In one of the most severely affected healthcare systems in the world, a team of doctors and engineers has achieved an unprecedented breakthrough. GLIA, an international medical relief organisation, has designed and produced the world’s first 3D-printed external fixator inside Gaza, an essential orthopedic device used to treat complex fractures. The project was carried out using locally available materials, 3D printing, recycled plastic, and solar power in a setting where supplies are critically limited and conventional medical equipment is largely inaccessible.
The device has already prevented amputation or permanent disability for three patients. This achievement comes at a time when more than 90 percent of healthcare facilities are damaged or destroyed, medical supply entry is severely restricted, and hospitals face acute shortages of the equipment needed to perform even basic trauma care.
How an External Fixator Works and Why It Is Essential in Gaza
Known as an “x-fix,” an external fixator is used to align fractured bones and is especially valuable because it can be adjusted to the specific type of fracture. Under normal conditions, surgeons choose an external fixator when a fracture is too unstable for internal fixation or when the surrounding tissues are too damaged for immediate surgery. This makes it an essential tool in critical situations, particularly because it allows surgeons to effectively “pause” the medical condition: it stabilizes and protects the injury and gives the patient’s body time to reduce infection or recover from traumatic shock.
Its effectiveness, however, depends on how quickly it is applied. Dr. Tarek Loubani, GLIA’s medical director, notes that delaying placement of an external fixator can lead to amputation or, in the worst cases, death. Conventional external fixators can cost more than 500 dollars, require specialized imports, and have become largely unattainable due to the Israeli blockade. In the Palestinian context, where hospitals are operating under near-collapse, and commercial devices cannot easily enter the Strip, the ability to produce medical tools and devices locally has become a vital necessity.
The First Surgery Using a 3D-Printed External Fixator
A Device Built Using What Is Available
Despite the constraints imposed by the geopolitical situation, the doctors had one advantage: many of the materials needed to produce the X-fix could be sourced locally. “For several weeks we knew that among the rubble there was the type of metal we needed to make the external fixator components,” notes Dr. Tarek, explaining how the metal rods are then connected to plastic joints produced with 3D printing. All plastic components are made from recycled materials and rely entirely on solar power, a necessary choice in a location where electricity and clean water are difficult to obtain.
Production is slow, taking up to 12 hours to print a single component, but the process is now fully operational. Twelve additional patients are awaiting the device, which has been regularly applied in the functioning healthcare facilities since August 2025. To date, these 3D-printed external fixators represent the only way to ensure precision, reproducibility, and safe support for the patients who need it most. The goal is to eventually move to a faster plastic extrusion system. However, uncertainty surrounding the ceasefire and the risk of new attacks make long-term planning extremely difficult. One of GLIA’s facilities in Gaza, for example, has already been targeted in the past, fortunately without casualties.
On the left, the kit with metal parts and 3D-printed components; on the right, one of the first patients with the external fixator.
An Open and Replicable Model
The good news is that the device is completely open-source. Jen Wilson, GLIA’s Director of Production and Design, explains that the organization does not intend to patent any part of the X-fix or profit from the devices. The goal is for it to be replicated wherever it is needed, especially in low-income areas or conflict zones.
GLIA emphasizes that the project was born from a collaboration between Palestinian, Canadian, and British teams. The team worked closely with Palestinian doctors to ensure that the materials were sterilized and structurally suitable for medical procedures. The organization rejects the notion of “aid,” instead describing the work as an example of Palestinian innovation. Dr. Loubani, who spent three months in Gaza’s emergency rooms, calls this “one of the most innovative projects” he has seen, highlighting Palestinian ingenuity and the ability to create a device essential for the most critical patients.
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*All Photo credits: GLIA