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3-D printing helping patients

Copyright © 2017 Albuquerque Journal

Operating the joystick on a motorized wheelchair can be difficult, if not impossible, for someone who has lost finger function after a spinal cord injury.

When a patient at Albuquerque’s VA hospital had difficulty operating the controls of his wheelchair, Ben Salatin used the hospital’s new 3-D printer to make a remedy.

Ben Salatin, a VA clinical rehabilitation engineer, displays a toggle switch made with a 3-D printer that makes it easier to operate a motorized wheelchair. (Adolphe Pierre-Louis/Journal)

Ben Salatin, a VA clinical rehabilitation engineer, displays a toggle switch made with a 3-D printer that makes it easier to operate a motorized wheelchair. (Adolphe Pierre-Louis/Journal)

Salatin, a VA clinical rehabilitation engineer, used the printer to make a pair of toggle-switch handles from durable plastic that allow the patient to control the chair with his knuckles.

The switches, each about an inch square, were made by a 3-D printer about the size of a desktop computer in Salatin’s lab at the Raymond G. Murphy VA Medical Center in Albuquerque.

Albuquerque’s VA hospital is one of only a dozen medical centers in the U.S. Department of Veterans Affairs system of 168 hospitals that have three-dimensional printers.

“The medical 3-D printing user community right now is very small,” Salatin said in an interview this week at his lab.

Potential uses for printing in medicine are limited only by the human imagination, say VA officials, who plan to sponsor an open house April 14 to display the technology to medical professionals and the public.

The intent of the open house is to inspire new ideas for using the versatile technology.

“We get more out of our resources if we collaborate,” Salatin said.

Albuquerque’s VA hospital is one of five that received new 3-D printers last year donated by the manufacturer, Stratasys, based in Minneapolis. Seven other VA hospitals already had the technology.

Today, printing is used primarily to custom-build assistive devices, such as the joystick toggles Salatin made for an Albuquerque veteran.

“Maybe they need their iPad mounted in just a perfect position,” he said. “With commercial technology, I can get an off-the-shelf mount that gets me 90 percent of the way, but then I use 3-D printing to make a custom bracket just right for that veteran.”

Salatin has also used 3-D printing to make orthotic devices, such as braces and splints, which can help a patient grasp an ax or a fishing pole, he said.

Orthotic devices are typically handmade by therapists, who customize them for each patient. With 3-D printing, the model can be digitally stored and quickly reproduced when the original wears out or breaks, he said.

But Salatin and others believe printing has the potential to change the practice of medicine in areas such as joint replacements and surgical practice.

Walter Reed National Military Medical Center in Bethesda, Md., has a 3-D printer that can build titanium parts, said Dr. Peter Woodbridge, chief health informatics officer for the New Mexico VA Health Care System.

Titanium is a strong, lightweight metal ideal for making replacement joints, such as hips and knees.

The printer can precisely build a part from a digital file created by a CT scan or magnetic resonance imaging, or MRI, he said.

“Walter Reed has offered to create titanium joints” for the VA, Woodbridge said. “If we create a file, we can upload it, and they will print a joint.”

Manufactured joints are typically made to preset sizes that may not fit a patient precisely, Woodbridge said. A printed joint could match the exact dimensions a patient requires, he said.

“Current manufacturing is like shoes,” he said. “It’s not necessarily the best fit you can get, and this is the beauty of 3-D printing.”

Printing joints remains a vision for the VA system, but it offers an exciting possibility for the future, he said.

The technology may also offer surgeons a way to better plan for surgery by creating three-dimensional models of bones or organs, which can be unique in each patient.

“If a person has had trauma to their abdomen, their gut is rearranged,” Woodbridge said. The new printing technology could allow doctors to inspect a patient using a three-dimensional model, “not just as a flat image on an X-ray or a CT scan.”

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