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It was reported that, after an orif surgery that had been performed on the (b)(6) 2025, one (1) intertan 10s 10mm x 20cm 125d broke inside the patient in the distal locking screw aperture on the (b)(6) 2025.The patient was attempting to get into the bed and felt a pop, and it had a sudden onset pain in the proximal thigh area.This adverse event was addressed by a revision surgery on (b)(6) 2025, in which the device was replaced with a long trigen intertan nail.The patient tolerated the procedure well, and it was able to bear weight and his pain is under control.
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Internal complaint reference: (b)(4).This complaint was opened by smith+nephew to document a patient complication related to a product problem with a smith+nephew device.The reported issue(s) relate to known inherent device and/or procedural risks that are appropriately documented in our risk files.Smith+nephew will continue to monitor trends in accordance with our post-market surveillance process and take necessary action as required if anticipated severity and/or occurrence rates are exceeded.Smith+nephew has no reason to suspect that the product failed to meet any specifications at the time of manufacture.Based on our review of all currently available information, we are unable to identify a definitive root cause.However, as the use of our product cannot be excluded as a potential cause or contributory factor to the reported issue, we are submitting this report in accordance with applicable regulations.If additional investigative findings or information becomes available that alters the conclusions of this report, a follow-up report will be submitted as required.
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H3, h6: the associated device was returned and evaluated.The visual inspection revealed that the complaint device and components from a lag/comp screw kit 95/90 returned.The complaint device is fractured at the distal aperture.There are significant discoloration and some surface damage to other areas of the complaint device.Im nail fractured by the initiation and subsequent propagation of fatigue cracking.The fatigue cracking eventually propagated to an extent that the remaining cross-sectional area of the nail could not bear the imposed patient loading, which led to an overload fracture.Fatigue cracking was likely caused by the nail bearing cyclic stresses more than the material endurance limit for an extended period of time.These excessive cyclic stresses may be caused by any number of conditions, including but not limited to excessive patient activity levels prior to full bone union, applications of loads in excess of the material¿s strength, and/or poor bone quality.The clinical/medical investigation concluded that based on the images provided, the fractured nail and periprosthetic fracture led to the revision surgery.However, the initial implant selection may have contributed to the fracture, as a longer nail was required during revision.It is unclear whether the instructions for use (ifu) for the trigen intertan nail system were followed.The ifu emphasizes the importance of selecting the correct implant type and size, proper fracture reduction, and accurate implant placement to ensure successful outcomes.It also warns that the implant has a limited lifespan and may break due to trauma or strenuous activity.Potential contributing factors include implant alignment, bone quality, patient anatomy, surgical technique, early weight bearing, and the patient¿s medical history¿including comorbidities, blindness, former smoking, and alcohol abuse.According to the report, the patient tolerated the revision well, was able to bear weight, and had controlled pain.The patient impact included the periprosthetic fracture, the need for revision to a longer nail, and the post-operative recovery period.A review of the production order did not reveal a manufacturing abnormality that could have caused or contributed to the reported incident.A review of complaint history revealed similar events for the listed part number over the previous 12 months, but no similar events for the batch based on the historical data, this failure mode will be monitored for future complaints for any necessary corrective actions.A review of the instructions for use documents for intramedullary nail system revealed in possible adverse effects that cracking or fracture of the implant may occur.Preoperative planning section states that proper type and size of implant must be selected to ensure effective treatment of patients considering factors such as patient¿s size, strength, skeletal characteristics, skeletal health, and general health.Overweight or musculoskeletal deficient or unhealthy patients may create greater loads on implants that may lead to breakage or other failure of the implants.Additionally, postoperative care section warns that early weight bearing substantially increases implant loading and increases the risk of breaking the device.A review of the risk management file revealed this failure mode was previously identified.The anticipated risk level is still adequate.A historical review concluded that there are no prior actions related to this product and event.According with inspection drawing, the final inspection includes the verification of part configuration per print.Also, per material specification, the quality and manufacture of standard grade titanium-6 aluminum-4 vanadium alloy shall be controlled.At this time, we have no evidence to conclude that the product failed to meet any specifications at the time of manufacture.Based on this investigation, the need for corrective action is not indicated.Should additional information be received, the complaint will be reopened.No further investigation is warranted for this complaint; however, we will continue to monitor for future complaints and investigate as necessary.We consider this investigation closed.Additional information: d9, h8.Corrected data: h6 (health effect - clinical code, health effect - impact code).
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