What Are 3D-Printed Casts?
Forget the sticky, itchy, plaster casts you might remember from childhood. Today, a new kind of cast is quietly changing how broken bones are treated — one made not with bandages, but with a 3D printer.
Instead of wrapping a limb in wet gauze and waiting hours for it to harden, doctors now scan the injured area, design a custom shell on a computer, and print it out in a few hours. The result? A lightweight, breathable brace that fits like a glove — and lets you shower, sleep comfortably, and even swim.
These aren’t sci-fi prototypes. They’re real. Used in hospitals, clinics, and private practices around the world, 3D-printed casts are built with a honeycomb-like mesh that lets air move, keeps skin dry, and reduces pressure on sensitive spots. And because they’re made from a digital scan, no two casts are alike — each one is shaped perfectly to the patient’s body.
It’s not just more comfortable. It’s smarter. And it’s catching on fast.
What Are 3D-Printed Orthopedic Casts?
Think of a 3D-printed orthopedic cast as a custom-made armor for your broken bone — designed not by hand, but by technology.
Instead of rolling on layers of wet plaster that harden into a one-size-fits-most shell, clinicians use a 3D scanner to capture the exact shape of your arm, leg, or wrist. That scan becomes a digital blueprint. Then, a 3D printer builds a cast that fits you — not the other way around.
The magic is in the design: a delicate lattice of plastic holds everything in place, but leaves gaps for air to flow. No more sweating under a sealed cocoon. No more scratching until your skin bleeds. And because it’s printed from a scan, the cast applies pressure exactly where it’s needed — and nowhere it isn’t.
The result? A cast that doesn’t just hold your bone still — it actually makes healing easier. For patients, that means less pain, fewer complaints, and more freedom. For clinics, it means faster service, happier patients, and a modern edge over traditional methods.
This isn’t about replacing plaster because it’s “new.” It’s about replacing it because it’s simply better.
How 3D Printed Orthopedic Casts Work (Step-by-Step Workflow)
If you’ve ever had a plaster cast, you know the drill: wet bandages, awkward wrapping, long drying times, and that itchy, trapped feeling afterward.
With 3D-printed orthopedic casts? That whole process gets turned on its head. There’s no mess, no guesswork, and no waiting around. Instead, it’s more like this: scan, design, print, wear.
It might sound futuristic, but hospitals and clinics from Colorado to Moscow are already using this method every day. Let’s break down exactly how it works — step by step.
Step 1: X-ray – Making Sure It’s Safe to Move Forward
Before any cast goes on — whether it’s plaster or 3D printed — doctors need to see what they’re working with. That starts with an X-ray.
The image shows the exact location and type of fracture, helping the medical team decide if immobilization is needed and how best to support the healing process. This step hasn’t changed with new technology — and it shouldn’t. You can’t build a smart solution without first understanding the problem.
Once the bone is stable and ready for a cast, the next phase begins: capturing the shape of the limb.
Step 2: 3D Scanning – A Digital Snapshot of Your Arm or Leg
Gone are the days of estimating size with tape measures or shaping plaster by hand. Now, clinicians use a handheld 3D scanner or even an iPad with LiDAR to take a full digital scan of the injured limb.
In under three minutes, the device captures thousands of data points, creating a precise 3D model of the arm or leg. It’s painless, non-invasive, and far more accurate than traditional methods.
Some systems, like those used by Xkelet, turn a smartphone or tablet into a scanning station. Just move around the limb, and the app builds the model in real time. Others, like the Shining 3D Einscan H2, offer lab-grade precision for clinics investing in high-volume production.
Either way, the result is the same: a perfect digital twin of the patient’s anatomy — ready to become a custom-fit cast.
The standard workflow for 3D-printed orthopedic casts: (1) X-ray, (2) 3D scanning, (3) CAD modeling, (4) 3D printing.
Step 3: Designing the Cast – Where Precision Meets Comfort
Now comes the magic: turning that 3D scan into a functional, comfortable brace.
Using specialized software, a technician or clinician designs the cast directly over the digital model. They don’t just make a shell — they engineer it. Thicker zones go where extra support is needed. Open mesh areas cover spots prone to sweating or irritation. The fit follows the body exactly, avoiding pressure points that could cause pain or sores.
