Immobilization for Fracture Care with Casting - A market ripe for digital disruption in the 21stcentury
Fracture care has revolved around one solution for thousands of years, which is application by wrapping wet material, like cotton with plaster or fiberglass that hardens while drying – called “casting.” There were limited innovations made throughout history regarding the fabrication and application of this treatment. The stagnant evolution of fracture treatment results in unsatisfactory healing outcomes.
One standard treatment used today requires layers of bandages combined with Plaster of Paris. The bandages are soaked in water and rolled over the appendage. Casts made using these materials take 36-72 hours to completely dry. It is uncommon for the patient to experience allergic reactions to these materials, but patients with neuropathy do have a greater chance of having skin problems with the cast. If the bandages are soaked in too hot of water the patient could experience a thermal burn because the Plaster of Paris creates a hypothermic reaction once mixed with water. The materials cannot be washed and can trap moisture and dirt/bacteria against the skin throughout use, and do not accommodate swelling – common with acute injuries.
Another very common type of cast used today is a fiberglass cast. These casts are made from a fiber-reinforced polymer made of a plastic matrix reinforced by fine glass. These casts are extremely strong and lightweight. They are 3 times stronger and ⅓ the weight when compared to a plaster cast. These casts cannot be washed and can trap moisture and dirt/bacteria against the skin throughout use. They also do not accommodate swelling. It is important to be careful when removing fiberglass casts because glass particles can become airborne and get into your eyes.
Other complications are very common when using either types of casts listed above. Patients have experienced deep vein thrombosis in their limbs, and is most common in lower limb casts. Soft tissue swelling is very common when a fracture occurs, so one issue that is most common in leg and forearm fractures is compartment syndrome. When pressure in the limb becomes too high the patient can experience pain, swelling, numbness, and sometimes tissue damage. In serious cases this could result in the loss of limb function or amputation. The selling usually subsides within 48 hours, which can result in the displacement of a reduced fracture when the cast becomes too loose. Padding is required to fill the excess room in the cast to prevent fracture displacement. Pressure sores can occur using traditional casts if the plaster or padding were not applied correctly. The skin can become macerated with trapped moisture, and itchy with dirt and dead skin that builds up when the limb is not washed over time. Many times patients will use a foreign body to scratch an itch and it can cause skin breakdown and infection. If a window is needed in the cast for an incision or sore it is possible for edema to occur if the window is not inserted back into the cast. Venous congestion can also be a result of using a traditional cast. Patients will experience swelling or blue discoloration on the surface of their skin. Traditional casts are not hygienic and can trap moisture against the skin, which can result in skin breakdown. A cast saw is needed for the removal of a cast, which can cause burns or injury to the patient’s limb.
ActivArmor is utilizing 3d printing to revolutionize the casting industry. The process of receiving an ActivArmor is to scan the limb that needs to be immobilized using the ActivArmor app found in the Apple store. Then the custom cast will be built using that scan. Once the design is complete the cast will be printed in a biocompatible plastic material. The patient gets to choose the color of their cast and has 11 different options to choose from. These casts can be printed at the ActivArmor manufacturing facility or clinics can obtain their own printer and produce casts in-house, which reduces the time it takes for the patient to receive their cast. ActivArmor casts are covered by most insurance companies, including Medicaid and Medicare. Many of the drawbacks of traditional casts can be eliminated using an ActivArmor cast. ActivArmor casts are waterproof and more hygienic than traditional casts because patients can wash and sanitize their limbs without the worry of viral transmission. Since each cast is custom-designed, important areas such as incisions or sores can be left open for treatment during the healing process.
ActivArmor casts can be immediately bivalved to prevent edema and compartment syndrome. The patented design is breathable so water doesn't get trapped against the skin and cause skin breakdown. Malunions are reduced because the cast is easily adjustable and any movements under the skin are easily observable. Using this cast saves a lot of time because traditional casts usually require multiple casts by the end of the healing process and ActivArmor is reusable, adjustable, and convertible from a cast to a splint through the patient’s healing phases. There are 14 different types of casts that ActivArmor can produce. These range from long arm devices that can be converted into wrist cockups to walking boots and AFO’s. All of these casts can be converted into splints simply by changing the closure type. ActivArmor also created a trauma split that can be used at onset of injury and until the patient receives their custom device. Insta-Armor is free to any patient receiving an ActivArmor cast and has all of the same benefits as the standard ActivArmor cast. The Insta-Armor can immobilize all shapes and sizes of arms and is easily applied.
Utilizing the emergence of new technologies, ActivArmor provides a higher standard of fracture care. Providers and patients all can benefit from the application of 3d printing in this field.
