Helping Hands: 3D Printing Program Creates Free Prosthetics for Patients, Materials to Support Surgeons, and More

For engineers and hobbyists, 3D printing technology is seen as a useful tool to quickly produce objects such as machine parts. But at Children’s Hospital Los Angeles, this technology is being harnessed to support and enhance medical care in a variety of inventive ways—from replicating patient anatomy so surgeons can prepare for upcoming operations to creating prosthetic hands for kids with hand and limb differences.

“I started this work last February to establish a 3D printing hub at CHLA, and already we have branched out into working with at least seven or eight different departments in the hospital,” says Satchel Clendenin, the 3D Printing Program Lead/Simulation Technician in CHLA’s Las Madrinas Simulation Center.

Clendenin’s role at CHLA began as a grant-funded position and was made possible thanks to Omkar Kulkarni, MPH, Vice President and Chief Transformation and Digital Officer at CHLA, along with his team. “Omkar was the first person who said, ‘Hey, let’s see if a 3D printing program would work for us here at CHLA,’” explains Kim Lindstadt, Administrator of the Las Madrinas Simulation Center. “And in the time since the program was established a couple of years ago, it has really exploded.”

Clendenin agrees. “We’ve done a variety of different projects, including printing anatomical models for provider education purposes,” he explains. His team, which also includes Simulation Specialist Nehemie Jules, has also worked on printing medical devices for clinical use. They collaborated with Eugene Kim, MD, Chief of Pain Medicine at CHLA, to create and print a prototype for 24-gauge IV catheter holders that can be more specifically customized for particular patient needs than commercially available catheter holders.

Presurgical planning and prosthetics

“One of the efforts I’m most proud of is our work with the Jackie and Gene Autry Orthopedic Center at CHLA,” Clendenin says. His team has printed materials for orthopedic surgeons to use in their presurgical planning. “We’ve been looking at specific cases of kids with tibia or fibula deformities, brachial plexus issues, or wrist and forearm deformities, and we are able to take a patient’s computed tomography (CT) scan and turn it into an exact 3D model of that specific patient’s anatomy that we can print using materials that mimic human bone, skin, and other tissues.”

Surgeons are then able to use these models to practice how they will approach a surgery in advance of the actual operation. “There is a plethora of research showing that by using these presurgical models, you can improve patient outcomes and cut down on time in the operating room by an average of 60 minutes, reducing the amount of time patients need to be under anesthesia,” Clendenin adds.

Part of Clendenin’s role involves researching new ways that 3D printing technology can be used to benefit pediatric health care. This research is what inspired the team to start printing prosthetic hands for CHLA patients.

“I was searching through news articles and different 3D printing outlets one day, and I stumbled upon Freehand, a club at USC that creates prosthetic hands for kids with limb differences,” Clendenin explains. “I looked into this club further and learned that there are full, open-source digital files for several models of prosthetic hands online, along with instruction manuals and toolkits to help with assembling the pieces of each hand after you print them. I realized that there could be an opportunity for us to use these files on a larger scale at CHLA.”

Comfort, joy, and colorful fun

To make this opportunity a reality, Clendenin and Lindstadt next reached out to Physician Assistant Allison Tarrasch, MPAP, PA-C, and Nina Lightdale-Miric, MD, Director of CHLA’s Hand and Upper Extremity Orthopedic Program, and Founder and Director of the Center for Achievement of Teens and Children With Hand Differences (CATCH) in the Jackie and Gene Autry Orthopedic Center. CATCH utilizes mentor experiences, parent and peer support groups, scholarships, volunteering opportunities, special events, and fun activities like adaptive rock climbing to empower CHLA patients with missing, small, or weak arms, hands, or fingers. The program also works to provide patients with prosthetics.

But for children with limb and hand differences, prosthetic hands can elicit mixed emotions. “If we give a child a more old-school hook prosthetic that other kids at school think looks scary, they may not use it,” Dr. Lightdale-Miric explains. Many prosthetics are also prohibitively expensive for families. “So about 50% of kids with hand differences choose not to ever use prosthetics and just adapt to their differences. But for those who might want to try prosthetics and explore the benefits that they can provide, we want to give them the best possible introduction to prosthetic hands.”

The 3D Printing Program addresses this by creating prosthetic hands that are designed to look close to a human hand and can be printed to match a patient’s skin tone, or in a variety of fun colors inspired by a patient’s favorite comic book hero or sports team.

And importantly, the 3D Printing Program offers these prosthetics to patients free of charge.

“These hands allow kids to experience prosthetics comfortably and joyfully, and at no cost,” Dr. Lightdale-Miric says. “Kids can customize the design and choose something that looks familiar, colorful, and fun, which can give them more function and start them down the path of being more accepting of prosthetics throughout their lives.”

The 3D printing team can meet with a patient family to understand what specific type of hand the child wants and then size the digital file so that the printed hand fits the patient perfectly. The prosthetics are constructed using a variety of different materials, including polylactic acid, a hard plastic that provides durability and structure; thermoplastic polyurethane (TPU), a flexible yet tough material that allows the palm of the hand to bend and fold; and soft rubber for the fingertips, which assists with gripping objects.

A patient is able to strap the prosthetic onto their arm so that their partial hand or fingers extend inside the prosthetic hand. A bend of the patient’s wrist or finger activates the cables built into the prosthetic hand, causing the hand’s fingers to close in a tight grip.

Launching during the holiday season

After spending time refining their printing and assembly process, the 3D printing team officially launched their services for patient families at the CATCH Holiday Party on Dec. 6, 2024. Clendenin and Jules had a table set up at the annual event featuring three sample prosthetic hands and several other examples of 3D printed medical items. Many kids with hand and limb differences were eager to examine and try on the prosthetic hands while Clendenin and Jules explained how they worked, and parents were able to scan a QR code on the table to fill out a digital survey if they were interested in ordering a prosthetic from the 3D printing team.

While this event represented a successful step forward in the partnership between the 3D Printing Program and CATCH, Clendenin, Lindstadt, and Dr. Lightdale-Miric have many goals and hopes for the future, including creating hands out of a wider range of materials and potentially collaborating with schools to provide prosthetics to students with limb differences.

“You need a team of talented people who understand this technology and really know the patients to be able to provide effective prosthetics and improve functionality for the kids,” Dr. Lightdale-Miric says. “We are so fortunate to have that here at CHLA, and I think that uniquely positions our partnership to succeed.”