Some companies have automated this step entirely. Zdravprint in Russia uses biometric algorithms to generate a ready-to-print model based on simple measurements. CastPrint in Latvia offers pre-designed templates that adapt to individual scans. And Xkelet’s app does most of the work in seconds — no advanced training required.
This isn’t just faster than hand-wrapping a cast. It’s smarter. Every decision — thickness, ventilation, contour — is intentional.
Step 4: 3D Printing – From Data to Physical Support
With the design complete, it’s time to bring the cast to life. The file is sent to a 3D printer, which builds the orthosis layer by layer.
Most clinics use one of two types of printers:
- FDM (Fused Deposition Modeling): Melts flexible plastic filament (like TPU) and lays it down in thin lines. Great for durable, lightweight casts. Machines like the Raise3D Pro2 Plus and Picaso Designer XL are popular choices.
- Resin (SLA/MSLA): Uses UV light to cure liquid resin into solid form. Produces smoother surfaces and finer details. Ideal for clinics focused on comfort and aesthetics. Models like the Phrozen Transform Fast and Formlabs Form 3L deliver excellent results.
Print time depends on the size and complexity. A small wrist brace might take 30 minutes. A full forearm cast could take 4–6 hours. Once done, the cast is cleaned, sterilized, and fitted to the patient — often within the same visit.
Why This Process Matters
Compared to traditional casting, this digital workflow saves time, reduces errors, and improves patient comfort. No more rushed applications or misshapen wraps. No more skin issues from trapped moisture.
And because everything is digital, the model can be saved, adjusted, or reprinted if needed — something impossible with plaster.
It’s not just an upgrade in materials. It’s a whole new way of thinking about how we treat broken bones.
History and Evolution of 3D Printed Casts
The story of 3D-printed casts didn’t start in a high-tech lab. It started with a simple, universal frustration: “Why does a broken bone have to be so uncomfortable?”
To understand how far we’ve come, it helps to look back at where it all began — not with printers, but with plaster.
From Pirogov’s Plaster to a 175-Year Stalemate
In 1847, during a brutal conflict in the Caucasus, Russian surgeon Nikolai Pirogov had a breakthrough. Instead of letting broken limbs heal crooked, he used starch-soaked bandages to create a rigid mold around the injury. Later, he switched to gypsum — the same material still used in plaster casts today.
His idea was brilliant for its time: immobilize the bone so it heals straight. And for over 175 years, the basic model barely changed. Wrap, wait, dry, saw off. Generations wore the same itchy, heavy shells — not because it was perfect, but because no one had a better option.
That finally started to shift in the early 2010s, when 3D printing moved out of factories and into workshops, schools, and eventually, hospitals.
2013: The First Real Alternative
The turning point came in 2013, when two New Zealand designers — Ollie and Jake Evill — asked a bold question: What if a cast didn’t have to be solid?
Working not in a hospital, but in a design studio, they created a prototype unlike anything seen before: a lightweight, lattice-style brace made on a 3D printer. It was breathable, waterproof, and custom-fitted — and it looked more like futuristic armor than medical gear.
Their design earned them **2nd place** in the prestigious James Dyson Award, and caught the attention of orthopedic innovators worldwide. Later, their aesthetic sensibilities even landed them roles designing props for Hollywood — including the sci-fi hit Blade Runner 2049.
But their real legacy wasn’t on the big screen. It was in proving that a cast could be both functional and human-centered.
From Prototype to Practice
It didn’t take long for clinicians to see the potential. By the mid-2010s, small orthotic labs and forward-thinking hospitals began experimenting with in-house scanning and printing.
In Spain, engineers at Xkelet focused on speed — cutting the time from scan to cast from hours to minutes. In Latvia, entrepreneurs Janis Olins and Sigwards Krongorns founded CastPrint, offering custom orthoses not just for wrists, but for complex finger and leg injuries.
And in Russia, Zdravprint began working directly with major Moscow hospitals, proving that this wasn’t just a niche idea — it could work at scale in public healthcare.
A Major Milestone: Children’s Hospital Colorado
The big breakthrough in the U.S. came when Children’s Hospital Colorado announced it was the first pediatric hospital in the country to offer 3D-printed orthoses as a standard option.
Why start with kids? Because they’re the ones who suffer most from traditional casts — sensitive skin, fear of saws, constant movement, and a love of water that makes plaster impractical.
The hospital’s decision sent a clear signal: this technology wasn’t just for early adopters anymore. It was ready for real patients, in real clinics.
