Additive Manufacturing and Experimental Biomechanical Validation of Low-Cost Body-Powered Upper-Limb Prostheses for Pediatric Users: A Systematic Review of Evidence for PETG-Based Hybrid Flexible–Rigid Designs in Uganda

Children with congenital upper-limb differences or limb absence may experience difficulties with bimanual activities, object handling, participation, and independence. These challenges can be greater in settings where prosthetic services, fabrication facilities, technical expertise, and maintenance resources are limited. This systematic review examines evidence relevant to developing and experimentally evaluating an affordable, body-powered upper-limb prosthesis for pediatric users in Uganda. Emphasis is placed on fused filament fabrication (FFF), polyethylene terephthalate glycol-modified (PETG), flexible–rigid structures, cable actuation, growth accommodation, mechanical performance, durability, and functional assessment. Evidence from biomedical engineering, prosthetics, rehabilitation, additive manufacturing, and assistive-technology studies was synthesized thematically. The reviewed studies show that additive manufacturing supports customized designs, rapid modification, and accessible prototype production, while body-powered systems can reduce dependence on batteries and electronic components. However, existing studies commonly involve small samples, limited long-term testing, inconsistent reporting of printing conditions, and varied assessment methods. PETG is suitable for several printed components, but its performance depends on build orientation, raster arrangement, layer bonding, and processing conditions. The evidence supports an integrated development approach combining local requirements, anthropometry, material-process control, mechanical testing, durability assessment, functional evaluation, maintenance, and cost analysis. This approach provides a basis for developing and validating a locally adaptable pediatric prosthetic prototype for Uganda.