K990717 · Disco-O-Tech Medical Technologies, Ltd. · HSB · Jun 2, 1999 · Orthopedic
Device Facts
Record ID
K990717
Device Name
FIXION INTRAMEDULLARY NAILING SYSTEM
Applicant
Disco-O-Tech Medical Technologies, Ltd.
Product Code
HSB · Orthopedic
Decision Date
Jun 2, 1999
Decision
SESE
Submission Type
Traditional
Regulation
21 CFR 888.3020
Device Class
Class 2
Attributes
Therapeutic
Indications for Use
The Fixion"M Intramedullary Nailing System ("Fixion" Nail") is intended for use in the fixation of long bone fractures, including diaphyseal fractures in the humerus, femur and the tibia. It is indicated for use in shaft fractures 5cm below the surgical neck to 5cm proximal to the distal end of the medullary canal.
Device Story
Fixion Intramedullary Nailing System; single-use orthopedic implant for long bone fracture fixation. System components: expandable stainless steel nail, driver, and manual inflation pump. Surgeon inserts nail into medullary canal; uses driver to connect inflation device. Inflation device pumps sterile liquid into nail, expanding diameter to contact canal walls; expansion monitored via X-ray. Provides mechanical fixation equivalent to locking nails. Used in clinical settings by orthopedic surgeons. Benefits: secure fixation via expansion against medullary wall.
Clinical Evidence
Evidence includes in-vitro mechanical testing and animal studies. Mechanical testing performed per ASTM F1264 (4-point bending) and ASTM F383 (torsion). No human clinical trial data provided.
Technological Characteristics
Expandable non-slotted cylindrical stainless steel 316L nail (ASTM F138). Features reinforcement bars for structural integrity. Driver and manual inflation pump system. Mechanical expansion principle using sterile fluid. Dimensions/form factor: intramedullary rod. Sterilization: single-use.
Indications for Use
Indicated for fixation of long bone fractures, including diaphyseal fractures of the humerus, femur, and tibia, specifically shaft fractures located 5cm below the surgical neck to 5cm proximal to the distal end of the medullary canal.
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.
SYNTHES's AO Universal Tibial and Femoral Nails (K914453, K914371)
SYNTHES's AO Unreamed Humeral (UHN) Tibial (TNN) and Femoral (UFN) Nails (K933518, K932330, K923580)
Submission Summary (Full Text)
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K 99 0 717
7.1
#### 510(K) Summary
# Disc-O-Tech Medical Technologies Fixion Intramedullary Nailing System
#### Company Name
Disc-O-Tech Medical Technologies, Inc. 3 Hasadnaot St. Herzlia Israel, 46728
### Submitter's Name and Contact Person
Jonathan S. Kahan, Esq. 555 Thirteenth Street, N.W. Washington, DC 20004 Tel: 202-637-5794 Fax: 202-637-5910
### Date Prepared
February, 1999.
# Trade/Proprietary Name
Fixion™ Intramedullary Nailing System
## Classification Name
Intramedullary Fixation Rod 21 C.F.R. § 888.3020 Class II
3 1999
JUN
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## Predicate Devices
- · CINTOR Orthopedic Div's Aginsky Nail (K803106
- · HOWMEDICA's Seidel Humeral Locking Nail (K883882, K924004, K925544, K931256)
- SYNTHES's AO Universal Tibial and Femoral Nails (K914453, and K914371
- · SYNTHES's AO Unreamed Humeral (UHN) Tibial (TNN) and Femoral (UFN) Nails (K933518, K932330, and K923580, respectively).
### Performance Standards
No performance standards applicable to Intramedullary Nails have been established by the FDA. However, the following standards were used:
- · Stainless steel 316L which is used to manufacture the Fixion™ Intramedullary Nailing System meets the requirements of ASTM F138 - Standard Specification for Stainless steel Bar and Wire for Surgical Implants.
- · The 4 point bending mechanical testing was performed according to ASTM F 1264 - standard for mechanical performance considerations for intramedullary fixation devices.
- · The torsional mechanical testing was performed according to ASTM F383 -Standard Practice for Static Bend and Torsion Testing of Intramedullary Rods.
### Intended Use
The Fixion"M Intramedullary Nailing System ("Fixion" Nail") is intended for use in the fixation of long bone fractures, including diaphyseal fractures in the humerus, femur and the tibia. It is indicated for use in shaft fractures 5cm below the surgical neck to 5cm proximal to the distal end of the medullary canal.
