K Number
K181640
Device Name
X-BOLT Hip Fracture Fixation System
Date Cleared
2018-10-12

(113 days)

Product Code
Regulation Number
888.3020
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The X-BOLT® IM Hip Nailing System is intended for use in fracture fixation in adults with osteopenia or osteoporosis. The X-BOLT® IM Hip Nailing System is indicated for use in: - · Intertrochanteric and subtrochanteric fractures - Segmental fractures - · Comminuted fractures - · Pathological fractures - Fractures with bone loss - · Pseudoarthrosis, non-union, mal-union, and delayed union - · Surgically created defects such as osteotomies The X-BOLT® Dynamic Hip Plating System is intended for use in fracture fixation in the proximal femur in adults with osteopenia or osteoporosis. The X-BOLT® Dynamic Hip Plating System is indicated for use in: - · Intracapsular and extracapsular fractures of the femoral neck - · Trochanteric fractures of the proximal femur - · Stable subtrochanteric fractures of the proximal femur
Device Description
The X-BOLT® Hip Fracture Fixation System is a single use device intended for long-term (greater than 30 days) implantation into the femur or proximal femur. The system consists of two parts: the IM Hip Nailing System and the Dynamic Hip Plating System. IM Hip Nailing System components: A. X-BOLT®: An expanding hip bolt. B. X-BOLT® IM Hip Nail: A metal nail used with the X-BOLT® for femur fracture fixation. C. End-Cap: Prevents bone ingrowth into the proximal end of the nail. D. Set Screw: Prevents X-BOLT® rotation while allowing dynamic movement. E. X-BOLT® Distal Locking Screws: Bone fixation screws used with the IM Hip Nail for distal fixation. Dynamic Hip Plating System components: A. X-BOLT®: An expanding hip bolt. B. X-BOLT® Dynamic Hip Plate: An angled metal plate used with the X-BOLT® for proximal femur fracture fixation. C. X-BOLT® Cortical Screws: Bone fixation screws used with the Dynamic Hip Plate for proximal femur fracture fixation.
More Information

No
The summary describes a mechanical orthopedic implant system for fracture fixation and does not mention any software, algorithms, or data processing capabilities that would indicate the use of AI or ML.

Yes
The X-BOLT® Hip Fracture Fixation System is explicitly stated to be "intended for use in fracture fixation," which is a therapeutic function addressing a medical condition (fractures).

No

The X-BOLT® Hip Fracture Fixation System is described as a "single use device intended for long-term (greater than 30 days) implantation into the femur or proximal femur" for fracture fixation. It is a surgical implant used therapeutically to fix fractures, not to diagnose a condition.

No

The device description clearly outlines physical hardware components such as nails, plates, screws, and bolts, indicating it is a hardware medical device for fracture fixation.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In Vitro Diagnostic devices are used to examine specimens taken from the human body (like blood, urine, tissue) to provide information about a person's health. This information is used for diagnosis, monitoring, or screening.
  • Device Description: The X-BOLT® Hip Fracture Fixation System is a surgical implant designed to fix bone fractures in the femur. It is a physical device that is implanted into the body.
  • Intended Use: The intended use is for fracture fixation, which is a surgical procedure to stabilize broken bones. This is a therapeutic intervention, not a diagnostic test performed on a specimen.

The description clearly indicates that this is a medical device used for surgical treatment, not for testing biological samples.

N/A

Intended Use / Indications for Use

The X-BOLT® IM Hip Nailing System is intended for use in fracture fixation in adults with osteopenia or osteoporosis. The X-BOLT® IM Hip Nailing System is indicated for use in:

  • · Intertrochanteric and subtrochanteric fractures
  • Segmental fractures
  • · Comminuted fractures
  • · Pathological fractures
  • Fractures with bone loss
  • · Pseudoarthrosis, non-union, mal-union, and delayed union
  • · Surgically created defects such as osteotomies

The X-BOLT® Dynamic Hip Plating System is intended for use in fracture fixation in the proximal femur in adults with osteopenia or osteoporosis. The X-BOLT® Dynamic Hip Plating System is indicated for use in:

  • · Intracapsular and extracapsular fractures of the femoral neck
  • · Trochanteric fractures of the proximal femur
  • · Stable subtrochanteric fractures of the proximal femur

Product codes

HSB, KTT

Device Description

IM Hip Nailing System
The X-BOLT® IM Hip Nailing System is a single use device intended for long-term (greater than 30 days) implantation into the femur. The X-BOLT® IM Hip Nailing System consists of the following components.

