Custom design improves the aesthetic of prosthetic for kids

Like a lot of 9-year-old boys, Zachary Pamboukas has an impish streak. Born without a portion of his right arm below the elbow, the Seattle-area fourth-grader sometimes is asked about his missing arm. “I’ll tell them, ‘I lost my hand in the war,’” he says. “Or I’ll say, ‘A shark ate it.’”

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Zachary Pamboukas, 9, and his family check out a new prototype myoelectric arm designed by Limbitless Solutions, a nonprofit organization based at the University of Central Florida. Zachary has been utilizing a previous model of the prosthetic that will be used in the first U.S. clinical trial testing 3D printer produced prosthetics for children.
Source: OHSU/Kristyna Wentz-Graff

Zachary’s playful answer belies an uncomfortable truth: It’s not easy to go without a limb. Besides the physical limitation, experts say that children missing a limb can experience lasting psycho-social effects that can shape the course of their lives. “Many times these children have some social stigma and they’re embarrassed of their affected limbs,” said Albert Chi, M.D., an associate professor of surgery in the OHSU School of Medicine.

Limbitless Solutions, a nonprofit organization is ramping up the “cool” factor for kids with congenital limb loss. The organization, founded by students at University of Central Florida, produces custom-made prosthetics using 3D printing technology. They’ve built and distributed prototype myoelectric – or bionic – arms designed to match a child’s unique interests. Zachary, a fan of Spider Man, sports a web-themed forearm.

A newly announced clinical trial aims to test the functionality of a more-advanced version of the arm, gauge the effect on quality of life, and determine how children are using the arm for specialized tasks. Chi will be the lead clinical investigator in collaboration with Albert Manero, Ph.D, the CEO and a co-founder of Limbitless Solutions.

“Where this goes from here is going to be huge,” said Chi, a national leader in advanced prosthetic technology. “It’s my personal aspiration to provide advanced prosthetics to all those in need. Making it affordable and accessible is the goal, and I really do believe 3D printing technology is the solution,” Chis said. “The key benefit is really the cost,” Chi agreed. “The ultimate aim is to provide 3D-printed prosthetic devices to children at no cost.”

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Bionic arm clinical trial A new U.S. clinical trial will test bionic arms for children produced on 3D printers. The trial is a partnership between OHSU and a nonprofit based at the University of Central Florida in Orlando, Limbitless Solutions.
Source: OHSU/Kristyna Wentz-Graff

Thousands of children are born without arms each year. There are few good options for them. Advanced prosthetics have been challenging for children because of their relatively high cost (traditional prosthetics can easily exceed $100,000) and the fact that children quickly outgrow them. 

Advancements in 3D printing technology change that dynamic, providing an opportunity to easily replace prosthetics as children grow and their tastes change; Zachary is already interested in updating his arm to Iron Spider, a comic book spinoff character.

“We hope our work will ultimately allow us to provide prosthetic arms to children at little or no cost. There is a real psychological-social aspect of having an arm they can customize and which reflects their personality. It allows kids to be kids and understand their opportunities are limitless,” Manero said.

Limbitless’ myoelectric arms operate using a pair of leads placed on the skin which activate when children flex their muscles. These devices can be produced at a hardware cost of less than $1,000 each in the lab at UCF. The latest version of the arm includes multiple motors and smart phone technology to improve a child’s ability to grip objects and use it for various gestures.

Experts who have worked with Zachary and other kids who have received prototypes say they’ve already noticed a major difference in attitude. “It has a huge long-term effect on the goals that they’ll set, how comfortable they are going to school and thereby studying really hard to go into a field like science, or engineering or medicine,” said Manero. “A beautiful, expressive arm not only gives them the tools they need for their daily tasks, but gives them the confidence to chase all their dreams and become anything they can imagine.”

Zachary wears his prototype three or four times a week, helping him to hold down paper for school work and to grip the handle on his bike. “When I first wore it to school, some kid

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