2020 and Beyond: Evidence Meets Adoption
A landmark 2020 study from Chinese researchers gave the field its first major clinical validation. Comparing 3D-printed orthoses to plaster and splints, they found significantly lower pain, higher satisfaction, and better hygiene outcomes.
Since then, adoption has quietly accelerated. Private orthopedic practices in the U.S. and Europe now offer 3D casts as a premium service. Startups are building all-in-one scanning apps. And 3D printer manufacturers are releasing medical-grade materials approved for skin contact.
We’re still in the early chapters of this story. But one thing is clear: the 175-year reign of the plaster cast is finally facing a worthy successor — not because it’s newer, but because it’s kinder.
Benefits of 3D Printed Casts: Why Patients and Clinics Are Switching
It’s easy to get excited about the technology — scanners, printers, custom designs. But the real test is this: Does it actually make life better for the person wearing the cast?
Turns out, the answer is a resounding yes. From kids terrified of plaster saws to adults tired of sweaty, itchy wraps, 3D-printed orthopedic casts are solving real problems that traditional methods have ignored for over 150 years.
1. Breathability That Actually Works
Traditional casts seal the skin in a dark, humid tunnel — perfect for odor, rashes, and discomfort. 3D-printed casts take the opposite approach: they’re built like lace.
Using a lattice or honeycomb structure, they let air flow freely around the limb. This isn’t just pleasant — it’s healthier. Better airflow means less sweat buildup, fewer skin infections, and a dramatically lower risk of pressure sores.
For patients who’ve worn both, it’s night and day. “It felt like I could finally breathe through my skin,” one patient told clinicians at a clinic in Riga using CastPrint braces.
2. You Can Shower — Seriously
One of the biggest frustrations with plaster? You can’t get it wet. Showers become stressful, swimming is off-limits, and even rain can cause panic.
3D-printed casts are made from medical-grade thermoplastics like TPU — the same flexible, water-resistant material used in prosthetics and sportswear. That means you can shower, wash your hands, or even go for a swim without worrying.
No more plastic bags, no more sponge baths. Just normal hygiene — during one of the most inconvenient times in your life.
3. No More Itch That Can’t Be Scratched
Almost everyone who’s worn a plaster cast has faced the same nightmare: an unbearable itch deep under the surface, with no safe way to reach it.
Because 3D-printed casts are open and ventilated, that problem largely disappears. And if you do need to clean or inspect the skin, many designs are made to be unclipped, cleaned, and resecured — something impossible with hardened plaster.
4. Custom Fit = Better Healing
Plaster casts are shaped by hand, which means they’re only as good as the person applying them. Slight errors in pressure or alignment can slow healing — or cause new problems.
3D-printed casts are different. Because they’re built from a precise scan of your actual limb, they apply pressure exactly where it’s needed — and avoid sensitive areas entirely.
This isn’t just about comfort. A well-distributed, anatomically accurate cast reduces movement at the fracture site, which can lead to more stable healing and fewer complications.
5. Faster, Cleaner Application
Applying a plaster cast takes 30–45 minutes of messy, hands-on work. Drying time adds hours. Removal requires a loud, vibrating saw that scares both kids and adults.
With 3D-printed orthoses, the cast is ready before the patient even leaves the office. Fitting often takes less than a minute — just a few clips or straps. And removal? Unbuckle and take it off. No noise, no stress, no risk of skin nicks.
6. A Game-Changer for Kids
Children are especially vulnerable to the downsides of plaster: sensitive skin, fear of medical tools, and constant movement that can loosen or damage traditional casts.
Hospitals like Children’s Hospital Colorado — the first pediatric hospital in the U.S. to offer 3D-printed casts — report fewer emergency visits for cast-related issues and higher satisfaction from both parents and young patients.
Some even let kids choose colors or custom designs, turning a medical necessity into something fun.
7. Backed by Real Evidence
This isn’t just opinion. In a 2020 study published in the Journal of Orthopaedic Surgery and Research, scientists compared 120 patients treated with either plaster, splints, or 3D-printed orthoses for hand fractures.
The results were striking:
- Pain scores were 58% lower in the 3D cast group
- Patient satisfaction was 72% higher
- Reported skin irritation and odor were near zero in the 3D group
As one researcher put it: “The technology doesn’t just improve the cast — it improves the entire healing experience.”
