Advanced design and manufacturing tools are transforming prosthetic care

LimbForge helps clinicians develop 3D-printed prosthetic limbs for amputees in developing countries, creating high-quality, affordable devices that are custom made to fit individual needs. LimbForge’s prosthetics improve the lives of patients, as well as their families and communities. This small nonprofit organization is using digital-design tools and 3D printing to bring prosthetic care to the poorest regions of the world as part of a wave of innovation that’s making advanced manufacturing tools accessible to anyone, anywhere.

Sam Hobish (back row, fifth from left) and the LimbForge team with the staff of the Healing Hands for Haiti clinic in Port-au-Prince. Courtesy of LimbForge.

A mission to transform the lives of amputees

LimbForge was established in 2014 by a group of volunteers to address the needs of the approximately 35 million people around the world who live with limb loss, most of them in developing nations. Experts in prosthetics, 3D printing, software development, health policy, social change, and design, they aimed to create an accessible solution that anyone could learn to use. Today, this nonprofit organization develops software, devices, and training to explore new approaches to prosthetic manufacturing.

Sam Hobish, LimbForge’s creative director and lead user-experience (UX) designer, came to the organization with a background in industrial design. He was inspired by his volunteer experience helping kids with limb loss to design custom prosthetics, such as a glitter-spraying superhero arm for a 10-year-old girl. “I never really thought about prosthetics before, but it brought my attention to the basic need that’s out there,” Hobish says. “That’s how I eventually got involved with LimbForge—I loved working in that world. You’re making something that is so essential to someone. You can’t say that about other things that you traditionally design as an industrial designer.” Hobish now oversees the development of LimbForge’s prosthetic devices along with the UX design of its proprietary prosthetics software.

Sam Hobish (back row, fifth from left) and the LimbForge team with the staff of the Healing Hands for Haiti clinic in Port-au-Prince. Courtesy of LimbForge.

The pressing need for prosthetics

The World Health Organization estimates that fewer than 10% of the millions of people living with limb loss have access to prosthetic care. Not only is there a significant global shortage of trained prosthetists, but the average device costs thousands of dollars to produce.

There’s also devastating social stigma against disability in some parts of the world. Amputees may be shunned by their community and even by family. In addition to losing a limb, an individual might also lose his or her livelihood, self-confidence, and sense of safety.

LimbForge’s belief is that “if we can make high-quality, low-cost prosthetics available that are culturally appropriate in the developing world, we can change lives,” Hobish says. By creating devices to match a patient’s specific needs and social context with the right skin tone, fit, and functionality, it would impact “not just the amputee but their families, their communities, and even their countries, by reducing the negative impact of limb loss.”

A LimbForge patient in Haiti with her prosthetic arm. Courtesy of LimbForge.

The LimbForge Upper Limb System is a modular catalog of 3D-printable components for upper-limb prosthetics. Courtesy of LimbForge.

A high-tech solution made simple

To help meet the urgent need for prosthetics in developing countries, the LimbForge team created a customizable system that gives each individual a unique prosthesis that’s cosmetically pleasing. It looks like a real arm but is also very affordable and quick to make.

The LimbForge Upper Limb System is designed as modules for the upper arm, elbow, forearm, wrist, and hand, with options for different proportions and functionality. Each module is configured to an individual using LimbForge’s purpose-built software, then sent to a 3D printer to be fabricated in a plastic material in a range of skin tones.

The LimbForge software was built with the Autodesk Forge developer platform to connect the process of creating a prosthetic limb from design through 3D printing. It employs the powerful CAD capabilities of Fusion 360, honed down to the essentials for this task. The team created a simplified user interface to make it accessible to users with a variety of skill sets. “When we enter a patient’s measurements into the software, the model is drawn from Fusion 360 APIs,” Hobish explains. “For all the modules, the generic original versions are parametrically designed in Fusion so everything remains in the correct proportions when it’s resized.”

The LimbForge Upper Limb System is a modular catalog of 3D-printable components for upper-limb prosthetics. Courtesy of LimbForge.

Patient-centered design and fabrication

To prove the LimbForge system in the field, the organization partnered with Healing Hands for Haiti in Port-au-Prince. “We talked to patients and caregivers to figure out, through design inquiries and research, what patients are looking for,” Hobish says. Local clinicians, trained in the system, ask each person what their “greatest perceived loss” is—the thing they can no longer do that pains them the most. The individual’s needs inform what kind of prosthetic device will be created.

“Some patients just want a cosmetic device, something that will make them feel comfortable and avoid stigmatization,” Hobish says. This type of passive device doesn’t have any mechanism, “but we also offer active devices with some physical functionality,” he continues. “A common thing we hear is, ‘I want to be able to comb my daughter’s hair,’ or ‘I want to wash clothes.’ By adding the ability for the opposable thumb to close, the patient can pick up a bucket or hold a comb. We’re also testing elbow mechanisms for patients with upper-arm amputations.”

