A 3D printed prosthetic limb being made at CoRSU hospital in Uganda. PHOTO | FILE
What you need to know:
Limb amputations, especially in developing countries are largely attributed to the effects of landmines in conflict or former conflict areas, severe bone infections, accidents and birth defects.
A prosthetic replacement is needed typically every six to 12 months for children, and every three to five years for adults.
Ten-year-old John Lomuria would ordinarily be a schoolgoing boy, but he is not. A fire in 2010 left him disabled with his right leg amputated above the knee.
Lomuria hails from the cattle-keeping Karamoja sub-region of northeastern Uganda, and has been spending most of his time watching over the family’s kraal.
In the company of his caretaker Gabriel Lorupe, he travelled to the Comprehensive Rehabilitation Services hospital in Uganda (CoRSU), a specialised health facility for children with disabilities in Kampala, where he will acquire a prosthetic leg.
Lomuria is one of the pioneer beneficiaries of the 3D printing technology to make artificial limbs now being used at Corsu, courtesy of Christian Blind Mission (CBM), a Canadian charity.
The charity has partnered with researchers from the University of Toronto and Autodesk, a 3D-design company, to make cheap, customised 3D-printed prosthetic limbs for children.
Before the adoption of this technology, the process of making prosthetic limbs was manual and time-consuming, following the International Red Cross and Red Crescent formula, which involves using plaster of paris that is wrapped around a plastic mould, then waiting for it to dry and harden. After it dries, the plaster is used as a negative cast to make a positive cast of a limb. Then a socket is moulded around the positive cast before it is ready for use.
“This method is labour-intensive. Patients will typically wait for at least one week before they can get an artificial limb. Another problem with using this method is that it often results in ill-fitting sockets, which cause discomfort for users,” said Mitch Wilkie, the director of international programmes at CBM, whose team was in Kampala last week to install the new technology.
Using a 3D-print, on the other hand, allows for a quick scan to digitise the limb.
“In less than a minute, the computer can capture a 3D image of the patients’ residual limb. This image can then be manipulated by the prosthetic technician to recreate a 3D image within a computer interface, a process that takes just about 30 minutes,” explained Mr Wilkie.
“The image is then exported to a 3D printer, which can produce the socket in about three hours. If you look at the whole spectrum — the scanning, software manipulation and 3D-printing — it can all be done in one day.”
Prof Matt Rato from the University of Toronto, the principal investigator for the 3D project, says the ultimate goal of shifting to 3D-printed limbs is to speed up the process through which prosthetic limbs are made across the world.
“We want to shorten the time to one or two days. With newly available, inexpensive 3D scanning technologies, it is possible to recreate the manual process within a digital environment,” he said.
Limb amputations, especially in developing countries are largely attributed to the effects of landmines in conflict or former conflict areas, severe bone infections, accidents and birth defects.
This has led to an increase in demand for prosthetic limbs, while manpower to deal with the problem remains a challenge.
According to the World Health Organisation, there is an estimated shortfall of 40,000 prosthetic technicians in the developing world.
In Uganda, there are about 12 prosthetic technicians for the more than 250,000 children in need of such devices. This problem, according to Malcolm Simpson, who heads the CoRSU hospital in Kampala, can be partly addressed once the 3D technology is made available across the country.
A prosthetic replacement is needed typically every six to 12 months for children, and every three to five years for adults. For example, if a child loses a limb at the age of 10, they will need approximately 25 limbs in their lifetime. Adults on the other hand, may require between 15 and 20 limbs during their lifetime.
But how long a prosthetic limb lasts also depends on the environment in which a person lives. “We normally use plastic materials to make these limbs. If a person using them has to walk several kilometres every day or has to tend to the garden, it means they may have to change their prosthesis more frequently,” said Abdullah Issa, an orthopaedic technician at CoRSU.
In Uganda, an artificial limb costs between Ush500,000 ($177.1) and Ush1 million ($354.3), depending on the extent of a person’s disability.
