K Number
K221366
Device Name
Smart Correction System Rings and Compatible HA-Coated Half Pins
Date Cleared
2022-06-06

(25 days)

Product Code
Regulation Number
888.3030
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Smart Correction System is indicated for pediatric subpopulations (excluding newborns) and adults for the following: · Joint contracture resulting in loss of range of motion. · Fractures and disease which generally may result in joint contractures or loss of range of motion. · Fractures requiring distraction. · Open and closed fracture fixation, including fractures of long bones (intracapsular, intertrochanteric, supracondylar, condylar). · Correction of bony or soft tissue defects. · Correction of bony or soft tissue deformities. · Joint arthrodesis. · Infected fractures or nonunion. · Limb Lengthening by epiphyseal or metaphyseal distraction. · Pseudoarthrosis of long bones.
Device Description
The WishBone Medical Smart Correction System: a multilateral hexapod circular external fixator device used to stabilize and maintain alignment of complicated fractured bones, soft tissues and/or congenital deformity repairs of an extremity. The basic system consists of a minimum of two rings connected by six (6) telescopic struts that are lengthened and shortened independently. The struts' independent motion allows the surgeon to adjust the position of the proximal and distal ring. The system allows for movement in six different axes to correct difficult trauma extremity situations and/or congenital limb deformity correction. The Smart Correction System capitalizes on the body's natural ability of osteogenesis, guiding the orientation and position of this new bone to the desired corrected location in a steady controlled fashion. In addition to the hardware, the Smart Correction System has a web-based software treatment planning tool with Radiographic Navigation. The surgeon enters data from direct examination, radiographic images and the fixator parameters into the software. The software is used preoperatively to plan the reconstruction/correction and identify the frame construction. Post operatively, the surgeon enters the X-ray images and the current frame parameters to establish an adjustment schedule for the patient during the healing process. The Smart Correction System is modular and facilitates a multitude of frame configurations to serve a wide variety of patient needs. Listed below are the high-level components and accessories: . The fixator bridge is constructed of two (2) or more ring components, and each ring component is connected to another via six (6) telescopic struts. Full, 2/3, and 1/3 ring components are available, along with standard and rapid adjust struts in multiple lengths. Femoral arches and threaded rods are used as needed to provide added frame stability. Rings and femoral arches are manufactured from aluminum material; struts from titanium, stainless steel, and aluminum; and threaded rods are made from titanium material. . The fixator bridge is anchored to the patient's bone by crossed tensioned wires and half pins that are secured to the rings by connector elements (wire clamps, pin clamps, cubes, bolts, nuts, washers, and twisted plates). Standard, olive wires, and threaded wires are available, as well as multiple diameters and styles of half pins. Pins and wires may also be used to secure fragments of bone and are made from stainless steel and titanium. Connector elements are manufactured out of titanium material. This submission also includes a line extension to add HA-coated titanium Half Pin components. . A foot ring is available and connected to the distal ring when a procedure such as ankle arthrodesis is performed. The foot rings are manufactured out of aluminum material. . Patient comfort accessories are also included: strut ID bands (polycarbonate), foot walking attachment (POM-C), and pin/wire caps (silicone, PVC) are also included. . The Smart Correction System includes reusable surgical instruments to facilitate surgical assembly of the fixator construct. The non-sterile implants and other fixator elements are contained within sterilization cases, along with the reusable instruments
More Information

No
The description mentions a web-based software treatment planning tool with Radiographic Navigation that uses surgeon input and radiographic images for planning and adjustment schedules. However, it does not describe any features or capabilities that explicitly indicate the use of AI or ML algorithms for tasks like image analysis, prediction, or automated decision-making beyond basic software calculations based on input parameters. The "Mentions AI, DNN, or ML" section also explicitly states "Not Found".

Yes
The device is used to correct joint contractures, fractures, and deformities, and also for limb lengthening, which are all therapeutic interventions.

No

The device is a surgical fixation system used for correcting bone and soft tissue deformities and fractures. While it uses software with radiographic navigation for planning, its primary function is therapeutic (correction and fixation), not diagnostic.