Bottom Line
3D-printed casts aren’t about flashy tech for its own sake. They’re about solving decades-old problems with empathy and engineering.
For patients, that means dignity, comfort, and freedom during recovery.
For clinics, it means fewer complaints, faster workflows, and a clear differentiator in a competitive market.
When comfort and care go hand in hand — healing gets easier for everyone.
Limitations & Challenges of 3D Printed Casts
3D-printed casts are exciting — but they’re not a magic solution. Like any emerging medical technology, they come with real-world hurdles that clinics, patients, and developers are still working through.
Being honest about these challenges isn’t a knock against the technology. It’s part of making it better, more accessible, and truly ready for everyday use.
1. Slow Adoption in Mainstream Healthcare
Despite their benefits, 3D-printed casts are still rare in public hospitals and insurance-covered care. Why? Because healthcare moves slowly — and for good reason.
Before a new treatment becomes standard, it needs strong evidence, regulatory approval, and proven cost-effectiveness. While early studies are promising, large-scale, long-term trials are still underway. Until then, many hospitals — especially those serving public or underfunded systems — stick with tried-and-true plaster.
That means most patients only discover 3D casts if they’re at a private clinic, ask specifically for them, or live in a region where innovators have already paved the way.
2. Upfront Cost and Equipment Needs
You can’t print a cast without a printer. And for many small clinics or solo practitioners, the initial investment is a real barrier.
A medical-grade 3D printer, scanner, design software, and biocompatible materials can cost anywhere from $3,000 to $15,000 to get started. Add training and maintenance, and it’s not a decision most providers make lightly.
That said, the math often works out over time. One cast printed in-house costs **$10–$30 in materials**, compared to $150+ for traditional supplies and labor. But that ROI takes volume — something new adopters may not have right away.
3. Leg Casts Are Still Tricky
While wrist and arm braces work beautifully, full leg casts present a tougher challenge.
They’re larger, heavier, and harder to design in a way that’s both supportive and practical. Wearing shoes over a 3D-printed ankle-foot orthosis? Possible, but not always easy. And for thigh or hip injuries, the technology simply isn’t there yet at scale.
Most current solutions focus on **distal limbs** — hands, wrists, feet, and ankles. That’s where the design, comfort, and clinical need align best.
4. Insurance and Reimbursement Hurdles
In many countries — including the U.S. — insurance companies are still figuring out how to bill for 3D-printed orthoses.
Some private insurers will cover them under existing codes for custom orthotics (like CPT 29075), but others see them as “experimental” or “premium,” leaving patients to pay out of pocket.
Until reimbursement becomes standardized, clinics risk either losing money or charging patients more — which limits access to those who can afford it.
5. The Need for More Clinical Data
Here’s the truth: we need more research.
The 2020 Chinese study showed great results. Children’s Hospital Colorado reports high satisfaction. But global medical consensus requires larger, multi-year trials across diverse populations.
Do 3D casts lead to *faster bone healing*? Do they reduce complications like malunion or stiffness? These questions are still being studied. And until the data is rock-solid, cautious institutions will wait.
Why These Challenges Matter — and Why They Won’t Last Forever
None of these issues are deal-breakers. They’re growing pains.
Every major medical innovation — from MRIs to robotic surgery — faced similar skepticism at first. What’s different now is that patients are asking for better options, entrepreneurs are building affordable tools, and early adopters are proving it works.
The biggest limitation isn’t the technology. It’s access. And that’s changing — faster than many expect.
Best 3D Printing Technologies for Orthopedic Casts
Not all 3D printers are built for medical use. Just because a machine can print a phone case doesn’t mean it can safely print a cast that touches skin, holds a broken bone, and survives daily life.
When it comes to orthopedic casts, two main technologies dominate: **FDM (Fused Deposition Modeling)** and **resin-based printing (SLA/MSLA)**. Each has strengths, trade-offs, and ideal use cases.
FDM 3D Printing for Casts
FDM printers work by melting plastic filament and laying it down layer by layer. Think of it like a hot glue gun drawing in 3D.
