3D-printed cable tie-assisted static progressive splints for fixed flexion contractures of the proximal phalangeal joint: a proof of concept study

Abstract

Background: Proximal interphalangeal joint (PIPJ) contractures are common sequelae following trauma to the hand and represent a treatment impasse in South Africa’s resource-constrained setting. Various splinting techniques are advocated for first line management, but there is no consensus on the optimal splint, and many studies report equivocal outcomes between modalities with only moderate improvements. This proof-of-concept study aimed to describe the design, production and use in a single case, of a 3D-printed splint, within an environment with limited access to therapy.

Methods: The evolution in the design idea that yielded the final concept is described and a case in which the splint was used for a patient with a PIPJ flexion contracture, secondary to soft tissue trauma of a single finger, outlined.

Results: The splint was designed using computer-assisted design (CAD) software, printed to custom-fit the patient, applied, and contracture improvement serially monitored. The PIPJ contracture was fully corrected and maintained at three months post cessation of splint use. No complication were experienced by the patient.

Conclusion: We describe a custom 3D-printed cable tie-assisted static progressive splint from conception to application to a patient. The patient had a 15° flexion contracture of his PIPJ which corrected uneventfully. Further investigation is warranted to determine applicability and safety of the splint for use among patients with PIPJ contractures of variable severity, chronicity and aetiology.

Level of evidence: Level 5