Designing an Affordable Distal Radius Fracture Reduction Simulator for Medical Training, The Impacts of Surgical Robots on Healthcare

Technical Project Abstract   Wrist fractures are consistently one of the most common types of broken bones, with the most common type of wrist fracture being the distal radius fracture, accounting for up to 1 of every 6 broken bones treated per year. To treat this type of fracture, orthopedic surgeons often use a closed reduction technique in which they must perform a precise sequence of movements to move the bone back into its original position before applying a splint. There is currently no affordable training simulator to teach medial students how to perform this reduction, so my team was tasked with creating a low-cost simulator for use in medical training.   The major requirements for our simulator were as follows: it must accurately simulate the movements required to reset a distal radius fracture, it must require an accurate level of force to simulate the muscles in a human forearm, it must cost of less than $150 to produce one model, and it must be made only of materials that are 3D printed or readily available on the open market.   After creating a list of initial design specifications and selecting and screen multiple design options, we selected a final design and began prototyping. Our design included features such as a silicone cover to simulate human skin, guitar tuners to fine tune the tension in elastic bands that simulate muscle, and a wide base to allow splinting and clamping the simulator to a table. During the prototyping phase, we went through multiple iterations of our design, meeting with an orthopedic surgeon with each iteration to get feedback on the accuracy of the reduction movement. Finally, we performed testing and did mathematical analysis to ensure that our design would be durable and able to withstand the forces required to reduce a distal radius fracture.      STS Project Abstract   With the cost of healthcare in the United States rising greatly over the past few decades, it has become increasingly important to determine what can be done to mitigate these rising costs without hindering innovation in medical technology. This has highlighted many new medical technologies and brought their worth to the healthcare industry and society into question.   One medical technology that has received attention in how it is changing the healthcare industry is robot-assisted surgery. With the growing popularity of this new technology, it is important to consider whether its benefits outweigh the costs. To perform this comparison of costs and benefits, I used a Utilitarian ethics approach, which promotes decisions that create the greatest amount of good for the greatest number of people.   The benefits of robot-assisted surgery are mostly medical in nature, stemming from its minimally invasive nature resulting in quicker recoveries and lower complication rates. Meanwhile the downsides typically stem from the fact that new technologies increase the cost of medical care overall. This comes with the high price tag of surgical robots as well as ongoing costs that are higher than necessary due to the small market of surgical robot producers. Data shows that high healthcare costs have a disproportionate effect on minority and low-income populations regarding their likelihood to receive and afford necessary medical care, showing that increased medical costs affect equity in access to healthcare. However, the medical benefits and cost savings that come as a result of shorter hospital stays and lower risks of infection do help the benefits of robot-assisted surgery outweigh the associated costs, making further pursuit and adoption of this technology worth the effort.      Connection Between Technical and STS Projects   New medical technologies often have a large impact on the affordability of medical treatment as well as the level of access to it. This fact lies at the heart of my STS project and is also a key aspect of my technical project.   In my STS project, I explore how robot-assisted surgery as an emerging technology affects the cost of individual medical procedures as well as healthcare in general. This comes from the high initial cost of the full robotic system and ongoing costs of additional supplies needed for each operation. Ultimately the expensive nature of this technology has the capability to make medical care more expensive, which puts healthcare accessibility at risk for many low-income groups.  In relation to those ideas, one of the main constraints of my technical project revolved around the cost of our device. While distal radius fracture reduction simulators have already been designed by others, nearly all cost over $1,500, making them a notable cost for medical schools to acquire, and even more difficult for schools in low-income communities and nations to afford. By designing a simulator that costs less than $150 to make, we are producing a lower cost technology for medical trainers to choose and playing a part in mitigating the increasing cost of healthcare.