The Agile Nail is intended for insertion in the medullary canal of a femur for the alignment and the stabilization of fractures, and for the correction of deformities. It is indicated for the treatment of subtrochanteric fractures and of femoral shaft fractures, with the exception of newborns and infants, and in adult patients with an appropriate medullary canal. The indications include: prophylactic nailing of impending pathologic fractures; fixation of femurs that have been surgically prepared (osteotomy); nonunions and malunions; reconstruction following tumor resection and grafting and bone lengthening and shortening.
Device Story
Agile Nail system comprises ante grade intramedullary nails, end caps, and screws; includes instrumentation for insertion and extraction. Used by orthopedic surgeons in clinical settings for femoral fracture stabilization and deformity correction. Device inserted into medullary canal to provide mechanical alignment and fixation. System supports various clinical scenarios including pathologic fractures, osteotomies, nonunions, malunions, and tumor-related reconstructions. Benefits include restoration of bone stability and alignment, facilitating healing. No software or AI components involved.
Clinical Evidence
Bench testing only. Mechanical testing performed per ASTM F1264-16 and ASTM F543-17. Biocompatibility and non-pyrogenicity established via USP 38 <85>, USP 38 <161>, and ANSI/AAMI ST72:2011. No clinical data provided.
Technological Characteristics
Intramedullary fixation rod system. Materials are metallic (implied by bone screw standards). Mechanical testing conducted per ASTM F1264-16 (intramedullary fixation devices) and ASTM F543-17 (metallic bone screws). No software, electronics, or energy sources.
Indications for Use
Indicated for pediatric (excluding newborns/infants) and adult patients with appropriate medullary canal for treatment of subtrochanteric and femoral shaft fractures, prophylactic nailing of impending pathologic fractures, fixation of surgically prepared femurs (osteotomy), nonunions, malunions, and reconstruction following tumor resection, grafting, and bone lengthening/shortening.
Regulatory Classification
Identification
An intramedullary fixation rod is a device intended to be implanted that consists of a rod made of alloys such as cobalt-chromium-molybdenum and stainless steel. It is inserted into the medullary (bone marrow) canal of long bones for the fixation of fractures.
Predicate Devices
Synthes Adolescent Lateral Entry Femoral Nail System (K070843)
Orthopediatrics PediNal Intramedullary Nailing System (K083726)
Submission Summary (Full Text)
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Orthofix Srl % Cheryl Wagoner Consultant Wagoner Consulting LLC PO Box 15729 Wilmington, North Carolina 24408
Re: K172699
Trade/Device Name: Agile Nail Regulation Number: 21 CFR 888.3020 Regulation Name: Intramedullary Fixation Rod Regulatory Class: Class II Product Code: HSB Dated: March 23, 2018 Received: March 26, 2018
Dear Cheryl Wagoner:
We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.
If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.
Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820);
April 23, 2018
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and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.
Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.
For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/) and CDRH Learn (http://www.fda.gov/Training/CDRHLearn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (http://www.fda.gov/DICE) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).
Sincerely,
## Katherine D. Kavlock -S
for Mark N. Melkerson Director Division of Orthopedic Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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## Indications for Use
510(k) Number (if known) K172699
Device Name Agile Nail
Indications for Use (Describe)
The Agile Nail is intended for insertion in the medullary canal of a femur for the alignment and the stabilization of fractures, and for the correction of deformities.
It is indicated for the treatment of subtrochanteric fractures and of femoral shaft fractures, with the exception of newborns and infants, and in adult patients with an appropriate medullary canal.
