Pennsylvania, USA

2 Department of Orthopaedic Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA 3 Chief of Hand Surgery Division, Rothman Institute, Philadelphia, Pennsylvania, USA

3 Department of Orthopaedic Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA 4 Rothman Institute, Philadelphia, Pennsylvania, USA

4 Department of Orthopaedic Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA Hand Surgery Division, Rothman Institute, Philadelphia, Pennsylvania, USA

Abstract

To reduce the risk of spread of the novel coronavirus (COVID-19), the emerging protocols are advising for less physicianpatient
contact, shortening the contact time, and keeping a safe distance. It is recommended that unnecessary casting
be avoided in the events that alternative methods can be applied such as in stable ankle fractures, and hindfoot/
midfoot/forefoot injuries. Fiberglass casts are suboptimal because they require a follow up for cast removal while a
conventional plaster cast is amenable to self-removal by submerging in water and cutting the cotton bandages with
scissors. At present, only fiberglass casts are widely available to allow waterproof casting. To reduce the contact time
during casting, a custom-made 3D printed casts/splints can be ordered remotely which reduces the number of visits
and shortens the contact time while it allows for self-removal by the patient. The cast is printed after the limb is 3D
scanned in 5-10 seconds using the commercially available 3D scanners. In contrast to the conventional casting, a 3D
printed cast/splint is washable which is an advantage during an infectious crisis such as the COVID-19 pandemic.
Level of evidence: V

Keywords


1. Clinical guide for the management of trauma
and orthopaedic patients during the coronavirus
pandemic. Specialty guides for patient management
during the coronavirus pandemic. Available at:
URL: https://www.england.nhs.uk/coronavirus/
wp-content/uploads/sites/52/2020/03/specialtyguide-
orthopaedic-trauma-and-coronavirus-v1-16-
march-2020.pdf; 2020.
2. Hoogervorst P, Knox R, Tanaka K, Working ZM, El
Naga AN, Herfat S, et al. A biomechanical comparison
of fiberglass casts and 3-dimensional-printed,
open-latticed, ventilated casts. Hand (N Y). 2019;
27:1558944719831341.
3. Blaya F, Pedro PS, Silva JL, D’Amato R, Heras ES, Juanes
JA. Design of an orthopedic product by using additive
manufacturing technology: the arm splint. J Med Syst.
2018; 42(3):54.
4. Medical device exemptions 510(k) and GMP 
requirements. U.S. Food and Drug Administration.
Available at: URL: https://www.accessdata.fda.gov/
scripts/cdrh/cfdocs/cfpcd/315.cfm?GMPPart=
888#start; 2019.
5. Chiellini E, Cinelli P, Chiellini F, Imam SH.
Environmentally degradable bio-based polymeric
blends and composites. Macromol Biosci. 2004;
4(3):218-31.
6. Samykano M, Selvamani S, Kadirgama K, Ngui W,
Kanagaraj G, Sudhakar K. Mechanical property of
FDM printed ABS: influenceof printing parameters.
Int J Adv Manufact Technol. 2019; 102(3):2779-96.
7. Ali M, Yerbolat G, Amangeldi S. Material optimization
method in 3D printing. Proceedings of the 2018 IEEE
International Conference on Advanced Manufacturing,
ICAM 2018, Institute of Electrical and Electronics
Engineers Inc; Taiwan; 2019. P. 365-8.