A. X-BOLT®: The X-BOLT® is an expanding hip bolt available in various sizes.

B. X-BOLT® IM Hip Nail: The X-BOLT® IM Hip Nail is a metal nail which is designed to be used in conjunction with the X-BOLT® to provide fixation of fractures of the femur. It is available in various lengths, in right and left configurations.

C. End-Cap: End-Caps prevent bone ingrowth into the proximal end of the nail.

D. Set Screw: The set screw prevents the X-BOLT® from rotating, while still allowing for dynamic movement.

E. X-BOLT® Distal Locking Screws: The X-BOLT® Distal Locking Screws are bone fixation screws which are designed to be used in conjunction with the X-BOLT® IM Hip Nail to achieve distal fixation of the nail. The X-BOLT® Distal Locking Screws are available in various lengths.

Dynamic Hip Plating System
The X-BOLT® Dynamic Hip Plating System is a single use device intended for long-term (greater than 30 days) implantation into the proximal femur. The X-BOLT® Dynamic Hip Plating System consists of the following components.

A. X-BOLT®: The X-BOLT® is an expanding hip bolt available in various sizes.

B. X-BOLT® Dynamic Hip Plate: The X-BOLT® Dynamic Hip Plate is an angled metal plate which is designed to be used in conjunction with the X-BOLT® to provide fixation of fractures of the proximal femur. It is available in various sizes.

C. X-BOLT® Cortical Screws: The X-BOLT® Cortical Screws are bone fixation screws which are designed to be used in conjunction with the X-BOLT® Dynamic Hip Plate to provide fixation of fractures of the proximal femur. The X-BOLT® Cortical Screws are available in various lengths.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Femur, proximal femur

Indicated Patient Age Range

Adults

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

The X-BOLT® Hip Fracture Fixation System underwent the following testing which supports its substantial equivalence to predicate devices:

  • . ASTM F1264-03:2012 – Standard specification and test methods for intramedullary fixation devices.
  • . ASTM F384-06:2006 - Standard specifications and test methods for metallic angled orthopedic fracture fixation devices.
  • . ISO 7206-04:2002 –Partial and Total Hip Joint Prostheses – Part 4: Determination of Endurance Properties of Stemmed Femoral Components.
  • . ASTM F543-07 – Standard specification and test methods for metallic medical bone screws.
  • . Cadaver testing to evaluate the post-implantation strength of the femoral head
  • Cut-out strength of device from femoral head
  • Simulated expansion testing of the X-Bolt device
  • . Pyrogen LAL testing

The results of all testing of the X-BOLT® Hip Fracture Fixation System demonstrate that it performs comparably to predicate devices, thereby supporting its substantial equivalence.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K083497, K091566, K120715, K050226, K993289, K921786, K895241, K062066

Reference Device(s)

K072818

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 888.3020 Intramedullary fixation rod.

(a)
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.(b)
Classification. Class II.

0

Image /page/0/Picture/0 description: The image contains two logos. The logo on the left is the Department of Health & Human Services logo. The logo on the right is the FDA logo, which includes the text "FDA U.S. FOOD & DRUG ADMINISTRATION" in blue.

October 12, 2018

X-Bolt® Orthopaedics Dr. Brian Thornes Founder & CEO Unit 5. Northwood Court Dublin, IE

Re: K181640

Trade/Device Name: X-BOLT® Hip Fracture Fixation System Regulation Number: 21 CFR 888.3020 Regulation Name: Intramedullary fixation rod Regulatory Class: Class II Product Code: HSB, KTT Dated: June 21, 2018 Received: June 21, 2018

Dear Dr. Brian Thornes:

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.

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

1

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/CombinationProducts/GuidanceRegulatoryInformation/ucm597488.htm); good manufacturing practice requirements as set forth in the quality systems (OS) 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 http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm.

