Q: What is e-NABLE and how does it work?

e-NABLE is a global network of volunteers who are using their 3D printers, design skills, and personal time to create free 3D printed prosthetic hands for those in need  – with the goal of providing them to underserved populations around the world.

We are not a company and we do not sell these devices.

Q: How did e-NABLE get started?

e-NABLE began with one random act of kindness for one and has blossomed into a global movement that is now involving and helping thousands!

Please visit our “About us” page! It’s an incredible story!

Q: Where are you based?

e-NABLE is a web-based community that doesn’t have a central location.  As you can see from this map, e-NABLE is a truly global volunteer organization, perhaps 2/3 of us are (currently) based in the United States.

Q: How many volunteer 3D printing experts do you have?

The Google-Plus community consists of thousands of members, and grows by a few percent each week.  Approximately half of the volunteers operate 3D printers and include everybody from hobbyists to those who are professional involved in the 3D printing industry as researchers and engineers.

Q: How many people have you helped and are in the process of helping?

We currently estimate that we’ve delivered about 1800 hands, mostly to children.  However, anecdotal reports indicate that an equivalent number have been produced outside of our community’s documented process.

Q: Where are your volunteers and recipients mainly based?

The map is not comprehensive, but indicates that e-NABLE volunteers are based largely in North America and Europe, thought we have many active groups in South America and Asia.

Q: Who can get an e-NABLE device?

People who are missing their fingers or arms below the elbow can benefit from these 3D printed devices. They are especially helpful for children who do not normally have the option of traditional prosthetic device either due to cost, time, or due to the uniqueness of the limb difference.

Individuals must have a functional wrist or elbow to make most current and recommended e-NABLE devices operate properly.  e-NABLE hands open and close using the flexing of the wrist or elbow to create the tension to pull the fingers closed.

Q: How old do you  have to be to get an e-NABLE device?

We recommend that children be at least 3 years old before wearing a device due to the choking hazards that small parts pose and so that children can have the chance to learn to do every day things without a helper hand.

Q: What can these 3D printed hands be used for?

These devices should be seen as tools and not a fully functional prosthetic device. Children use them for simple tasks like holding water bottles while being able to hold a snack in their other hand at the same time, helping to give them balance by allowing them to use two hands to ride a bike or swing on the swings, holding sports equipment like baseball or cricket bats, catching soccer or footballs etc. and other simple tasks that having two hands is helpful for. Some children have found that swimming with them has been helpful as well.

These devices can not hold more than a few pounds of weight  and the grip strength is not that strong on most of the designs and can not be used for playing on monkey bars, doing hand-stands, working the brakes on bicycles or anything else that may lead to harm if the device fails or breaks.  Additionally, the fingers do not move individually – they have a simple basic grasping function.

Q: How much does a prosthesis from e-NABLE cost?

e-NABLE does not charge for the prosthetic devices it provides. We are a volunteer community and offer these devices completely free of charge.

The cost of materials of the Raptor Hand is approximately $35. However, that does not factor in the time involved in building one, which can include assembly, fitting, testing, and more. Since this can be done by a volunteer or the recipient and his/her family, this is difficult to put a dollar figure on.

Q: What would an equivalent, partial hand prosthesis made by a professional cost?

A professionally made, muscle-actuated hand can cost around $6,000 – $10,000, with much of the cost from the materials and parts alone.  With good insurance coverage, you may want to consider one of these because it would be custom made, the care would be supervised by a doctor, and it would likely be made out of strong materials like carbon fiber.

 Q: If an equivalent partial hand prosthesis costs $8000, why do people talk about $40,000 prosthetic hands?

In the media, e-NABLE hands have been favorably compared to myoelectric hands costing $40,000,” but the comparison is misleading.  Forty thousand dollar myoelectric hands with custom, “life like” silicone skin used to be the only option for active finger movement on a partial hand prosthesis, and some people are unfortunately still being fit with these.  But $8000 alternatives are available and these alternatives are fairer benchmarks for an e-NABLE hand like the Raptor.

Q: How durable is an e-NABLE hand?

A: The hands hold up quite well to the activities of a typical child. Many of our recipients have sent in videos of children using the hands to ride bikes, throw a ball with the dog, swim, and perform other activities.

While more rigorous mechanical testing in ongoing, a group of students has conducted initial impact testing by dropping the hands from a height of several stories.  The hands sustained minor damage, but survived.