Pros
- Low material cost — TPU filament runs under $30 per kilogram
- Durable and flexible — Ideal for lightweight, impact-resistant casts
- Easy to maintain — No post-processing needed for most designs
- 24/7 reliability — Great for clinics printing multiple casts daily
Cons
- Surface texture — Layer lines can feel rough if not sanded
- Slower for fine details — Not ideal for ultra-thin lattice structures
- Requires high-quality filament — Cheap plastic won’t hold up or be skin-safe
For orthopedic casts, the key is using the right material: **medical-grade TPU (Thermoplastic Polyurethane)**. It’s flexible like rubber, strong enough to hold a fracture, and safe for skin contact when certified. Avoid PLA or standard ABS — they’re too rigid and not biocompatible.
Popular FDM printers used by clinics include the Raise3D Pro2 Plus and Picaso Designer XL. Both offer large build volumes, reliable extruders, and consistent results — even during long print runs.
Resin (SLA/MSLA) 3D Printing for Casts
Resin printers use UV light to cure liquid photopolymer into solid layers. The result? Smoother surfaces, finer details, and a more polished look — closer to a custom orthotic than a 3D-printed object.
Pros
- Superior surface finish — Less friction against skin, more comfortable
- Higher precision — Better for intricate lattice designs and thin walls
- Faster print speeds — Especially with newer MSLA tech
- Medical-grade resins available — FDA-cleared options exist for skin contact
Cons
- Higher material cost — Medical resins can cost $150–$300 per liter
- Post-processing required — Prints need washing, curing, and cleaning — adds time and safety steps
- More maintenance — Resin is messy, toxic if mishandled, and requires ventilation
For clinics focused on **patient comfort and aesthetics**, resin is often the preferred choice — especially for hand and wrist casts where smoothness matters. But it’s not for everyone. The extra steps and cost make it less ideal for high-volume, low-margin use.
Top resin printers used in orthopedics include:
- Formlabs Form 3L — The gold standard. Uses FDA-cleared medical resins and automated post-processing.
- Phrozen Transform Fast — A budget-friendly MSLA option that delivers excellent detail for under $3,000.
Suitable Filaments & Resins: What’s Safe for Skin?
This is non-negotiable: not all plastics are safe for direct skin contact.
Here are the only materials you should consider for orthopedic casts:
| Material | Type | Best For | Biocompatible? |
|---|---|---|---|
| TPU (Thermoplastic Polyurethane) | FDM Filament | Wrist, hand, ankle casts — flexible support | ✅ Yes (if certified: ISO 10993, FDA-compliant) |
| PETG | FDM Filament | Light-duty braces, temporary supports | ⚠️ Sometimes — check manufacturer’s certification |
| Formlabs Medical Grade Resin | Resin (SLA) | High-comfort casts, pediatric use | ✅ Yes — FDA-cleared for prolonged skin contact |
| PA12 Nylon (SLS) | Powder-based (industrial) | High-strength orthoses, industrial labs | ✅ Yes — but requires expensive SLS machines |
Important note: Always verify that the filament or resin you use is explicitly labeled for **medical or skin-contact applications**. A “flexible” TPU from Amazon might be great for a phone case — but not safe for a cast.
Brands like Formlabs, BASF, and HP offer certified medical resins. For FDM, look for filaments labeled “medical-grade TPU” from suppliers like Bambu Lab or Prusa.
Best 3D Printers for Making Orthopedic Casts (2025 Buyer’s Guide)
If you’re serious about offering 3D-printed casts — whether in a clinic, hospital, or private lab — your choice of printer makes or breaks the experience.
You need reliability, the right build size, compatibility with skin-safe materials, and support for continuous operation. Not every “best 3D printer” list online meets those needs.
Below are the **top machines actually used by orthopedic professionals in 2025**, grouped by technology and budget. Each has been vetted for real-world medical use — not just hobbyist projects.
Top FDM Printers for Orthopedic Casts
FDM printers dominate the orthopedic space because they’re affordable, durable, and perfect for flexible TPU casts. These are the models clinics trust:
1. Bambu Lab X1E – Best Overall for Clinics
- Why it leads: Built-in AI vibration compensation, automatic material system, and heated chamber ensure flawless TPU printing — even for complex lattices.
- Build volume: 256 × 256 × 256 mm (ideal for wrist, hand, and ankle casts)
- Medical use: Used by orthotic labs in Germany and the U.S. for daily cast production
- Price: ~$2,000
- Best for: Clinics wanting automation, reliability, and minimal failed prints
2. Raise3D Pro3 Plus – Best for Large Limbs & High Volume
- Why it leads: Massive 500 × 500 × 600 mm build volume — one of the few FDM printers that can handle full forearm or lower-leg casts in one piece.