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## System Description
The Fixion™ Intramedullary Nailing System is a single use system that features 3 main components: Nail implant, Driver, and Inflation device.
- · The Nail implant is an expandable non-slotted stainless steel cylindrical tube, with a conical shaped distal end and a cap protected, female threaded proximal end.
- · The Driver is a stainless steel cylinder with plastic handle. used for the nail insertion, location and adjustment at the intramedullary canal. In addition, it serves as a delivery system for the inflation liquid.
The Driver has a male threaded end to be connected to the Nail implant proximal end. A quick connector is located on the Driver to be connected to the Inflation device.
- · The Inflation device is a single use manual plastic "pump", filled with sterile inflation liquid, similar to a PTCA inflation pump but with higher pressure. The inflation device outlet pipe end has a female quick connector to be connected to the Driver connector.
Once the nail is positioned within the medullary canal, rotation of the "pump" handle allows for nail diameter increase to its intended diameter under X-ray and controlled pressure.
### Substantial Equivalence
The Fixion™ Nail has the same intended use and substantially similar indications for use as the predicates, i.e., fixation of long bone fractures of the humerus, tibia, and femur.
The performance characteristics of the Fixion Nail have been tested and approved through a series of in-vitro and animal studies.
The Fixion™ Nail, like the Synthes Universal Tibial and Femoral Nails, is a Stainless Steel 316L canulated design. The cross section of the Fixion™ Nail is circular with reinforcement bars, which was found to be equivalent in mechanical properties to the circular cross section of the predicate devices.
With respect to fixation, the expansion of the Fixion™ Nail results in the attachment of the 4 reinforcement bars to the medullary canal wall, providing equivalent fixation to the distal mechanism of the Seidel Humeral locking nail, in which the nail distal end's three leaves are expanded and attached to the medullar canal wall.
The expansion of the Fixion nail with saline, which is a non-compressible biocompatible fluid, does not raise any safety concerns.
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Public Health Service
Image /page/3/Picture/2 description: The image shows the seal of the Department of Health & Human Services (HHS). The seal features a stylized caduceus, a symbol often associated with medicine and healthcare, with a double-stranded snake winding around a staff. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular pattern around the caduceus.
2 1999 JUN
Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
Jonathan s. Kahan, Esq. Hogan & Hartson, L.L.P. Representing Disc-O-Tech Medical Technologies, Inc. 555 Thirteenth Street, N.W. Washington, DC 20004
Re: к990717 Fixion™ Intramedullary Nail System Trade Name: Regulatory Class: II Product Code: HSB Dated: February 24, 1 ਰੇ ਰੇ ਰੋ March 4, 1999 Received:
Dear Mr. Kahan:
We have reviewed your Section 510(k) notification of intent to market the device referenced above and we have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to 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). 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.
If your device is classified (see above) into either class II (Special Controls) or class III (Premarket Approval), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 895. A substantially equivalent determination assumes compliance with the current Good Manufacturing Practice requirement, as set forth in the Quality System Regulation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic (QS) inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory In addition, FDA may publish further announcements action. concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.
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Page 2 - Jonathan s. Kahan, Esq.
This letter will allow you to begin marketing your device as described in your 510(k) premarket notification. The FDA findinq of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.
If you desire specific advice for your device on our labeling requlation (21 CFR Part 801 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4659. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to ene regaration chosers. (21 CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its internet address "http://www.fda.gov/cdrh/dsmamain.html".
Sincerely yours,
Celia M. Witten, Ph.D., M.D.
Director Division of General and Restorative Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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### INDICATION FOR USE
k990717 510(K) Number (if known): _
Device Name:
Fixion™ Intramedullary Nailing system
Indication for Use:
The Fixion™ Intramedullary Nailing system is intended for use in the fixation of long bone fractures, including diaphyseal fractures in the humerus, femur and the tibia. It is indicated for use in shaft fractures 5cm below the surgical neck to 5cm proximal to the distal end of the medullary canal.
# (PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED)
Concurrence of CDRH, Ofice of Device Evaluation (ODE) (Division Sign-off) Division of Reproductive, Abdominal, Ear, Nose and Throat, and Radiological Devices
510(k) Number:
Prescription Use (per 21 CFR 801.109)
OR
Over the Counter
Use
livision of General Restorative De
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.