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Ahmad is the first patient to receive an above-elbow 3D printed prosthetic from MSF. Technicians added an extra piece to substitute the humerus in the prosthetic, and Ahmad will be able to both bend and stretch the arm.

For over ten years now, Médecins Sans Frontières (MSF), known in English as Doctors Without Borders, has been operating a reconstructive surgery hospital in Amman, Jordan. Patients from many Middle Eastern countries who are victims of bomb blasts, shrapnel, bullets, and other war-related wounds are healed there.

But the MSF-run hospital also offers upper limb amputees something in addition to emergency medical care – 3D printed prosthetics.

Moreau scans the amputated hand of Ibrahim, a patient from Iraq. The scanned image appears in real-time on his computer and will provide accurate measurements for his tailor-made prosthetics.

Pierre Moreau, the clinical coordinator for MSF’s 3D printed prosthetic project in Jordan, said, “The MSF Foundation launched the 3D project in Amman in February last year, and we started to see the first patients two months later.

“So far, we have delivered 16 printed prosthetics. But our role doesn’t stop here. We support patients through a string of occupational therapy sessions to show what they can do with them.”

The project began as a study and is still technically in its experimental phase. Patients come to the hospital from places where it’s hard to get proper treatment, and too expensive for subsequent therapy, like Gaza, Iraq, Syria, and Yemen, and MSF uses 3D scanning and printing to help them regain partial functionality. In turn, patient feedback helps the organization improve the quality of the 3D printed prosthetics.

34-year-old Ibrahim suffered injuries to his head, hand, and leg from a car explosion, and has had a total of six surgeries. While his hand was only initially broken, improper treatment caused it to rot, and doctors soon amputated it; Ibrahim has been dealing with the resulting pain for over two years.

Ibrahim’s 3D scans

At MSF’s Jordanian hospital, Ibrahim’s hands were scanned, and a mirrored picture will “be matched with the scan of the injured part” to make a more accurate prosthetic. Before his injury, Ibrahim was a driver, and his 3D printed prosthetic will allow him to return to work.

MSF is also 3D printing transparent masks for patients with facial burns, which are used to apply pressure on the affected surface to keep skin soft and flat after graft surgeries to help the face heal with less scarring. 7-year-old Nour Saleh suffered head injuries in 2014 when a small device exploded near the family home, and eventually underwent a skin graft procedure in Baghdad.

The family didn’t have enough money to cover all of her medical costs, and MSF accepted the case two years ago. Thanks to four surgeries at the Jordanian hospital, Nour was able to grow her hair back, which really helped with her self esteem.

Traditionally manufactured below-elbow prosthetics can cost anywhere from $200 to $2,000. But for a 3D printed prosthesis, factoring in the material, production time, case estimation, and assessment of the patient’s needs, the overall costs are much lower.

“The idea is to be able to produce 3D-printed prosthetics in the future in places difficult to access and lacking a sound healthcare system, like in conflict areas,” explained Moreau. “But the way to do it is still under discussion, as it is not always easy to find technicians available in these areas, and printers are still expensive.”

Samar Ismail

Prices are expected to keep going down as people in the industry work to develop cheaper 3D printers and innovative materials. Speaking of materials, MSF 3D Project Supervisor Samar Ismail takes care of the post-processing work for the 3D printed prosthetics, which includes painting them a color that matches the patients’ complexions and adding a varnish safety layer so food can be safely handled.

44-year-old Abu Mohammad was working in a field when a bomb was dropped, which affected both his hands and legs.

“It was impossible to escape the accident,” he explained. “Warplanes arrive suddenly and when you notice their presence, it is because you are on the ground groaning in pain.”

He uses a walker to move, and, as he has a nerve injury and multiple amputated fingers, received an active-system prosthetic, which will allow him to open and close his hand and activate the prosthetic thumb by moving his shoulder. This will help Mohammad complete tasks like combing his hair or holding a phone.

23-year-old Abdulkareem was also injured by a bomb dropped from an airplane. At the local hospital where he sought treatment, he received an uncomfortable prosthesis made with traditional methods that he rarely used. 17-year-old war victim Ahmad Meqdad was injured outside when a plane dropped a barrel bomb near his home seven years ago, and was taken to the hospital with his arm barely hanging on; his hand was soon amputated, and his mother says that he “refuses to talk about the accident.”

MSF has used 3D printing to help all of these patients, and will hopefully continue to do its good work for as long as it’s necessary.

Note: Some of the patient’s names were changed on request.

Discuss this story and other 3D printing topics at 3DPrintBoard.com or share your thoughts below. 

[Source: Al Jazeera / Images: Elisa Oddone]
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