No

The device description explicitly details numerous hardware components, including rings, struts, wires, pins, and surgical instruments, in addition to the software.

Based on the provided information, the Smart Correction System is not an In Vitro Diagnostic (IVD) device.

Here's why:

  • IVD Definition: In Vitro Diagnostic devices are used to examine specimens derived from the human body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening.
  • Smart Correction System Function: The Smart Correction System is a physical external fixator device used to stabilize and correct bones and soft tissues. It is applied externally to the patient's body and directly interacts with the musculoskeletal system.
  • Intended Use: The intended use clearly describes the treatment of musculoskeletal conditions like fractures, deformities, and contractures. This is a therapeutic intervention, not a diagnostic one based on analyzing bodily specimens.
  • Device Description: The description details the mechanical components of the fixator and its use in guiding bone healing and alignment. It does not mention any components or processes related to analyzing biological samples.
  • Input Imaging Modality: The use of radiographic images is for planning and monitoring the physical correction, not for analyzing biological markers or substances.

While the system includes software that uses radiographic images for planning and monitoring, this software is a tool to guide the application and adjustment of the physical fixator, which is a therapeutic device. The software itself is not performing an in vitro diagnostic test.

N/A

Intended Use / Indications for Use

The Smart Correction System is indicated for pediatric subpopulations (excluding newborns) and adults for the following:

  • Joint contracture resulting in loss of range of motion.
  • Fractures and disease which generally may result in joint contractures or loss of range of motion.
  • Fractures requiring distraction.
  • Open and closed fracture fixation, including fractures of long bones (intracapsular, intertrochanteric, supracondylar, condylar).
  • Correction of bony or soft tissue defects.
  • Correction of bony or soft tissue deformities.
  • Joint arthrodesis.
  • Infected fractures or nonunion.
  • Limb Lengthening by epiphyseal or metaphyseal distraction.
  • Pseudoarthrosis of long bones.

Product codes (comma separated list FDA assigned to the subject device)

KTT

Device Description

The WishBone Medical Smart Correction System: a multilateral hexapod circular external fixator device used to stabilize and maintain alignment of complicated fractured bones, soft tissues and/or congenital deformity repairs of an extremity. The basic system consists of a minimum of two rings connected by six (6) telescopic struts that are lengthened and shortened independently. The struts' independent motion allows the surgeon to adjust the position of the proximal and distal ring. The system allows for movement in six different axes to correct difficult trauma extremity situations and/or congenital limb deformity correction. The Smart Correction System capitalizes on the body's natural ability of osteogenesis, guiding the orientation and position of this new bone to the desired corrected location in a steady controlled fashion. In addition to the hardware, the Smart Correction System has a web-based software treatment planning tool with Radiographic Navigation. The surgeon enters data from direct examination, radiographic images and the fixator parameters into the software. The software is used preoperatively to plan the reconstruction/correction and identify the frame construction. Post operatively, the surgeon enters the X-ray images and the current frame parameters to establish an adjustment schedule for the patient during the healing process.

The Smart Correction System is modular and facilitates a multitude of frame configurations to serve a wide variety of patient needs. Listed below are the high-level components and accessories:

  • The fixator bridge is constructed of two (2) or more ring components, and each ring component is connected to another via six (6) telescopic struts. Full, 2/3, and 1/3 ring components are available, along with standard and rapid adjust struts in multiple lengths. Femoral arches and threaded rods are used as needed to provide added frame stability. Rings and femoral arches are manufactured from aluminum material; struts from titanium, stainless steel, and aluminum; and threaded rods are made from titanium material.
  • The fixator bridge is anchored to the patient's bone by crossed tensioned wires and half pins that are secured to the rings by connector elements (wire clamps, pin clamps, cubes, bolts, nuts, washers, and twisted plates). Standard, olive wires, and threaded wires are available, as well as multiple diameters and styles of half pins. Pins and wires may also be used to secure fragments of bone and are made from stainless steel and titanium. Connector elements are manufactured out of titanium material. This submission also includes a line extension to add HA-coated titanium Half Pin components.
  • A foot ring is available and connected to the distal ring when a procedure such as ankle arthrodesis is performed. The foot rings are manufactured out of aluminum material.
  • Patient comfort accessories are also included: strut ID bands (polycarbonate), foot walking attachment (POM-C), and pin/wire caps (silicone, PVC) are also included.
  • The Smart Correction System includes reusable surgical instruments to facilitate surgical assembly of the fixator construct. The non-sterile implants and other fixator elements are contained within sterilization cases, along with the reusable instruments