When e-NABLE hands do break, simple repairs can be made using a 3D printing pen (i.e. the 3Doodler) or by reprinting the broken part.

The hands can also be printed in a variety of materials, including very durable nylon. 

Q: Are any health care professionals involved in e-NABLE?

At Creighton University an Occupational Therapist named Jean Peck is working with muscle physiologist Jorge Zuniga, designer of the Cyborg Beast e-NABLE hand.   They are  working on a study of the long term effects of using the hands for patients, and recently reported on the results of their research.

Dr. Albert Chi at Johns Hopkins Medical Center in Baltimore also works closely with the e-NABLE community. He is a trauma surgeon with a background in biomedical engineering, clinical research, and has been featured on 60 minutes (twice!) for his work on high-tech brain-controlled robotic arms.

Dr. Gloria Gogola at Shriners Hospital in Houston, Texas works with a team of e-NABLE volunteers at Rice University to help fit her patients with 3D printed devices and teach families how to assemble them.

Approximately 30 other Certified Prosthetist-Orthotists and Occupational Therapists are members of our Google Plus community. These volunteers work with engineers and 3D designers in e-NABLE, to provide input on comfort factors, usability, and design. 

Q: What kinds of prostheses does e-NABLE offer?

See here for a list of current and recommended designs.

Our most-recently developed prosthetic hand is the Raptor Reloaded.  Like the Cyborg Beast, Raptor Original, and other models, this muscle-assist prosthetic is for people who lack some fingers, but still have at least a small, functional wrist. It can be made with or without a thumb.

The Ody Hand is a three fingered hand developed for children whose wrist muscles may not be strong enough to pull all five fingers.

Other designs are in development. The body-powered RIT arm is for recipients whose arm ends between elbow and wrist.  The Limbitless myoelectric arm is for recipients whose arm ends above the elbow.  The Raptor Wing is for recipients who have a full forearm but no wrist.

Q: If someone wanted to become an e-NABLE volunteer, but did not own a 3D printer, what would one cost?

The price and quality of desktop 3D printers has improved considerably in recent years. Our volunteers routinely make hands on machines ranging from $500 to $3000.

Q: Is this organization only in need of fabricators and designers?

There are many e-NABLE members/volunteers who do not own a 3D printer and who do not fabricate hands.  There are other ways to participate – please join us!

Q: Does this mean the end of professionally made prostheses?

No. e-NABLE typically focuses on underserved communities for whom traditional prostheses are too expensive (because they can cost thousands of dollars per year) or impractical (because children outgrow them). Many children simply never get one because of the expense.

Professional prostheses serve different needs and provide things that a volunteer community cannot. For example:

Issue	Professionally Made Partial Hand Prosthesis	e-NABLE Device
Provisioning	Provided by Certified Prosthetist with formal education, under a prescription of a Doctor.  A Prosthetist must provide care in an accredited local facility.	Developed by volunteers in an innovative online community
Population	There is a wide variety of prostheses which work for a wide variety of amputation types. Prostheses have been found to be effective for all types of amputation including people with fragile skin from traumatic amputation or people with dysvascular concerns.	Most users are congenital amputee because their tissue is generally pressure tolerant and they don’t require custom made devices to protect their skin.  Other amputees may want to consult a doctor before considering an e-NABLE device.
Fabrication	Generally custom fabricated around a specific mold of the users anatomy.  This produces an intimate fit. Prosthesis are generally made out of lightweight material like carbon fiber. This process is involved, difficult, and expensive.	Custom fit standardized parts based on measurements of the users residual limb.  Most of the e-NABLE parts are made from 3D printed plastics
Health Insurance	Health Insurance may pay for all or some of the cost of a conventional prosthesis because it is  provided by certified prosthetist per prescription from a Doctor and meets FDA regulation as a class 1 device.More on device classes: http://www.oandp.org/jpo/library/2010_02_121.asp	Has not been reviewed by FDA.
Cost	Prostheses can be expensive, however most prostheses prices are not set by prosthetists  They are based on govt. regulated billing codes called Lcodes. These code take into account the device itself, the time for evaluation, fabrication, delivery and 3 months of follow up care. Private insurances negotiate the prices of prostheses based on these codes.	No charge for labor and the $35 that has been mentioned only covers the materials (as stated above)