In developing countries and low-income areas, access to affordable prosthetics for amputees can be challenging. With their low cost and custom 3D-printed prosthetics, the Victoria Hand Project (VHP) is looking to improve the lives of amputees around the world. The company spun out of the University of Victoria in 2014 and operates in eight countries: Haiti, Guatemala, Ecuador, Egypt, Nepal, Cambodia, Kenya, and Uganda.

At Autodesk University 2021 (AU2021), VHP’s Chief Operating Officer, Michael Peirone, outlined the organization’s innovative prosthetic and the Fusion 360 software that will help healthcare workers make custom 3D-printed limbs. With little to no CAD experience, healthcare workers can enter a patient’s dimensions into an interface to create a unique limb socket using a parametric Fusion 360 model. The patient-specific prosthetic can then be 3D-printed, making a custom device for about $100 in materials. This is a fraction of the cost for a conventional prosthetic, which can cost upwards of $2,000–$5,000 for parts alone.

The founder and current Chief Technical Officer of VHP, Dr. Nick Dechev, began researching prosthetics during his Master’s degree at the University of Toronto in 1999. As part of his degree, Dechev created the Toronto Bloorview Macmillan (TBM) hand that introduced adaptive grasp technology to the field. However, the prosthetic was expensive to make as it relied on traditional manufacturing methods like machining.

After joining the Department of Engineering at the University of Victoria, Dr. Dechev re-designed the hand to be 3D-printed. In 2014, Dechev tested this new prosthetic design with patients in Guatemala and VHP was inspired by his experiences. The goal was to develop a low-cost, 3D-printed prosthetic hand to meet the global needs of amputees. In 2016, VHP was incorporated as a not-for-profit, and with additional funding from Grand Challenges Canada, the organization expanded to patients in Nepal and Cambodia.

Since then, VHP has received funding from the Google Impact Challenge Canada, TD Ready Challenge, and anonymous donors that allowed the organization to expand to eight countries.

VHP now includes a team of engineers and volunteers who help design the prosthetic and fundraise for the organization. Peirone joined VHP in 2015 as part of the co-op program at the University of Victoria during his undergraduate studies in biomedical engineering. As part of this program, he was involved in the research that led to the original Victoria Hand prosthetic. Since his presentation at AU2021, he has transitioned from Chief Operating Officer to Chief Executive Officer of VHP.

At AU2021, the post-presentation discussion was also led by Kelly Knights, a VHP engineering design team member. She joined the organization in 2016 while studying biomedical engineering at the University of Victoria.

Together, Peirone and Knights walked through the recent advancements in the hardware and software underlying VHP’s low-cost prosthetic device.

To design a low-cost prosthetic device, VHP needed to use iterative design to reduce the cost of materials and make the 3D printing process accessible to healthcare workers.

To optimize the building materials of the prosthetic, the engineering team needed to shift the original aluminum design of the TBM to plastic. The team compared both FDM and SLA 3D printing, and tensile tested PLA, SGA, and nylon. Ultimately, the team landed on black PLA plastic as the best construction material for both the strength and functionality of the prosthetic while decreasing manufacturing costs.

With the original PLA prosthetic, some patients were breaking the hand when performing heavy-duty tasks. This led the team to add a series of metal pins and bolts to make the prosthetic stronger after the 3D printing process. As of October 2020, the design included laser-cut stainless steel links to further improve strength in an easy-to-assemble limb.  

The fingertips of the Victoria Hand are molded with silicone in a curing process that takes less than 24 hours in warmer climates and more than 48 hours in colder Canadian climates. The final product is a functional prosthetic for patients who have lost their limb below the elbow (trans-radial).

Beyond the mechanical design of the hand, the VHP team is working on making the custom design process easier for healthcare workers worldwide. In as little as one day, a healthcare provider can now create a custom trans-radial prosthetic for any patient.

The original workflow of the custom socket design was inexpensive but required manually exporting thousands of combinations of sockets, making it time-consuming to deliver design updates. Instead of expensive 3D scanners, the healthcare teams use photogrammetry to create 3D scans of a patient’s limb shape in Meshmixer. Using a DSLR camera, a healthcare worker takes photos of a patient’s limb to generate a 3D model. Then, the limb shape is cut from the socket, which can be 3D-printed.

Through Autodesk consulting, VHP then developed software in the Fusion 360 API. Their Python software creates a parametric model of a limb socket in CAD, with the back end designed in API and a front-end user interface intended for healthcare practitioners. The back-end design was led by Derek Bell, a software developer with VHP, and Knights was involved with the front-end user interface design.

“The user interface for the software is designed to very closely mimic the paper fitting sheets that O&P [orthotic and prosthetic] professionals already use. By using the same symbols, body diagram, and language, our clinical partners can very easily create limb sockets or orthotic bracing using our software without needing to spend a lot of time figuring out how to use it,” said Knights.

The parametric model now uses four measurements of a patient’s limb: the elbow to the wrist in both directions, the wrist circumference, and the forearm circumference. This parametric model no longer requires manually exporting thousands of combinations of sockets, and healthcare workers can more easily develop custom prosthetics that are amenable to design updates from the engineering team.

“Victoria Hand Project developed a custom software workflow using the Fusion 360 API to allow healthcare providers around the world to create customized prosthetic and orthotic devices by using 3D printing. This workflow cuts down on the time to create the custom devices, freeing up the clinician’s time so they can help more people in need of affordable care,” added Peirone.

During the AU2021 session, Peirone shared the story of a three-year-old boy in Northern Kenya named Bin-Amin who had received a 3D-printed prosthetic from VHP. While playing with friends, Bin-Amin had lost both hands and feet after falling into a pile of goat dung that was on fire. When they met him at seven years old, the young boy needed help with everything from eating to getting dressed. At the Kenya VHP clinic, Bin-Amin received a custom 3D-printed prosthetic fitted with a device designed by University of Victoria engineering students to hold a pen. This was the first time Bin-Amin could write and attend school, thanks to his new prosthetic.

In partnership with Certified Prosthetists, VHP is now beginning to roll out their trans-radial technology in Canada and the USA. The VHP team is also developing an end-to-end workflow for socket design in Fusion 360. This would allow healthcare practitioners to add in their 3D scan and align the custom socket using the parametric model, all in one place. The prosthetic device also continues to be improved as patient feedback is received and the engineers discover new ways to enhance functionality without increasing costs.

VHP is looking to expand beyond the trans-radial hand prosthetic to develop both a trans-humeral prosthetic and a back brace for scoliosis treatment. Both devices are still in development and are being optimized for functionality. The goal is to develop a similar Fusion 360 workflow for 3D printing these devices in the future.