Development of a Custom 3D-Printed Ankle Brace for Chronic Ankle Instability; Analysis of the Disproportionate Rate of Lower Limb Amputations among Races

Donatelli, Emma, School of Engineering and Applied Science, University of Virginia
Laugelli, Benjamin, University of Virginia
Allen, Timothy, EN-Biomed Engr Dept, University of Virginia
Barker, Shannon, University of Virginia

My technical work and STS research are connected as they both focus on the lower limb anatomy of humans. The technical project focuses on ankles and designing a product for the ankle to target a specific injury. The STS research focuses on lower limbs (legs) and a procedure that is associated with the limb. Both are treatment methods for underlying injuries and illnesses; however, the technical project is a common treatment method while the STS research project is used in extreme cases. Additionally, the STS research project is a life-altering and irreversible procedure while the technical work is an assistive device that can be taken off at any moment. While both projects have different aspects, the underlying theme is the same in that they both focus on improving patient health after an injury or disease.
My capstone team worked with Icarus Medical Innovations in Charlottesville, Virginia to develop a 3D-printed, customizable, and adjustable tensioning ankle brace. The design of the ankle brace went through numerous iterations starting with a cuff attached to a compression sock and ending with an orthotic and strapped support system. The goal of the brace is to target lateral Chronic Ankle Instability (CAI) which occurs when an ankle undergoes an injury to the lateral ligaments in the ankle and does not fully recover. Bracing is a common treatment method for CAI; however, our brace is unique in its customizability and tensioning system that allows the user to raise or lower tension in the brace based on their needs at the moment. One goal of our brace is to restrict movement in the inversion direction so the lateral ankle injury can heal while still allowing movement in other directions as to not hinder daily activities. The preliminary data shows that our brace does restrict movement in the inversion direction while still allowing movement in other directions.
My STS research focuses on the disparity among race seen in cases of lower limb amputations. A lower limb amputation is the removal of part or all of the leg (anywhere from the foot to hip) and can have many causes including underlying diseases including diabetes. Lower limb amputation should be one of the last options for a doctor to consider and preventative care should be attempted first. However, in the case of three teaching hospitals in Chicago, African Americans are more likely to get lower limb amputations when compared to white Americans. This is likely due to external factors such as economics and geographic location, but my paper argues that it is also due to biases that have been built into the healthcare system in America. The goal of my research is to provide a complete understanding of the disparity and expose the root issues of the problem.
Working on these two products simultaneously allowed me to ensure my technical work did not have underlying biases such as can be seen in my STS research. Seeing the unintended biases built into the healthcare system and with lower limb amputations while I was designing the ankle brace made me constantly reflect and ensure that the design was not intentionally or unintentionally excluding any groups of people. Our group saw that with our first design, it may be harder for older people to be able to put the brace on by themselves, which was an unintended bias in our design. As a result, we changed our design so that it would be easy for most people to put on. Overall, working on both the technical work and STS research at the same time made me constantly reflect on our design to ensure no biases were being built in, which ended up improving our overall design.

BS (Bachelor of Science)
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