The indications include:
prophylactic nailing of impending pathologic fractures;
fixation of femurs that have been surgically prepared (osteotomy);
nonunions and malunions;
reconstruction following tumor resection and grafting and bone lengthening and shortening.
| Type of Use (Select one or both, as applicable) | |
|-------------------------------------------------|--|
|-------------------------------------------------|--|
X Prescription Use (Part 21 CFR 801 Subpart D)
Over-The-Counter Use (21 CFR 801 Subpart C)
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Image /page/3/Picture/0 description: The image shows the Orthofix logo, which is a blue abstract shape above the word "ORTHOFIX" in black, with a registered trademark symbol. Below the logo is the text "510(k) Summary" in a smaller font size. The text "(as required by 21 CFR 807.92)" is below the summary in an even smaller font size.
| Submitter Name | Orthofix Srl | | |
|----------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------|--|
| Address | Via delle Nazioni, 9 37012 Bussolengo (VR) - Italy | | |
| Telephone | + 39 045 6719.000 | | |
| Fax | + 39 045 6719.380 | | |
| Contact Person | Gianluca Ricadona<br>Sr. Quality & Regulatory Affairs Manager | | |
| Address | Via delle Nazioni, 9<br>37012 Bussolengo (VR) - Italy | | |
| Telephone | + 39 045 6719 000 | | |
| Fax | + 39 045 6719 380 | | |
| email | GianlucaRicadona@orthofix.it | | |
| Date Prepared | August 29, 2017 | | |
| Trade Name | Agile Nail | | |
| Common Name | Rod, fixation, intramedullary and accessories | | |
| Panel Code | Orthopedic | | |
| Classification Name | Intramedullary fixation rod. | | |
| Class | Class II | | |
| Regulation Number | 21 CFR 888.3020 | | |
| Product Code | HSB | | |
| Predicate Device Name | 510(k) Number | Manufacturer | |
| Synthes Adolescent Lateral Entry<br>Femoral Nail System | K070843 | Synthes(USA) | |
| Orthopediatrics PediNal Intramedullary<br>Nailing System | K083726 | Orthopediatrics, Corp. | |
| Device description | The Agile Nail consists of ante grade intramedullary nails, end caps and screws, and related instrumentation for insertion and extraction of the implantable components.<br>The System is designed to address femoral fractures and deformity corrections procedures. | | |
| Indications for use | The Agile Nail is intended for insertion in the medullary canal of a femur for the alignment and the stabilization of fractures, and for the correction of deformities.<br>It is indicated for the treatment of subtrochanteric fractures and of femoral shaft fractures, in pediatric patients, with the exception of newborns and infants, and in adult patients with an appropriate medullary canal.<br>The indications include:<br>prophylactic nailing of impending pathologic fractures;<br>fixation of femurs that have been surgically prepared (osteotomy);<br>nonunions and malunions;<br>reconstruction following tumor resection and grafting and bone lengthening and shortening. | | |
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| Technological<br>Characteristics and<br>Substantial<br>Equivalence | Documentation was provided to demonstrate that the Agile Nail<br>is substantially equivalent to the legally marketed predicates.<br>Components included in the Subject system and the predicates<br>are all dedicated to internal fracture fixation procedure, as<br>defined in 21 CFR 888.3020.<br>The Agile Nail is substantially equivalent to the predicate<br>devices in: intended use, site of application, patient population,<br>conditions of use, mechanical performances, operating<br>principles and materials. Mechanical testing demonstrate how<br>the mechanical properties of the Subject Device are equivalent /<br>better than the predicate involved. |
|--------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Performance Data | The potential hazards have been evaluated and controlled<br>through a Risk Management Plan. |
| | All testing met or exceeded the requirements as established by<br>the test protocols and applicable standards. |
| | A review of the mechanical data indicates that the components<br>of the Subject device are capable of withstanding expected<br>loads without failure. The Agile Nail was therefore found to be<br>substantially equivalent to the predicate involved in the<br>performance.<br>Clinical data were not needed to support the safety and<br>effectiveness of the Subject Device. |
| | Mechanical testing were performed according to the following<br>standards: |
