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The reported event could be confirmed since physical inspection matches the reported failure mode; received nail was completely broken in the webs of the proximal drill hole for the lag screw.Furthermore, one locking screw was also confirmed to be broken.Based on investigation the nail breakage is not linked to a deficiency of the device but is rather considered patient related.According to the damage and the evidence of the breakage surfaces, the nail broke in a fatigue fracture due to axial overload.Exceeding bearing points are usually the result of increased load application.This is also supported by the proven failed locking screw (most proximal one at distal nail end), which was also verified to be broken due to the increased load on the entire system.General aspects: the gamma3 nail is a temporary implant which inevitably will be subject of a fatigue fracture if the biomechanical stresses on the implant are too high or not considerably reduced during the period of implantation.During this period there is a race between bony consolidation / fracture healing and implant breakage as noted in the labelling of the product.Usually, a breakage is contributed by one or more deficits, e.G.Insufficient bone healing, product damage.Generally, the risk of a breakage will increase with the increase of load cycles and load level.Nail breakage in general has been experienced but does not present an unanticipated event in itself.Depending on load application, also, depending on the patient¿s post implant behavior and depending on suitable anatomical reduction, depending on the kind of bone breakage, depending on the course of bone healing and other factors (e.G.Increased post-operative activities) a nail breakage can rather be classified as anticipated; specifically, if one or more contributing issues concurrence with each other.A review of the device history for the reported lot did not indicate any abnormalities.No corrective actions are required at this time.A review of the labeling did not indicate any abnormalities.No indications of material, manufacturing or design related problems were found during the investigation.According to available information a deficiency of the nail was not verified.In case substantive information will become available in future that suggests otherwise we reserve the right to reopen the case.
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