## 5 Conclusions  
This work aimed to enhance the design of MEX-printed orthoses by identifying and analyzing the design factors and requirements involved in developing different types of orthoses. It began by offering a glance at requirements and standard orthosis design, and then analyzed the state-of-the-art in MEX-printed orthoses. This approach underscored the significant evolution from traditional orthotic solutions to advanced, customized designs made possible by MEX technology.  
The research highlighted that many current designs are suboptimal, largely due to a lack of viable alternatives. This underscores the critical need for clear, accessible design considerations to improve design quality from the outset. By carefully evaluating these considerations, designers can develop orthoses that are not only functionally effective, but also manufacturable within the constraints of MEX technology.  
It is essential to recognize that designing orthoses extends beyond meeting medical and functional requirements. Designers must also consider the limitations inherent in the manufacturing process. MEX technology, while offering significant advantages, imposes specific constraints that must be carefully navigated to achieve the desired outcomes.  
One limitation of this review is its exclusive focus on MEX technology. While MEX has considerable promise, other additive manufacturing technologies present a broader range of design possibilities. While some of these alternative designs could potentially be adapted for MEX, research and experimentation are required to determine their feasibility.  
Hand orthotics pose unique challenges when using MEX, such us achieving the necessary strength and a good surface quality, as well as printing small, intricate components or very elastic parts. Despite these challenges, the potential of material extrusion methods to influence orthopedic manufacturing is undeniable. By enabling the production of customized, cost-effective solutions, MEX technology can drive continued innovation and adoption in the field. However, realizing this potential will require the implementation of specific technological solutions to address current limitations.  
The proposed modular design represents a promising approach that leverages the strengths of 3D printing. Modular designs could offer flexible, adaptable solutions that better meet individual patient needs, enhancing the overall effectiveness of hand orthotics, all achieved in the framework of a single solution. However, this solution remains conceptual, thus significant work remains to validate and refine these concepts. The design phase is merely the first step; the next crucial phase involves development of prototypes and evaluation of their safety and effectiveness.  
By aligning with DfAM principles and collaborating closely with medical and engineering experts, it is possible to unlock the potential of MEX in creating personalized, high-quality hand orthotics that meet both medical standards and practical usability, thereby enhancing patient outcomes.  
Conceptualization, P.M. and M.B.; methodology, P.M., M.S., R.W. and M.B.; validation, P.M. and M.S.; formal analysis, P.M. and M.S.; investigation, P.M. and M.S.; resources, M.B.; writing--original draft preparation, P.M. and M.S.; writing--review and editing, P.M., M.S., R.W. and M.B.; visualization, P.M.; supervision, R.W. and M.B.; project administration, M.B.; funding acquisition, M.B. All authors have read and agreed to the published version of the manuscript.  
The research leading to these results received funding from the Federal Ministry for Digital and Economic Affairs (BMDW) within the framework of COIN \"Aufbau\", 8 th call of the Austrian Research Promotion Agency (FFG)-project number 884136 (iLEAD).  
Not applicable.  
Data Availability Statement: Data is contained within the article.  
The authors declare no conflicts of interest.