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Corrections: h6 (method code), d9 (product return status).The reported event of a failed implant could be confirmed, since the returned nail is broken apart.The device inspection revealed the following: as received condition, the broken nail was returned for evaluation.The breakage at the most proximal distal hole can be confirmed.During the microscopic inspection of the nail fracture face the typical characteristics of a fatigue fracture could be identified on both fracture faces.There is a fatigue zone with a smooth surface and progression lines which ends in a rougher instantaneous zone, where the nail finally broke apart.The visible shiny surfaces were created by the fragments rubbing against each other.There are impression marks from the locking screw in the bore visible.These marks are consistent with high load transfer from the locking screw during continuous weight-bearing.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.No product related issue could be detected during the performed investigation of the returned device.Regarding the root cause of the implant failure no conclusive statement can be provided, because key clinical information (e.G.X-rays in different planes, clinical status, patient information and activity, assessment of the treating physician or operation reports) is missing.The root causes in such cases are often complex and multifactorial and cannot be determined scientifically without this decisive evidence.Due to these limitations, we are unable in such cases to provide statements about the patient, the procedure and/or the device in relation to cause of the failure.If more information is provided, the case will be reassessed.
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