- Reliability: Dual extruders, 24/7 operation, HEPA filtration for clean environments
- Medical use: Deployed by CastPrint (Latvia) and multiple EU orthotic labs
- Price: ~$8,000
- Best for: Hospitals and service bureaus printing multiple large casts daily
3. Creality K1 Max – Best Budget Powerhouse
- Why it leads: 300 × 300 × 300 mm volume, 600 mm/s print speed, and excellent TPU performance at under $1,000.
- Real-world use: Popular among solo practitioners and startup orthotic labs
- Caveat: Requires manual calibration — not fully automated like Bambu Lab
- Price: ~$850
- Best for: Cost-conscious providers testing the waters
Top Resin Printers for Orthopedic Casts
If smooth finish, fine detail, and premium comfort are your priorities — especially for pediatric or hand casts — resin is the way to go.
1. Formlabs Form 4L – Medical Gold Standard (2025)
- Why it leads: Formlabs’ new Form 4L (released early 2025) uses a large-format LFS (Low Force Stereolithography) system with **FDA-cleared Medical Resin LT** — safe for prolonged skin contact.
- Build volume: 330 × 200 × 300 mm — enough for most upper-limb casts
- Ecosystem: Fully integrated with Form Auto post-processing station (washing + curing)
- Used by: Children’s Hospital Colorado, Mayo Clinic pilot programs
- Price: ~$12,000 (printer + resin + post-processing)
- Best for: Hospitals and premium clinics prioritizing compliance and patient comfort
2. Phrozen Transform XL 4K – Best Value for Medical Resin
- Why it leads: 4K monochrome LCD, 220 × 123 × 500 mm tall build, and compatibility with third-party medical resins (e.g., DSM Somos WaterShed).
- Cost efficiency: Resin cost per cast is ~40% lower than Formlabs
- Medical use: Adopted by private orthotic labs in Spain and Canada
- Price: ~$3,200
- Best for: Mid-sized clinics wanting resin quality without Formlabs pricing
3. Anycubic Photon M5s Pro – Entry-Level Resin Option
- Why it’s included: Affordable (~$700), reliable for small casts (fingers, wrists), and compatible with certified biocompatible resins like Elegoo ABS-Like Medical.
- Limits: Build volume (230 × 128 × 300 mm) too small for full forearm; manual post-processing
- Best for: Solo practitioners or teaching clinics starting with small orthoses
Quick Comparison: Which Printer Is Right for You?
| Use Case | Best FDM Choice | Best Resin Choice |
|---|---|---|
| Hospital / High-Volume Clinic | Raise3D Pro3 Plus | Formlabs Form 4L |
| Private Orthopedic Practice | Bambu Lab X1E | Phrozen Transform XL 4K |
| Startup / Solo Provider | Creality K1 Max | Anycubic Photon M5s Pro |
A Final Note: It’s Not Just the Printer — It’s the Ecosystem
The best setup includes more than a printer:
- Scanner: iPad Pro + Polycam or Shining 3D Einscan H2
- Software: MeshMixer (free), Blender, or proprietary platforms like Xkelet’s app
- Materials: Only use certified medical-grade TPU or resin
- Post-processing: For resin, a Wash & Cure station is non-optional
If you’re ready to bring this into your practice, start with your most common cast type — wrist, hand, or ankle — and choose a printer that matches your volume, budget, and comfort level.
“We switched to the Bambu Lab X1E six months ago. Failed prints dropped to zero. Patients notice the smoothness. And we break even on the printer in under 4 months.”
— Dr. Elena Ruiz, OrthoInnovate Clinic, Madrid
History of 3D Printed Casts Technology
Orthopedic plaster cast is used to facilitate the healing process of broken bones. The cast acts as a pin and fixes the limbs in place to prevent improper bone healing.
Modern dressings are usually made of plaster or fiberglass. The idea of creating a fixing (immobilizing) dressing was promoted the Russian surgeon Nikolai Ivanovich Pirogov. In 1847, during the hostilities in the Caucasus, he first used a fixing “molded bandage”.
At first, Pirogov used starch as a hardening agent. Later, he replaced it with gutta-percha and, finally, with gypsum . The modern plaster cast is a hygroscopic bandage sprinkled with plaster. The plaster is produced industrially in sealed packaging.