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Radiographic images, X-ray images

Anatomical Site

Extremity, bones of an extremity, long bones

Indicated Patient Age Range

Pediatric subpopulations (excluding newborns) and adults

Intended User / Care Setting

Surgeon, clinical setting

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)

NON-CLINICAL TESTING
Engineering analyses were conducted in compliance with ASTM 1541-17: Standard Specification and Test Methods for External Skeletal Fixation Devices. Evaluations conducted include:

  • Ring Compressive Stiffness Justification
  • Construct Stiffness Test Justification
  • Construct Fatigue & Load to Failure Test Justification
    Engineering analyses were also conducted for the following:
  • Clinical Cleaning & Sterilization Validation Justification
  • Cleaning for Biocompatibility Test Justification
  • Biocompatibility Assessment Justification

CLINICAL TESTING
Clinical testing was not deemed necessary to demonstrate substantial equivalence.

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

Smart Correction System, (K193368)

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

ST.A.R. 90 F4 External Fixation Screws with Hydroxyapatite (K150661)

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 888.3030 Single/multiple component metallic bone fixation appliances and accessories.

(a)
Identification. Single/multiple component metallic bone fixation appliances and accessories are devices intended to be implanted consisting of one or more metallic components and their metallic fasteners. The devices contain a plate, a nail/plate combination, or a blade/plate combination that are made of alloys, such as cobalt-chromium-molybdenum, stainless steel, and titanium, that are intended to be held in position with fasteners, such as screws and nails, or bolts, nuts, and washers. These devices are used for fixation of fractures of the proximal or distal end of long bones, such as intracapsular, intertrochanteric, intercervical, supracondylar, or condylar fractures of the femur; for fusion of a joint; or for surgical procedures that involve cutting a bone. The devices may be implanted or attached through the skin so that a pulling force (traction) may be applied to the skeletal system.(b)
Classification. Class II.

0

June 6, 2022

Image /page/0/Picture/1 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which is a blue square with the letters "FDA" in white. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

WishBone Medical, Inc. Kellie Myers Regulatory Affairs Manager 100 Capital Drive Warsaw, Indiana 46582

Re: K221366

Trade/Device Name: Smart Correction System Regulation Number: 21 CFR 888.3030 Regulation Name: Single/Multiple Component Metallic Bone Fixation Appliances And Accessories Regulatory Class: Class II Product Code: KTT Dated: May 11, 2022 Received: May 12, 2022

Dear Kellie Myers:

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 801); medical device reporting of medical device-related adverse events) (21 CFR 803) for

1

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 (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely.

Ting Song, Ph.D. Assistant Director DHT6A: Division of Joint Arthroplasty Devices OHT6: Office of Orthopedic Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K221366

Device Name Smart Correction System

Indications for Use (Describe)

  • The Smart Correction System is indicated for pediatric subpopulations (excluding newborns) and adults for the following: · Joint contracture resulting in loss of range of motion.
  • · Fractures and disease which generally may result in joint contractures or loss of range of motion.
  • · Fractures requiring distraction.
  • · Open and closed fracture fixation, including fractures of long bones (intracapsular, intertrochanteric, supracondylar, condylar).
  • · Correction of bony or soft tissue defects.
  • · Correction of bony or soft tissue deformities.
  • · Joint arthrodesis.
  • · Infected fractures or nonunion.
  • · Limb Lengthening by epiphyseal or metaphyseal distraction.
  • · Pseudoarthrosis of long bones.
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/1 description: The image contains the logo for WishBone Medical. The logo consists of a blue circle with a white wishbone inside, followed by the text "WishBone" in a sans-serif font. Below "WishBone" is the word "MEDICAL" in a smaller, sans-serif font.