| | ASTM F1264-16 "Standard Specification and Test Methods for<br>Intramedullary Fixation Devices". |
| | ASTM F543-17 "Standard Specification and Test Methods for<br>Metallic Medical Bone Screws." |
| Biocompatibility data | In order to establish the Subject device non-pyrogenicity, some<br>tests were performed on an equivalent System implants,<br>according to the following international standard:<br>• USP 38: 2014 < 85 > "Bacterial endotoxin test (LAL)".<br>• USP 38: 2014 < 161 > "Medical devices – bacterial endotoxin<br>and pyrogen tests".<br>• ANSI / AAMI ST72: 2011 "Bacterial endotoxins – Test<br>methodologies, routine monitoring and alternative batch testing".<br>• FDA 2012 Q&A "Guidance for Industry Pyrogen and<br>Endotoxins Testing: Question and Answers".<br>Here below the test reports and test rationale references list:<br>• 166699_rep_fin dated 2016/10/07<br>• 166700_Report_final dated 2016/10/13<br>• 16VA00533 validation report dated 2016/10/13<br>• Cert_2016_7505, Cert_2016_7506, and Cert_2016_7507<br>report dated 2016/10/19<br>• AGILE_QE_RA03_R1 |
| Conclusion | Based upon similarities in: intended use, site of application,<br>conditions of use, operating principles and mechanical<br>performances, the Agile Nail has been shown to be substantially<br>equivalent to its legally marketed predicate devices. |
Two short videos show you everything — or skip straight to the written tutorial if you'd rather read. You can reopen this any time from the Tutorial button in the top bar.
Part 1 — Search, results, and everyday workflows 16 min
Part 2 — Embeddings: the galaxy map 3 min
1. Search: exact and fuzzy
Type a phrase like "coronary artery calcification" into the search box. You get two kinds of results. Exact results match the literal phrase — prefix searches work ("coronary artery calcificati") but suffix searches do not. Fuzzy results match on the meaning and intent of your phrase rather than the exact words, and are sorted by relevance score. Hover over the Exact or Fuzzy badge on any row to see exactly why it matched.
Use the checkboxes above the results to narrow: SaMD keeps only software-only devices, AI / ML keeps only devices with AI.
Exact vs. fuzzy search: what's the difference?
Exact matches on the literal phrase (prefix search works, suffix does not). Fuzzy matches on the meaning and intent of the phrase rather than the exact words. Hover over the badge on any row to see why it matched.
You search "coronary artery calcification" and want only software devices with AI. What two filters do you apply?
Narrow by SaMD (software-only devices), then narrow by AI/ML (devices with AI).
2. The results table
Scroll right in the results table. The intended use is extracted for you — no need to open the PDF. The device story gives a high-level snapshot of what the device does and how it's used. The AI Performance sub-table shows each output name, acceptance criteria, observed values, and development/test dataset descriptions — the same format Innolitics uses for regulatory strategy outputs, and the fastest high-level fingerprint of an AI device. It is AI-generated but has been very reliable in practice.
Where do you find a device's intended use without opening the PDF?
Scroll right in the search results table. The intended use column is extracted for you; no need to dig into the 510(k) summary PDF.
What does the AI Performance sub-table show, and why is it useful?
Output name, acceptance criteria, observed values, development dataset description, and test dataset description. It's the same format we use for regulatory strategy output and Fast 510(k) input, and the fastest high-level fingerprint of an AI device. AI-generated but reliable in practice.
3. Judging fuzzy relevance
Fuzzy results trail off in relevance as you scroll. Use three signals to decide how far down to go: the fuzzy badge explanations, the intended use column, and whether your target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, you're past the relevant zone. A top hit with a low score (~0.4) and a stretched explanation is a hint the closest predicates are far away — the project may be headed for De Novo. Note the fuzzy search is a pattern match: it doesn't handle negation ("not") well, and hardware devices can appear — filter by SaMD/AI ML to cut them.
How do you judge how far down fuzzy search results to go?
Use the relevancy signals: the fuzzy badge explanations, the intended use column, and whether the target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, results are trailing off in relevancy.
