A fracture table helps to position the patient during surgery which frees up health-care workers from holding the patient in position while a procedure is being done. Nine of the World Bank’s priorities for cost-effective surgical procedures that should be universally available are orthopedic procedures. However, surgeries in many locations are limited partly due to the unaffordability of surgical tables. The capital cost of a surgical fracture table, for example, would generally cost more than USD 250,000. As a result, health-care workers do not always have the help and technology available to do even simple procedures. Now, a 3D-printed, functional surgical fracture table built at a fraction of what it would normally cost could have significant impact in the developing world, where the financial burden of medical equipment is a significant barrier to universal access to health care.

In a collaborative project between Western Engineering (Ontario, Canada) and Michigan Tech University (Houghton, MI, USA), researchers have developed an innovative, step-by-step, techniques to build a functionally comparable operating table using open-source hardware and 3D printing. The team used an open-source desktop 3D printer and made the necessary components for the cost-effective surgical table in a little over a week of continuous printing. The final constructed operating table costs just under USD 4,000, or a 98.5% savings compared to commercially available systems, thus radically increasing both affordability as well as accessibility. The open-source surgical fracture table can assist surgeons to complete a wide range of orthopedic procedures as well as general surgical procedures, gynecological procedures and childbirth. ‘Open-source’ refers to the license for a publicly accessible design that anyone can modify, use and share. It uses materials that are widely available worldwide and the specialty components required are easily 3D printed.

The open-source fracture table can be adjusted 90 to 116 cm in height and tilted from +/-15 degrees. The leg height ranges from 31 to 117 cm, the arm supports and foot holder both have a 180-degree range, the foot traction has a 54 cm range, and the legs can be adjusted from 55 to 120 degrees. Geometrically flexible to allow for a wide array of common surgeries, the open source surgical table has a weight capacity of more than 130 kg, is radiolucent (permeable to X-rays) in surgical zones, and is completely modular and upgradeable. The table is mechanically adjustable so it does not require electricity, however, surgical staff will need to be trained on how to perform needed adjustments during surgery.

Being open-source, the surgical fracture table can be improved and built even more cost-effectively. Ideally, the table design is useful to hospitals that might otherwise be unable to afford one. And as the design of the table is freely available, the table can be built, used and repaired on location. As surgeons and other health-care workers find a need for further attachments and modifications, they can add to the functionality of the design, either by designing a modification themselves, or by describing what they would like to see in the design and having others contribute to these designs.

“We want everyone in the world to have cost-effective medical care and this is one step on the path to getting us there,” said Joshua Pearce, John M. Thompson Chair in Information Technology and Innovation at Western University. “And if we help those who are financially less fortunate with acquiring high-performance medical equipment, we will also be making better medical tools for ourselves at a lower cost, so really, everyone wins. Designs can be shared digitally and replicated with digital manufacturing like 3D printing anywhere in the world. We’re right at the start of a decentralized manufacturing revolution.”

“Medical technology is absurdly expensive. One way we can help reduce costs is to enable all manufacturers to build these, sell them directly, and to integrate some of the innovations, like the use of the radiolucent 3D-printed parts we made into their own designs,” added Pearce. “This is in no way the final fracture table. I’m sure any decent engineer could look at it and make it a little bit better and that’s exactly what it’s meant to do – to be a starting point for other people to build on.” 

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