The Operating Theatre Journal September 2021

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THE RELIABLE OPERATING TABLETHAT IS BUILT TO LAST!Introducing the Schaerer Axis Operating TableThe Axis Operating Table is auniversal table and is one ofthe most used tables in theworld due to its provenlongevity, outstandingflexibility and unique columndesign.• 1450mm X-ray Window• Highest grade stainlesssteel• Visco elastic pads forhighest patient comfortPlease Call 01244 660 954 to arrange a TrialDistributed by:For further information:01244 660 954www.melydsurgical.co.ukThe next issue copy deadline, Monday 27th September 2021All enquiries: To the editorial team, The OTJ Lawrand Ltd, PO Box 51, Pontyclun, CF72 9YYTel: 02921 680068 Email: admin@lawrand.com Website: www.lawrand.comThe Operating Theatre Journal is published twelve times per year. Available in electronic format from the website, www.otjonline.comand in hard copy to hospitals throughout the United Kingdom. Personal copies are available by nominal subscription.Neither the Editor or Directors of Lawrand Ltd are in any way responsible for the statements made or views expressed by the contributors.All communications in respect of advertising quotations, obtaining a rate card and supplying all editorial communications and pictures to the Editorat the PO Box address above. No part of this journal may be reproduced without prior permission from Lawrand Ltd. © 2021Operating Theatre Journal is printed on paper sourced from Forest Stewardship Council (FSC) approved paper mills and is printed with vegetable based inks. All paper and ink waste is recycled.Journal Printers: The Warwick Printing Co Ltd, Caswell Road, Leamington Spa, Warwickshire. CV31 1QD4 THE OPERATING THEATRE JOURNAL www.otjonline.com
A simple solution for improvingcommunication in the operating theatre20% discount for OTJ readersEnter ‘OTJ’ in the discount sectionIDC Develops Realistic Human Arm Model to Train Doctorsin Fracture ReductionInternational product design company, IDC (Industrial DesignConsultancy), has just completed a project to develop a high qualityhuman arm model to represent a fractured radius bone close tothe wrist. The model was developed for Limbs & Things, whichmanufactures models of human anatomy for use in medical trainingand simulation. The arm model was developed to help student doctorspractice a complicated technique called Colles’ fracture reduction.Colles’ fractures are breaks in the radius bone, close to where thebone joins the wrist. The Colles’ fracture reduction technique is anon-invasive procedure to re-set the bone. To do this the clinicianhas to extend the fracture and manipulate the hand into the correctposition. The Limbs & Things model aims to provide a realistic trainingexperience for doctors to practice this technique, as well as plasteringthe newly set arm. The design allows for common mistakes to occursuch as a partially reduced fracture. If the arm is not held correctlywhen plastered it will pop back to the original state.Limbs & Things came to IDC as an extension to their own in-housedesign team. A first 3D printed prototype had already been createdand IDC was tasked with improving the performance, simplifyingthe assembly, and adapting the design to be manufacturable. IDC’sengineers were briefed to develop an anatomically accurate model thatincluded the lower and upper arm. The model included an internalmechanical structure to represent the fractured radius bone. Thiscould be adjusted to different tensions to change the retraction force.The break itself needed to feel the same as a human wrist would,with realistic anatomical detail for the muscle, skin and bone. Aswell as this, the team needed to consider the design for manufacture;minimising the number of components and simplifying the assemblyprocess. With the skin being constantly touched during training, theclient also wanted an option for a replaceable hand and skin.The first challenge for IDC’s engineers was developing a designwhich mechanically simulated human wrist movement. The designwas simplified from a number of strap components to a simple dualdirectional hinge with limiting features which made assembly easier.Silicone was selected as the best material for a realistic skin, howeverthe silicone’s low friction properties caused issues with the skin rotatingaround the inner structure of the arm and the skeletal structure of thehand. IDC worked with its network of materials suppliers to find abonding material which was perfect for the job of bonding the twohand parts together. There were also a number of mechanical featuresto stop the skin sliding over the arm assembly, and the team developedan all-in-one silicone skin piece which could be easily peeled off andreplaced by the user if needed.A key feature of the product was the ability to adjust the tension of thefracture retraction, which would enable progressive levels of difficultyin training to replicate the differences in muscle tension across thehuman population. The tension could be changed by adjusting a hiddenscrew located in the elbow. The team also developed a clampingattachment on the upper arm, so the model could be fixed on a standif needed. The skin was designed to hide the internal mechanism andfixing features.Design for manufacture was an important element of this project.Limbs & Things wanted to produce a design that could be 3D printedinitially, and then injection moulded once volumes reached a suitablelevel. The team was able to improve the performance at the same timeas simplifying the assembly, successfully delivering a production readydesign. The Colles’ Fracture Reduction Trainer is now in productionand has received excellent feedback from clinicians.View the video here: https://bit.ly/IDCLTOTJAre You Linkedin ?Join our GroupThe Operating Theatre Journalin TMFind out more 02921 680068 • e-mail admin@lawrand.com Issue 372 September 2021 5
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