Nextra CH Cannulated Hammertoe System

K213530 · Nextremity Solutions, Inc. · HWC · Dec 9, 2021 · Orthopedic

Device Facts

• Record ID: K213530
• Device Name: Nextra CH Cannulated Hammertoe System
• Applicant: Nextremity Solutions, Inc.
• Product Code: HWC · Orthopedic
• Decision Date: Dec 9, 2021
• Decision: SESE
• Submission Type: Special
• Regulation: 21 CFR 888.3040
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

The Nextremity Solutions Nextra CH Cannulated Hammertoe System is intended for small bone reconstruction limited to inter-phalangeal repair and fusion of the lesser toes.

Device Story

The Nextra CH Cannulated Hammertoe System is a two-part cannulated bone screw implant construct used for inter-phalangeal repair and fusion of lesser toes. The system includes proximal and distal screw implants and optional Kirschner wires (K-wires) for temporary stabilization. Implants are inserted by a surgeon using system-specific drivers to facilitate bone fusion. The K-wire is removed by the physician once fusion is achieved. The device provides mechanical fixation to support bone healing in the lesser toes.

Clinical Evidence

No clinical data. Substantial equivalence demonstrated via non-clinical testing, including endotoxin testing per AAMI ST72, USP 161, and USP 85.

Technological Characteristics

Two-part cannulated bone screw system. Screw implants: Ti-6Al-4V ELI (ASTM F136). Optional K-wires: 316 Stainless Steel (ASTM F138). Provided sterile for single use. Includes specific surgical preparation and insertion instruments.

Indications for Use

Indicated for small bone reconstruction, specifically inter-phalangeal repair and fusion of the lesser toes.

Regulatory Classification

Identification

A smooth or threaded metallic bone fixation fastener is a device intended to be implanted that consists of a stiff wire segment or rod made of alloys, such as cobalt-chromium-molybdenum and stainless steel, and that may be smooth on the outside, fully or partially threaded, straight or U-shaped; and may be either blunt pointed, sharp pointed, or have a formed, slotted head on the end. It may be used for fixation of bone fractures, for bone reconstructions, as a guide pin for insertion of other implants, or it may be implanted through the skin so that a pulling force (traction) may be applied to the skeletal system.

Predicate Devices

• Nextra® CH Cannulated Hammertoe System (cleared as DuoHex™ CH Cannulated Hammertoe System) (K200840)

Submission Summary (Full Text)

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December 9, 2021

Nextremity Solutions. Inc. Elise Fox Quality and Regulatory Specialist 1195 Polk Drive Warsaw, Indiana 46582

Re: K213530

Trade/Device Name: Nextra® CH Cannulated Hammertoe System Regulation Number: 21 CFR 888.3040 Regulation Name: Smooth Or Threaded Metallic Bone Fixation Fastener Regulatory Class: Class II Product Code: HWC, NDL Dated: November 4, 2021 Received: November 5, 2021

Dear Elise Fox:

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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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.

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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) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; 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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). 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 (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email ([e-mail]) or phone [phone] or 301-796-7100).

Sincerely.

Shumaya Ali, MPH Assistant Director DHT6C: Division of Restorative, Repair and Trauma Devices OHT6: Office of Orthopedic Devices Office of Product Evaluation and Ouality Center for Devices and Radiological Health

Enclosure

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# Indications for Use

510(k) Number (if known)

#### K213530

Device Name

Nextra® CH Cannulated Hammertoe System

#### Indications for Use (Describe)

The Nextremity Solutions Nextra CH Cannulated Hammertoe System is intended for small bone reconstruction limited to inter-phalangeal repair and fusion of the lesser toes.

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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| 510(k) Summary | |
|--------------------|---------------------------------------------------------------------------------------------------|
| Prepared: | November 4, 2021 |
| Submitter: | Nextremity Solutions, Inc.<br>1195 Polk Drive<br>Warsaw, IN 46582 |
| Contact: | Elise Fox<br>Quality and Regulatory Specialist<br>[e-mail]<br>Phone: [phone] |
| Proprietary Name: | Nextra® CH Cannulated Hammertoe System |
| Common Name: | Screw, Fixation, Bone- Primary<br>Pin, Fixation, Smooth, Metallic |
| Classification: | II |
| Regulation Number: | 21 CFR § 888.3040 Smooth or threaded metallic bone fixation fastener |
| Panel: | 87/Orthopedic |
| Product Code: | HWC- Primary, NDL |

# Substantially Equivalent Devices:

- . Nextremity Solutions, Nextra® CH Cannulated Hammertoe System (cleared as DuoHexTM CH Cannulated Hammertoe System)- K200840- Predicate Device
### Device Description:

The Nextra® CH Cannulated Hammertoe System (originally cleared as DuoHex™ CH Cannulated Hammertoe System- K200840) consists of a two-part cannulated bone screw implant construct. The screw implants are provided in various sizes. The proximal screw implant diameters range from 2.75mm to 4.2mm. The middle screw implant diameters range from 2.75mm to 5.0mm in increments of 0.75mm. The proximal and distal screw implants are manufactured from Ti-6Al-4V ELI conforming to ASTM F136. The system offers an optional fixation method using a Kirschner wire (K-wire) in conjunction with the screw implants for additional fixation and temporary stabilization. The K-Wire is intended to be removed at the discretion of the physician upon joint fusion. The k-wires provided are manufactured from 316 Stainless Steel conforming to ASTM F138. The system includes the necessary surgical site preparation and insertion

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instruments, including implant specific drivers. The implants and instruments of the system are provided sterile for single use.

### Intended Use / Indications:

The Nextremity Solutions Nextra CH Cannulated Hammertoe System is intended for small bone reconstruction limited to inter-phalangeal repair and fusion of the lesser toes.

# Summary of Technologies/Substantial Equivalence:

The modified Nextra CH Cannulated Hammertoe system is substantially equivalent to the predicate devices regarding the intended use and indications, material. design, sizes, and mechanical properties. Differences between the subject device system and the predicate device systems do not raise new types of safety and effectiveness questions.

# Non-Clinical Testing:

Endotoxin testing was performed using the Limulus Amebocyte Lysate (LAL) method according to AAMI ST72, USP 161 and USP 85. Results met the Endotoxin limit of ≤20 EU per device.

# Clinical Testing:

Clinical testing was not necessary to demonstrate substantial equivalence of the Nextra CH Cannulated Hammertoe System to the predicate device.

### Conclusions/Substantial Equivalence:

Differences between modified Nextra CH Cannulated Hammertoe system and the predicate device do not raise new types of safety and effectiveness questions. The modified Nextra CH Cannulated Hammertoe system is substantially equivalent to the predicate device in regard to its intended use, material, design, sizes, and mechanical properties.