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The reported event was rated as confirmed due to the observed damages at the received plates.In total six locking screws were returned together with the distal medial femur plate.There was no information provided how many screw were affected by the reported screw prominence.The evaluation of the corresponding plate has shown that two of the universal holes were damaged in a manner that a proper locking of the screw was not possible anymore.Based on that it can be concluded that the two returned screws with the most severe damages at the locking head were affected by this occurrence.In addition are these the longest returned screws, which typical for the affected distal screw holes.The device inspection revealed the following: the inspection of the screws has shown that the locking threads are slightly damaged, especially the first thread flanks are flattened.This could be an indication for an excessive contact between the screw and the plate during the insertion, but it can also not be excluded that the damages occurred in-situ due to friction between the screw and the plate.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.The complaint was reviewed by r and d, including a interview with the operating physician.The review came to the result that the locking screws shown normal trace of use.No product related issue could be detected during the investigation.Based on the provided information, no pre-, intra- and post-operative x-rays in different planes, operation reports, detailed patient details, history and activity was provided, the root cause of the reported event cannot be defined.There are too many factors, like screw insertion angle and torque, position of other already present implants, fracture situation, patient condition, especially in relation to bone quality and activity, that could have played a role.If more information is provided, the case will be reassessed.
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