Design, Fabrication, and Evaluation of A 3D-Printed Hand Amputees within a Kathmandu Innovation Ecosystem

In low-resource settings such as Nepal, patients with partial hand amputation face serious difficulties in obtaining prosthetic options both in terms of functionality and social acceptability. This paper presents the design of a customized 3D-printed cosmetic prosthesis through local innovation ecosystems to bridge these gaps. With a participatory, user-led process, the project combined the expertise of occupational therapists (OTs), prosthetists and orthotists (P&Os), and engineers to design, produce, and test by iterative cycles a prosthetic device tailored to the anatomical and psychosocial needs of a partial hand amputee. Occupational therapists played a key role in establishing user requirements, that the prosthesis supported legitimate everyday activities, whereas P&Os contributed clinical input on biomechanical alignment and prosthetic performance. Advanced techniques, including computer-aided design and 3D scanning, directed the evolution of anatomically correct prototypes manufactured from thermoplastic polyurethane (TPU), selected for its blend of flexibility and strength. Multiple iterations emphasized aesthetic realism, ergonomic fit, and task-specific function, based on quantitative biomechanical assessment and qualitative user scores. The resulting prototype demonstrated meaningful improvements in user-reported confidence and performance in daily activities, as well as enhanced social integration. Material sustainability, scalability in production, and the technical limits of 3D printing were critically interrogated, highlighting the imperative for context-matched innovation. The study recognizes the capability of locally situated, inter-disciplinary interventions to democratize access to assistive technology in low-resource settings as a replicable model for inclusive healthcare innovation.