Authors (including presenting author) :
Ho SH(1), Wang H(2)
Affiliation :
(1)Prosthetic & Orthotic Department, Pamela Youde Nethersole Eastern Hospital (2)Prosthetic & Orthotic Department, Kowloon Hospital
Keyword 3: :
CADCAM technology
Keyword 4: :
Total Quality Management
Introduction :
Infant head deformities are classified as synostotic or non-synostotic. Non-synostotic deformities, particularly plagiocephaly, can be treated with orthotic helmets. Although this treatment is available in other public hospitals, the Hong Kong East Cluster (HKEC) lacks a milling machine for mold customization after CAD/CAM rectification. A new workflow was therefore required. In 2022, a CAD/CAM and 3D printing workflow for orthotic helmets was proposed, treating seven pediatric plagiocephaly patients from 2022 to 2025. By transitioning from traditional manufacturing to this digital approach, the department overcame hardware limitations while maintaining a focus on patient-centered care within the public hospital system.
Objectives :
This project aimed to develop and implement a CAD/CAM and 3D printing workflow at HKEC for fabricating orthotic helmets to treat pediatric plagiocephaly. It addressed the limitations in mold customization while evaluating the feasibility and clinical effectiveness of this approach
Methodology :
A four-stage digital workflow was applied to seven pediatric patients. The process began with 3D scanning to digitize the patient's head shape, followed by importation into Rodin4D Neo software for clinical rectification based on the Cranial Vault Asymmetry Index (CVAI). The final orthosis design was created using specialized Cube software and directly fabricated via 3D printing with polylactic acid (PLA). For clinical safety and skin protection, each helmet was equipped with a 6 mm soft inner liner made of Plastazote, a material commonly used in orthotic applications. Follow-up appointments were scheduled every 2–4 weeks to monitor CVAI progression and adjust the orthosis for the infant's growth
Result & Outcome :
This digital workflow proved clinically effective and operationally superior. Of the seven patients treated between 2022 and 2025, two were excluded from analysis due to poor compliance. For the remaining five compliant patients (mean age: 7.8 mths; SD = 3.7), a paired t-test showed statistically significant improvement in cranial symmetry, with mean CVAI reducing from 13.2 at treatment initiation to 6.4 at completion (t(4) = 3.72, p = 0.0205). These results confirm that 3D-printed helmets are effective when used consistently. Operationally, the workflow enhanced Total Quality Management (TQM) in hospital by eliminating cast milling and molding, thereby reducing manpower, material waste, and production costs. This approach is highly scalable for adoption across other hospital clusters, offering a sustainable model for modern pediatric orthotic care. Future research could explore AI-driven helmet design to further reduce time and labor requirements