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,

Daniel S. Ramsey -S 2018.10.12 15:54:43 -04'00'

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) K181640

Device Name

X-BOLT® Hip Fracture Fixation System

Indications for Use (Describe)

The X-BOLT® IM Hip Nailing System is intended for use in fracture fixation in adults with osteopenia or osteoporosis. The X-BOLT® IM Hip Nailing System is indicated for use in:

  • · Intertrochanteric and subtrochanteric fractures
  • Segmental fractures
  • · Comminuted fractures
  • · Pathological fractures
  • Fractures with bone loss
  • · Pseudoarthrosis, non-union, mal-union, and delayed union
  • · Surgically created defects such as osteotomies

The X-BOLT® Dynamic Hip Plating System is intended for use in fracture fixation in the proximal femur in adults with osteopenia or osteoporosis. The X-BOLT® Dynamic Hip Plating System is indicated for use in:

  • · Intracapsular and extracapsular fractures of the femoral neck
  • · Trochanteric fractures of the proximal femur
  • · Stable subtrochanteric fractures of the proximal femur
Type of Use (Select one or both, as applicable)
☑ Prescription Use (Part 21 CFR 801 Subpart D)☐ Over-The-Counter Use (21 CFR 801 Subpart C)

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510(k) Summary for X-BOLT® Hip Fracture Fixation System

1. Submission Sponsor

X-BOLT® Orthopaedics Unit 5 Northwood Court Santry, Dublin 9 Ireland Phone: 353 1 845 6011

Contact: Brian Thornes, MCh FRCSI MBA Founder & CEO Email: brian.thornes@x-bolt.com

2. Prepared by

Musculoskeletal Clinical Regulatory Advisers, LLC 1050 K Street, NW, Suite 1000 Washington, DC 20001 Phone: 202.552.5800

Contact: Ms. Hollace Saas Rhodes Senior Director, Orthopedic Regulatory Affairs Email: hrhodes@mcra.com

3. Date Prepared

October 3, 2018

4. Device Name

Trade/Proprietary Name:X-BOLT® Hip Fracture Fixation System
Common/Usual Name:Trochanteric Nail and Dynamic Hip Plating System
Classification Name:Intramedullary fixation rod; Appliance, Fixation, Nail/Blade/Plate
Combination, Multiple Component, Single/Multiple Component
Metallic bone fixation appliances and accessories.
Classification Regulation:21 CFR 888.3020 and 21 CFR 888.3030
Classification Panel:Orthopedics
Product Code:HSB, KTT
Device Class:II

5. Predicate and Reference Devices

The X-BOLT® Hip Fracture Fixation System is substantially equivalent to the Zimmer Natural Nail System (K083497, K091566, K120715), Smith & Nephew Asian Intramedullary Hip Screw Nails [IMHS] (K050226), Smith & Nephew Compression Hip Screw System (K993289, K921786, and K895241), and Stryker Howmedica Osteonics Omega 3 System (K062066) based on similarities in intended use, technological characteristics, and performance data. The PERI-LOC Proximal Femur

4

Locking Bone Plate System (K072818) serves as a predicate device based on similar technological characteristics and the same intended use.

6. Device Description

IM Hip Nailing System

The X-BOLT® IM Hip Nailing System is a single use device intended for long-term (greater than 30 days) implantation into the femur. The X-BOLT® IM Hip Nailing System consists of the following components.

A. X-BOLT®: The X-BOLT® is an expanding hip bolt available in various sizes.

B. X-BOLT® IM Hip Nail: The X-BOLT® IM Hip Nail is a metal nail which is designed to be used in conjunction with the X-BOLT® to provide fixation of fractures of the femur. It is available in various lengths, in right and left configurations.

C. End-Cap: End-Caps prevent bone ingrowth into the proximal end of the nail.

D. Set Screw: The set screw prevents the X-BOLT® from rotating, while still allowing for dynamic movement.

E. X-BOLT® Distal Locking Screws: The X-BOLT® Distal Locking Screws are bone fixation screws which are designed to be used in conjunction with the X-BOLT® IM Hip Nail to achieve distal fixation of the nail. The X-BOLT® Distal Locking Screws are available in various lengths.

Dynamic Hip Plating System

The X-BOLT® Dynamic Hip Plating System is a single use device intended for long-term (greater than 30 days) implantation into the proximal femur. The X-BOLT® Dynamic Hip Plating System consists of the following components.