When soaked in water, the gypsum plaster begins to harden. Applying a plaster cast can take up to 45 minutes, and a full cast can take 24 to 72 hours. Removing plaster is also a complex procedure. The hardened plaster can only be safely broken with a special electric saw.
There are many opportunities to improve this technology, and the pioneers of 3D printing saw the potential of additive manufacturing to solve emerging problems.
The first 3D printed anchors were introduced in 2013. At the same time, the orthosis production scheme became clear. It consists of 3 main stages.
Stage 1: X-ray
A standard x-ray of the patient’s limb is taken to determine the exact position of the broken bone.
Stage 2: 3D modeling
The patient’s hand is scanned with a 3D scanner to create a 3D model. Based on the exact measurements of the patient’s hand, a perfectly fitting impression can be made.
Stage 3: 3D printing
The orthosis is 3D printed from lightweight plastic and can be fitted to the patient in a matter of seconds.
Although the technology has been around for almost a decade, 3D printed orthopedic casts have yet to gain significant acceptance. This is mainly due to the lack of specific data on their practical benefits.
However, the situation has began to change.
In a 2020 study, Chinese scientists compared 3D-printed orthopedic casts for the treatment of fractured hands with traditional plaster casts and external fixed splints. The results of the study showed that, compared to plaster, 3D orthoses provide a higher level of comfort and reduce pain. The technology is being used more and more often.
Children’s Hospital in Colorado announced that it was the first pediatric hospital in the United States to offer 3D-printed orthoses for children. The new technology improves treatment results and removes a number of limitations of traditional methods of treatment.
Possibilities of 3D-printed Orthopedic Casts
The invention of plaster was one of the greatest medical discoveries. However, it has a number of disadvantages that can be overcome using 3D printing. For example, applying a plaster cast can be a long, laborious, messy and even painful process. Accurate measurements need to be care taken fully.
3D printing solves all of these problems. The cast can be easily fixed in seconds with a pair of clamps. Removal is also easy and does not require the use of hazardous electric saws.
Another disadvantage of plaster is that it is not breathable. The plaster prevents air contact with the skin. This can lead to clogged pores. Moreover, some patients can develop dangerous skin infections in their wounds. What’s more, constant heat, sweat, and pressure can cause very unpleasant itching.
3D printed casts or orthoses are made in form of a lattice, which consist of open sections with plastic posts. This ensures the required structure and incomplete coverage of the hand, which leads to a higher level of comfort.
Also, gypsum cannot be wetted as water will destroy the structure. Therefore, a patient with a traditional cast cannot take a shower or may be afraid of getting caught in the rain. On the flipside, 3D printed orthoses are made of water-resistant plastic. You can even swim with them.
Another disadvantage of conventional gypsum is the inability to properly distribute pressure. Perhaps this is the biggest disadvantage, as it slows down the healing process. On the other hand, 3D printed orthopedic casts are custom designed and their lattice structure can be designed to add strength to specific areas that need support and to relieve pressure elsewhere.
The idea of the mesh structure of the orthopedic casts was fronted by New Zealand engineers Ollie and Jake Evill. The two developed a prototype in 2013, and a little later created one of the world’s first 3D printed orthopedic casts. The cast was lightweight, breathable, high-tech and provided localized support for broken bones. This orthopedic cast showed the promise of this technology.
The 3D printed orthopedic cast work earned the two engineers 2nd place at the International James Dyson Technology Awards. Their design vision led them to work as designers in the recent Hollywood blockbuster Blade Runner 2049.
Let’s now talk a little about specific 3D printing technologies in the field of creating orthoses and companies that provide such services to patients and doctors.
3D Printing Orthopedic Casts Technologies
In most cases, FDM 3D printers are used to create 3D printed orthoses. The model is formed by layer-by-layer application of molten plastic filament.
The main advantage of the technology is the low cost of the material, which means the low cost of the model itself. However, the disadvantage is the printing speed, which does not allow creating a model in the presence of a patient.
Also consider the maximum build height. Large format 3D printers such as the Raise3D Pro2 Plus and Picaso Designer XL are great for these tasks. These printers are highly reliable and capable of 24/7 operation.
Recently, orthoses have begun to be printed on photopolymer resin 3D printers. These printers printer faster and the finished surface of the finished models is more pleasant to the touch. However, the technology has its drawbacks: the need for post-processing of models and a significantly higher cost of materials for printing.
