title: Cyborg beast: a low-cost 3d-printed prosthetic hand for children with upper-limb differences.
abstract: BACKGROUND
  There is an increasing number of children with traumatic and congenital hand amputations or reductions. Children's prosthetic needs are complex due to their small size, constant growth, and psychosocial development. Families' financial resources play a crucial role in the prescription of prostheses for their children, especially when private insurance and public funding are insufficient. Electric-powered (i.e., myoelectric) and body-powered (i.e., mechanical) devices have been developed to accommodate children's needs, but the cost of maintenance and replacement represents an obstacle for many families. Due to the complexity and high cost of these prosthetic hands, they are not accessible to children from low-income, uninsured families or to children from developing countries. Advancements in computer-aided design (CAD) programs, additive manufacturing, and image editing software offer the possibility of designing, printing, and fitting prosthetic hands devices at a distance and at very low cost. The purpose of this preliminary investigation was to describe a low-cost three-dimensional (3D)-printed prosthetic hand for children with upper-limb reductions and to propose a prosthesis fitting methodology that can be performed at a distance.
  
  
  RESULTS
  No significant mean differences were found between the anthropometric and range of motion measurements taken directly from the upper limbs of subjects versus those extracted from photographs. The Bland and Altman plots show no major bias and narrow limits of agreements for lengths and widths and small bias and wider limits of agreements for the range of motion measurements. The main finding of the survey was that our prosthetic device may have a significant potential to positively impact quality of life and daily usage, and can be incorporated in several activities at home and in school.
  
  
  CONCLUSIONS
  This investigation describes a low-cost 3D-printed prosthetic hand for children and proposes a distance fitting procedure. The Cyborg Beast prosthetic hand and the proposed distance-fitting procedures may represent a possible low-cost alternative for children in developing countries and those who have limited access to health care providers. Further studies should examine the functionality, validity, durability, benefits, and rejection rate of this type of low-cost 3D-printed prosthetic device.
authors.affiliation: Department of Exercise Science and Pre Health Professions, Creighton University, Omaha, NE, 68178, USA. JorgeZuniga@creighton.edu.
authors.forename: Jorge
authors.initials: J
authors.lastname: Zuniga
authors.affiliation: Department of Exercise Science and Pre Health Professions, Creighton University, Omaha, NE, 68178, USA. DimitriosKatsavelis@creighton.edu.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Katsavelis
authors.affiliation: CHI Health Creighton University Medical Center, Omaha, NE, 68131, USA. Jean.Peck@alegent.org.
authors.forename: Jean
authors.initials: J
authors.lastname: Peck
authors.affiliation: Department of Occupational Therapy, Creighton University, Omaha, NE, 68178, USA. JohnStollberg1@creighton.edu.
authors.forename: John
authors.initials: J
authors.lastname: Stollberg
authors.affiliation: Department of Exercise Science and Pre Health Professions, Creighton University, Omaha, NE, 68178, USA. MarcPetrykowski@creighton.edu.
authors.forename: Marc
authors.initials: M
authors.lastname: Petrykowski
authors.affiliation: Department of Exercise Science and Pre Health Professions, Creighton University, Omaha, NE, 68178, USA. AdamCarson@creighton.edu.
authors.forename: Adam
authors.initials: A
authors.lastname: Carson
authors.affiliation: Children's Hospital and Medical Center, Omaha, NE, 68114, USA. CristinaFernandez@creighton.edu.
authors.forename: Cristina
authors.initials: C
authors.lastname: Fernandez
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D001186:Artificial Limbs; D002648:Child; D002675:Child, Preschool; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008297:Male; D066330:Printing, Three-Dimensional / Q000191:economics*; D011474:Prosthesis Design; D016059:Range of Motion, Articular; D034941:Upper Extremity / Q000473:pathology*; D014953:Wrist / Q000503:physiopathology