A. X-BOLT®: The X-BOLT® is an expanding hip bolt available in various sizes.

B. X-BOLT® Dynamic Hip Plate: The X-BOLT® Dynamic Hip Plate is an angled metal plate which is designed to be used in conjunction with the X-BOLT® to provide fixation of fractures of the proximal femur. It is available in various sizes.

C. X-BOLT® Cortical Screws: The X-BOLT® Cortical Screws are bone fixation screws which are designed to be used in conjunction with the X-BOLT® Dynamic Hip Plate to provide fixation of fractures of the proximal femur. The X-BOLT® Cortical Screws are available in various lengths.

7. Intended Use

IM Hip Nailing System

The X-BOLT® IM Hip Nailing System is intended for use in fracture fixation in the femur in adults with osteopenia or osteoporosis. The X-BOLT® IM Hip Nailing System is indicated for use in:

  • Intertrochanteric and subtrochanteric fractures
  • Segmental fractures

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  • Comminuted fractures
  • Pathological fractures
  • Fractures with bone loss
  • Pseudoarthrosis, non-union, mal-union, and delayed union
  • Surgically created defects such as osteotomies

Dynamic Hip Plating System

The X-BOLT® Dynamic Hip Plating System is intended for use in fracture fixation in the proximal femur in adults with osteopenia or osteoporosis.

The X-BOLT® Dynamic Hip Plating System is indicated for use in:

  • Intracapsular and extracapsular fractures of the femoral neck
  • Trochanteric fractures of the proximal femur
  • Stable subtrochanteric fractures of the proximal femur

8. Technological Characteristics and Substantial Equivalence

The following tables compares the X-BOLT® Hip Fracture Fixation system to the respective predicate devices. The table below compares the IM Hip Nailing System to the Zimmer Natural Nail System (K083497; K091566; K120715) with respect to intended use, technological characteristics and principles of operation to support a determination of substantial equivalence for the X-BOLT® device.

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ManufacturerX-BOLT® OrthopaedicsZimmer
Trade NameX-BOLT® IM Hip Nailing SystemZimmer® Natural Nail™ System
510(k) NumberSubject deviceK083497; K091566; K120715
Product CodeHSBHSB
Regulation
Number21 CFR 888.302021 CFR 888.3020
ClassificationIIII
Indications for
use:The X-BOLT® IM Hip Nailing System is
intended for use in fracture fixation in
the femur in the adult population. The
X-BOLT® IM Hip Nailing System is
indicated for use in:
• Intertrochanteric and
subtrochanteric fractures
• Segmental fractures
• Comminuted fractures
• Fractures involving osteopenic
and osteoporotic bone
• Pathological fractures
• Fractures with bone loss
• Pseudoarthrosis, non-union,
mal-union, and delayed union
• Surgically created defects such
as osteotomiesThe Zimmer® Natural Nail™
System is intended for temporary
fixation and stabilization of the
bone. Indications for use of the
greater Trochanter and Piriformis
Fossa nails in the femur include:
• Compound and simple shaft
fractures
• Proximal, metaphyseal, and
distal shaft fractures
• Segmental fractures
• Comminuted fractures
• Fractures involving osteopenic
and osteoporotic bone
• Pathological fractures
• Fractures with bone loss
• Pseudoarthrosis, non-union,
mal-union, and delayed union
• Periprosthetic fractures
• Surgically created defects such
as osteotomies
• Intertrochanteric and
subtrochanteric fractures
Components
and Design• Intramedullary Nail, Fixation Bolt,
Distal Screws
• Achieves fixation via four
expanding wings that expand
precisely into premade cavities
and are designed to resist cut-out• Intramedullary nail, Lag Screw,
and Distal Screw
• Achieves fixation via a threaded
sliding lag screw
MaterialsImplant grade stainless steel
Parylene C CoatingTitanium Alloy (Ti-6Al-4V)
ManufacturerX-BOLT® OrthopaedicsStryker Howmedica Osteonics
Trade NameX-BOLT® Dynamic Hip Plating
SystemOmega 3 System
510(k) NumberSubject deviceK062066
Product CodeKTTKTT
Regulation
Number21 CFR 888.303021 CFR 888.3030
ClassificationIIII
Indications for
use:The X-BOLT® Dynamic Hip
Plating System is intended for
use in fracture fixation in the
proximal femur in the adult
population. The X-BOLT®
Dynamic Hip Plating System is
indicated for use in:
• Intracapsular and
extracapsular fractures of the
femoral neck
• Trochanteric fractures of the
proximal femur
• Stable subtrochanteric
fractures of the proximal
femurThe Omega (Systems) are
intended for use in the
temporary stabilization of types
of fractures to the proximal and
distal femur. The subject
devices are indicated for
fixation of proximal and distal
femoral fractures including but
not limited to:
• Intracapsular and basal neck
fractures including
transcervical and subcapital
fractures
• Intertrochanteric fractures
• Subtrochanteric fractures
• Supracondylar fractures
• Osteotomies for patients with
diseases or deformities of the
hip
• Hip arthrodesis
Components and
Design• Implant grade stainless steel
plate, screws and fixation
bolt
• Achieves fixation via four
expanding wings that
expand precisely into
premade cavities and are
designed to resist cut-out• Implant grade stainless steel
plate, screws and lag screw
• Achieves fixation via a
threaded sliding lag screw
MaterialsImplant grade stainless steel
Parylene-C coatingImplant grade stainless steel
SterilitySterile (irradiation)Sterile
ManufacturerX-BOLT® OrthopaedicsStryker Howmedica Osteonics
Trade NameX-BOLT® Dynamic Hip Plating
SystemOmega 3 System
DimensionsThe X-BOLT® is an expanding
hip bolt available in 10
different lengths ranging
from 80mm to 125mm in
5mm increments.The Omega 3 bolt is available in
various sizes ranging from
50mm to 140 mm in 5mm
increments
The X-BOLT® Dynamic Hip
Plate is a 135° angled metal
plate and is available in four
different sizes - 2-hole,
4- hole, 5-hole and 6-hole
configurations.The Omega 3 system plate is
available in keyed and keyless
configurations, in short and
standard barrel options,
ranging from 2 hole to 12
holes, with multiple options
for plate angles (130 – 150°)
and in lengths from 47 –
207mm.
X-BOLT® Cortical Screws are
4.5mm in diameter and
available in 10 different sizes
from 30mm to 48mm in 2mm
incrementsOmega cortical screws are
4.5mm in diameter and
available in 14-110 mm in 2-
5mm increments. Other
locking screws also offered (14-
95mm).