Some recommended resin 3D printers for orthopedic cast include the Phrozen Transform Fast and FormLabs 3L models.
The FormLabs 3L, together with the whole Formlabs ecosystem, can become an indispensable tool in 3D printing orthopedic casts. On the other hand, the Phrozen 3D printer is affordable and will make sense for anyone wanting to to try 3D printing casts.
Examples of 3D Printed Casts Business
In this section, we look at some interesting examples of businesses from different parts of the world that are involved in 3D printing casts for broken bones.
CastPrint
CastPrint is a service bureau founded by entrepreneurs Janis Olins and Sigwards Krongorns in Latvia. The company not develops orthoses for individual parts of the hands (wrist, thumb, other fingers), but also for the treatment of leg injuries.
CastPrint has expanded its business to the point where its technology has become commonplace in the Latvian healthcare market. The firm has also expanded into the UK, where several private healthcare firms have introduced the development into daily practice.
Xkelet
The Spanish company Xkelet has decided to speed up the 3D printing of orthopedic casts. Its COO, Tim Dobrinich, was unhappy with the 2-hour scan to production process and decided to cut it down to 15-30 minutes. He used a dedicated camera mount on the iPad and a specially crafted app.
The patient’s limb is photographed from all angles and a cast model is formed in seconds. This eliminates the need for longer, separate 3D scanning and simulation.
Xkelet braces use anchor points called o-rings. They allow the same model to be re-cast multiple times, making the product reusable.
In April 2021, the company received an award at the international design festival Red Dot Award in Berlin for the design of a 3D printed casts.
Zdravprint
The Russian company Zdravprint took a different path and began to create orthoses based on the patient’s biometric parameters. A special program converts the patient’s hand dimensions into a 3D model of an individual orthosis. The print time is 15 to 90 minutes.
The products have an internal three-dimensional structure, which makes the thermoforming process more convenient. Forming the product for the patient takes 5 minutes.
Zdravprint works with leading Moscow medical institutions, for example, the 29th Moscow City Clinical Hospital and the 4th Moscow City Clinical Hospital. Hundreds of patients have already been treated with the company’s products.
Advantages and Disadvantages of 3D Printing Casts
Summing up, let’s look at the pros and cons of the new method.
The advantages include patient comfort, easy application and removal, as well as a lower cost compared to a plaster cast. Individual modeling of the 3D printed orthopedic cast makes the treatment process much more efficient. Moreover, the open lattice structure improves breathability, which is especially important when treating children.
3D printed casts are durable, lightweight, and do not restrict movement like conventional plaster. The casts can also be reused, which helps reduce costs (as suggested by Xkelet). Finally, the orthopedic casts can be remodeled and modified using the existing structure and less material.
On the downside, there is less data on the effectiveness of the use of 3D printed casts in treatment of injuries compared to using plaster. Even now, with more research being conducted to support this efficacy, medical consensus is yet to be reached. For this reason, the technology has not yet become widespread. It will take time to collect the evidence.
Also, the use of orthoses for the treatment of leg fractures is still difficult. Leg orthoses are comparatively larger and more inconvenient than their counterparts for treating hand fractures. The casts make it difficult to wear socks and shoes. Moreover, they have more restrictions.
Further Technology Development
One of the next tasks that 3D printed orthoses must solve is to fix entire limbs, not just the hand, wrist, foot or ankle. Industry leaders are trying to develop arm orthoses that extend beyond the elbow to the shoulder and biceps. There is also research on orthopedic casts for the hip to treat leg fractures. Some of the most devastating injuries occur in these areas, mainly from car and motorcycle accidents. At the moment, plaster casts are used for such injuries.
3D printed orthopedic casts for broken bones are currently available worldwide in the commercial healthcare market. However, patients receiving free public health care are unlikely to have heard about them. This is primarily due to the same lack of the necessary research base that clearly confirms the effectiveness and safety of the technology.
However, we hope that research will be compiled soon and the technology will be available to everyone.
Above is an example of an automated 3D process in orthopedics. The scan is received through the phone (the shooting process took 5 minutes), is automatically converted into a 3D model (20 minutes), and finally printed on a 3D printer (5 hours). A Raise3D Pro2 Plus printer was used to print the orthosis.
Watch the feature below for more information:
