Fibular hemimelia (FH) is a disorder where the fibula, a bone in your leg, is completely or partially absent. The feet of children with FH are often different sizes and shapes making it hard to find properly fitting shoes. These children suffer from poor balance, and have an increased risk of tripping, which causes them to be teased by peers. Often, their self-esteem is negatively impacted, limiting participation in activities of daily living. By 3D printing patient-specific foot prosthetics, the Digital Lab and BC Children’s Hospital Limb Lengthening Clinic aimed to improve the fit of footwear and function of the affected foot to improve the motor function and well-being of FH patients.

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FH causes the feet of patients to be different sizes, with one being evidently smaller than the other resulting in shoes fitting poorly which compromises motor function. The goal of the research team was to improve the motor  functionality of pediatric patients with FH by improving the fit of shoes with a 3D-printed patient-specific prosthetic for their smaller foot. Ideally, this prosthetic would improve the fit of their shoes and allow them to regain motor function.

The research team selected five patients with a foot size discrepancy driven by FH. Patients were selected for this study based on their needs, as well as their motor proficiency including assessments of balance, agility and running speed. Additionally, their gait, or the manner in which they walk was evaluated during the selection process.

The prosthetic for the impacted foot was created in a patient-specific manner. Specifically, 3D models of the patient’s foot were created using a 3D surface scanner. Prosthetics were generated in a manner that aligned the anatomy of the affected foot with the unaffected foot to improve the fit of shoes. After printing, the prosthetics were fitted to the patients and were then evaluated. Specifically, patient satisfaction, motor proficiency and gait were assessed for each of the patients.

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Each patient was fit with a personalized prosthetic for their impacted smaller foot to improve the fit of their shoes. Patients' satisfaction with the prosthetics was evaluated with a survey. Notable results include that the:

• Prosthetics were easy to use
• Prosthetics had an acceptable fit and comfort
• Prosthetics reduced shoes falling off
• Prosthetic reduced incidents of tripping

This study was funded by the Evidence to Innovation seed grant at the BC Children's Hospital.