Comparison Table: X-BOLT® IM Hip Nailing System vs. Zimmer Natural Nail System

The table below compares the X-BOLT® Dynamic Hip Plating System to the Stryker Howmedica Osteonics Omega 3 System (K062066) with respect to intended use, technological characteristics and principles of operation, providing more detailed information regarding the basis for the determination of substantial equivalence.

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Comparison Table: X-BOLT® Dynamic Hip Plate vs. Stryker Howmedica Osteonics Omega 3 System

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9. Performance Testing

The X-BOLT® Hip Fracture Fixation System underwent the following testing which supports its substantial equivalence to predicate devices:

  • . ASTM F1264-03:2012 – Standard specification and test methods for intramedullary fixation devices.
  • . ASTM F384-06:2006 - Standard specifications and test methods for metallic angled orthopedic fracture fixation devices.
  • . ISO 7206-04:2002 –Partial and Total Hip Joint Prostheses – Part 4: Determination of Endurance Properties of Stemmed Femoral Components.
  • . ASTM F543-07 – Standard specification and test methods for metallic medical bone screws.
  • . Cadaver testing to evaluate the post-implantation strength of the femoral head
  • Cut-out strength of device from femoral head
  • Simulated expansion testing of the X-Bolt device
  • . Pyrogen LAL testing

The results of all testing of the X-BOLT® Hip Fracture Fixation System demonstrate that it performs comparably to predicate devices, thereby supporting its substantial equivalence.

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10. Biocompatibility Testing

The X-BOLT® Hip Fracture Fixation System was tested in accordance with ISO 10993 to demonstrate its biocompatibility.

  • . Part 3: Tests for genotoxicity, carcinogenicity, and reproductive toxicity
  • . Part 5: Tests for in vitro cytotoxicity
  • . Part 6: Tests for local effects after implantation
  • . Part 10: Tests for irritation and delayed-type hypersensitivity
  • Part 11: Tests for Systemic Toxicity

11. Conclusion

This 510(k) submission demonstrates the substantial equivalence of the X-BOLT® Hip Fracture Fixation System to the referenced predicate devices.