4. Device detail page: chat and citations
Click a device name to open its detail page: device facts on the left, a chat window on the right. Ask something like "Describe the training data". The answer carries little citation bubbles — click one to jump to the highlighted passage in the source PDF, so you can verify every AI answer against the document. There's also a Download PDF button for sharing.
How do you verify an AI chat answer on the device detail page?
Click the citation bubbles to jump to the relevant highlight in the source document.
Reading rule for every project: how many summaries do you read in full?
At least the three most relevant 510(k) or De Novo summaries, in full. After that, use targeted chat questions to confirm your memory quickly. The tool supports this professional habit — it doesn't replace it.
5. Side-by-side comparison
Select multiple rows in the results table (aim for under ~10), then open the PDF Viewer tab. Ask one question — it goes to all selected devices in parallel, each with citations. This is the fastest way to compare and contrast devices: training data, PCCP scope, how they handled adding new scanners, and so on.
What does the side-by-side PDF viewer mode do?
Select multiple devices, open the PDF viewer tab, and ask one question (e.g., "Describe the training data"). It queries all selected devices simultaneously with citations, so you can compare and contrast quickly.
6. Collections
With rows selected, go to the Collections tab and create a labeled collection (e.g., "Cobb Angle Project"). Reload that selection any time — before a client call, pull up the collection and ask questions across all of its devices at once.
How do you save a set of selected devices for later use?
Select the rows, go to the Collections tab, and create a labeled collection (e.g., "Cobb Angle Project"). You can reload the selection anytime and carry it into the PDF viewer and other tabs that support selections.
7. Product codes and the regulations tree
Click a product code in the results to jump to it in the regulations tree — identification text, sibling product codes, and devices you can open in a PDF viewer on the right. Click a regulation number to see its identification, special controls, and related product codes. You can also search by product code or regulation number at the top of the tree. Always read the special controls if any exist for your device — it broadens your search and sharpens pre-kickoff research.
What can you do from the regulations tree view?
Browse product codes and regulation numbers, read the identification text and special controls, browse sibling product codes, open device PDFs on the right, and search by product code or regulation number at the top of the tree.
8. Chart view
Click Show Chart and segment by regulation number (or product code) to see which regulations dominate your result set. Clicking a regulation takes you into the regulations tree. Great for spotting that most matches are, say, hardware laparoscopic devices — a cue to go back and filter.
How do you see which regulations dominate a search result set?
Click "Show Chart" and segment by Regulation Number. Clicking a regulation takes you to the regulations tree.
9. The predicate graph
Open the Predicates tab for a family-tree view of predicate relationships. Click a node to trace its parents and children; selections from search carry over pre-selected. Commonly predicated devices are worth reading — a lot of people predicated them for a reason. The visual lineage is also handy on client calls, e.g. to show how a predicate family evolved and justify why your predicate still holds.
In the predicate graph, why are commonly predicated devices worth reading?
A lot of people predicated them for a reason. Clicking a node traces parents and children, and selections from search carry over pre-selected.
10. Embeddings: the galaxy map
The Embeddings tab plots every matching document in a 2-D "galaxy map" where semantically similar devices cluster together. Hover or click clusters to explore, and let AI label the clusters for you. Embeddings beat product codes for grouping: two devices can carry different product codes (LLZ vs. QIH) yet do the same thing — the embedding captures the meaning of the intended use and device story. This is also exactly how retrieval-augmented generation (RAG) works under the hood, and it makes a great visual on client calls.
Try it yourself
Head to the search page and work through a few of these AI/ML fuzzy searches to build intuition: perivascular fat on CT · aortic valve calcification opportunistic screening on noncontrast CT · breast cancer prediction on digital pathology slides · autism detection · gestational age prediction · a hearing aid that can also detect a pulse · foundation model based analysis of ECG · large language models · penetration test. Watch how the relevance scores, intended use, and AI Performance tables tell you when results stop being meaningful.