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A clinician uses a 3D scanner to scan a patient’s residual limb in a fitting process that was traditionally done with a plaster cast.
The patient data is entered into the LimbForge software, which automatically adjusts the design proportions according to the individual’s measurements.
The software sends the design to a 3D printer that uses plastic materials in a range of colors to match the patient’s skin tone as closely as possible.
3D printing is critical to bringing quick and inexpensive fabrication to remote locations. Patients can get a device in days—instead of waiting weeks or months.
After the individual parts are 3D printed, clinicians assemble the prosthetic limb.
Clinicians work with the patient to test and fit the assembled prosthetic.

Photos courtesy of LimbForge

A clinician uses a 3D scanner to scan a patient’s residual limb in a fitting process that was traditionally done with a plaster cast.

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The patient data is entered into the LimbForge software, which automatically adjusts the design proportions according to the individual’s measurements.

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The software sends the design to a 3D printer that uses plastic materials in a range of colors to match the patient’s skin tone as closely as possible.

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3D printing is critical to bringing quick and inexpensive fabrication to remote locations. Patients can get a device in days—instead of waiting weeks or months.

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After the individual parts are 3D printed, clinicians assemble the prosthetic limb.

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Clinicians work with the patient to test and fit the assembled prosthetic.

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Photos courtesy of LimbForge

3D printing at the Healing Hands for Haiti clinic. Courtesy of LimbForge.

Scaling up to serve more patients

The final critical component of LimbForge’s mission is building capacity to serve more patients in more locations. “We want to train local clinicians, prosthetists, NGOs [nongovernmental organizations], even some government organizations to operate the LimbForge system,” Hobish says. “We train them in 3D scanning, basic CAD work, and obviously 3D printing, 3D-printer maintenance, and materials.” After a full training was conducted at Healing Hands for Haiti, the clinicians have been using the system for the past year with LimbForge’s ongoing support.

The organization has also found a powerful ally in Doctors Without Borders, working with conflict victims and refugees in the Middle East to test the LimbForge system. In turn, Doctors Without Borders offers learnings from the field that help LimbForge refine the tools and designs. In another partnership, a medical school graduate in Sri Lanka was inspired by LimbForge’s rehabilitation model to assemble a team of doctors, mechanical engineers, and prosthetists to implement a program at a local university.

3D printing at the Healing Hands for Haiti clinic. Courtesy of LimbForge.

Empowering caregivers and communities

Patients report that the prosthetics created using the LimbForge system make a big difference in their daily lives. “This is not just about building a device; it’s about learning how to use it, accepting it as part of your body, and feeling comfortable showing it to other people,” Hobish says.

And as the organization empowers local caregivers with LimbForge’s manufacturing technology, the clinicians in return provide feedback about tools that will better meet local needs. By training people who themselves become trainers, they’re also building capacity to deliver continuing care to patients.

LimbForge is already planning to expand to other countries, including Turkey and Jordan, early next year. “We constantly get inquiries about how people can use our system,” Hobish says. “We’re trying to field as many of them as possible, but we’re looking forward to doing more as we grow.”

“Our model is to teach the local professionals and then step back into a supporting role. So it’s also an opportunity to provide jobs and advanced expertise for people in the countries in which we’re working.”

—Sam Hobish, Creative Director and Lead UX Designer, LimbForge

LimbForge software was developed to connect the process of creating a prosthetic limb from design through 3D printing. Courtesy of LimbForge.

Expanding access to advanced tools to improve more lives

LimbForge’s ultimate goal is to foster a network of organizations that can bring its design and manufacturing technologies to poor and conflict-torn regions around the world. To that end, the team is working to bring down costs and further simplify the process. “Then there’s the continued improvement of designs, finding better materials, finding better skin-tone matches,” Hobish says. The team also aims to integrate third-party devices into the LimbForge system, to provide patients with additional designs to fulfill even more needs. “We want to make this inclusive for other organizations working in the field.”

The current technology is just the start. “We would love to be at a point where an organization can come to us with a prosthetic-rehabilitation need that could be met by 3D printing or a parametric CAD design,” Hobish continues. “And we would be able to consult, help build tools, and work with them on their projects.”

LimbForge offers a fast, affordable way to design and manufacture quality prosthetics that change lives for the better. But beyond that, LimbForge is breaking new ground by making advanced technology more accessible, to help changemakers address critical health-care and social problems wherever the need exists.

LimbForge software was developed to connect the process of creating a prosthetic limb from design through 3D printing. Courtesy of LimbForge.

LimbForge

3D-printed prosthetics improve lives in the world’s poorest regions

Advanced design and manufacturing tools are transforming prosthetic care