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Hacking medicine: How two young innovators are rethinking ways of manipulating the body

The Joule Innovation grant program offered funding, professional support and mentorship to physicians and medical learners making a difference in health care. This is part of a series of stories about the 2020 recipients and their innovations.

Dr. Abhi Cherukupalli was still a fourth-year medical student, on an orthopedic rotation at Vancouver General Hospital, when he encountered the problem that led him to create Tractus Medical.  

Multiple patients in the emergency department (ED) were presenting with broken wrists, and Dr. Cherukupalli’s job was to round up supplies to place the injured arms in manual traction.

“I can’t even imagine in the 21st century, that I need to run to get an IV pole from one place and finger traps from another place and saline bags and rope from another place to MacGyver this thing together.” — Dr. Abhi Cherukupalli, Tractus Medical

In addition to finger-trap traction, the traditional treatment of a wrist fracture involves reduction —putting the broken bones back into place — with at least one physician pulling forcefully on the patient’s wrist while another physician resets the bone. The first physician must then maintain the same amount of force while the arm is cast. If an x-ray shows a wrist wasn’t set properly, the physician has to cut the cast, re-anesthetize the patient and redo the entire process.

Not surprisingly, nearly half of all manual reductions fail and patients must be referred for surgery.

“It’s archaic,” says Dr. Cherukupalli. “Everything else we do in medicine has some sophisticated tool, so why can’t we create one that will eliminate the 45% failure rate and decrease the number of people that go into surgery?”

Watch Dr. Cherukupalli describe setting an Olympic weightlifter’s broken wrist:

From concept to collaboration

A few months later, during a health hackathon, Dr. Cherukupalli set out to build a better tool. With the expertise of his teammates — a biomedical engineer and industrial designer — he emerged with a device design that could be operated by a single physician, while offering consistent fixed traction throughout the entire treatment and casting process. The design won the competition, and the team decided to pursue the development of Tractus Medical.

“What the competition enabled me to do was collaborate with people outside the field of medicine and get the physical sciences involved in actually putting the design together and making it into something we could look at and examine,” he recalls.

Hacking medicine to prevent concussions

In 2019, Brandon Spink also benefited from working with an interdisciplinary team on a medical innovation. A second-year medical student at the University of Saskatchewan, Mr. Spink and fellow medical student Richard Ngo teamed up with biomedical and mechanical engineering students to win a 48-hour hackathon with their idea for the Nexagon.

“By teaming up with individuals from different disciplines, you see solutions to problems from completely different perspectives and realize that this is how we should move forward. This is how we move medicine into the 21st century.” — Mr. Brandon Spink, The Nexagon

The Nexagon is a protective neck brace designed to prevent concussions in athletes. In 2016–17, more than 46,000 Canadians between the ages of five and 19 were diagnosed with concussions, and roughly half of these were the result of participation in a sport or recreational activity.

Mr. Spink and his team focused on one of the key causes of concussions that is often overlooked — whiplash injuries — the result of a rapid rotation of the head and neck. The Nexagon collar consists of a polymer-based material with an elastic hexagonal design that absorbs the impact of a collision and lessens movement of the head.

“Concussions are a major cause of admission to emergency rooms and are often difficult to diagnose and treat,” explains Mr. Spink. “If the Nexagon can help prevent or reduce the number of concussions, then these health care dollars can be spent elsewhere in the system.”

Joule Innovation grant helps teams build a perfect prototype

Mr. Spink plans to use his Joule Innovation grant to design and build a full-size working model of the Nexagon, using CAD software and 3D printing technology. The grant will also cover the expense of further testing to meet the necessary US and Canadian technical standards, similar to international certification for sports headgear and helmets.

“We want the device to be safe and practical. We want it to be something that athletes can feel safe wearing without impeding their performance,” says Mr. Spink.

Dr. Cherukupalli and his team are busy machining their own prototype, an L-shaped device that cuffs the bicep at one end and tractions the fingers at the other. The Joule Innovation grant will help pay for manufacturing costs and allow Tractus Medical to incorporate, apply for a provisional patent, begin clinical trials and apply for regulatory approval from Health Canada.

“I want this device to be the new gold standard for treating wrist fractures, to the point that future medical students will look at it and say, ‘Oh, yeah, this is how we treat them now,’” says Dr. Cherukupalli. “And manual traction becomes a thing of the past.”

The 2020 Joule Innovation grant program provided $500,000 to support physician-led innovations in the areas of sustainable health care, physician health and wellness, health care solutions and access to care.

Read about the other innovations funded through the program:


About the author(s)

CMA Joule supports physicians and medical learners in the pursuit of clinical excellence. As a subsidiary of the Canadian Medical Association (CMA), we support the profession with continuing education and other learning opportunities as well as leading evidence-based clinical products and research.