In accordance with 21 CFR $807.92 and the Safe Medical Devices Act of 1990, the following information is provided for the WishBone Medical Smart Correction System Small Rings and compatible HA-Coated Half-Pins Special 510(k) premarket notification. The submission was prepared in accordance with the FDA guidance document The Special 510(k) Program, issued September 13, 2019.

SUBMITTER INFORMATION
ApplicantWishBone Medical, Inc.
Address100 Capital Drive
Warsaw, IN 46582
Phone Number(574)306-4006
Establishment Registration Number3013680140
Name of Contact PersonKellie Myers
Date PreparedJune 6, 2022
NAME OF DEVICE
Trade or Proprietary NameSmart Correction System
Common or usual nameExternal Skeletal Fixation Device,
Classification NameAppliance, Fixation, Nail/Blade/Plate Combination, Multiple Component,
Regulatory ClassificationII
510(k) Review PanelOrthopedic Devices (OHT6)
Regulation888.3030 Single/multiple component metallic bone fixation appliances and
accessories.
Product Code(s)KTT
Legally marketed device to
which equivalence is claimedSmart Correction System, (K193368)
Reference DeviceST.A.R. 90 F4 External Fixation Screws with Hydroxyapatite (K150661)
Device DescriptionThe WishBone Medical Smart Correction System: a multilateral hexapod
circular external fixator device used to stabilize and maintain alignment of
complicated fractured bones, soft tissues and/or congenital deformity
repairs of an extremity. The basic system consists of a minimum of two rings
connected by six (6) telescopic struts that are lengthened and shortened
independently. The struts' independent motion allows the surgeon to adjust
the position of the proximal and distal ring. The system allows for
movement in six different axes to correct difficult trauma extremity
situations and/or congenital limb deformity correction. The Smart
Correction System capitalizes on the body's natural ability of osteogenesis,
guiding the orientation and position of this new bone to the desired corrected
location in a steady controlled fashion. In addition to the hardware, the
Smart Correction System has a web-based software treatment planning tool
with Radiographic Navigation. The surgeon enters data from direct
examination, radiographic images and the fixator parameters into the

4

Image /page/4/Picture/2 description: The image contains the logo for WishBone Medical. The logo consists of a blue circle with a white wishbone inside of it on the left. To the right of the circle is the company name, "WishBone" in a larger font and "MEDICAL" in a smaller font below it.

software. The software is used preoperatively to plan the reconstruction/correction and identify the frame construction. Post operatively, the surgeon enters the X-ray images and the current frame parameters to establish an adjustment schedule for the patient during the healing process.

The Smart Correction System is modular and facilitates a multitude of frame configurations to serve a wide variety of patient needs. Listed below are the high-level components and accessories:

  • . The fixator bridge is constructed of two (2) or more ring components, and each ring component is connected to another via six (6) telescopic struts. Full, 2/3, and 1/3 ring components are available, along with standard and rapid adjust struts in multiple lengths. Femoral arches and threaded rods are used as needed to provide added frame stability. Rings and femoral arches are manufactured from aluminum material; struts from titanium, stainless steel, and aluminum; and threaded rods are made from titanium material.
  • . The fixator bridge is anchored to the patient's bone by crossed tensioned wires and half pins that are secured to the rings by connector elements (wire clamps, pin clamps, cubes, bolts, nuts, washers, and twisted plates). Standard, olive wires, and threaded wires are available, as well as multiple diameters and styles of half pins. Pins and wires may also be used to secure fragments of bone and are made from stainless steel and titanium. Connector elements are manufactured out of titanium material. This submission also includes a line extension to add HA-coated titanium Half Pin components.
  • . A foot ring is available and connected to the distal ring when a procedure such as ankle arthrodesis is performed. The foot rings are manufactured out of aluminum material.
  • . Patient comfort accessories are also included: strut ID bands (polycarbonate), foot walking attachment (POM-C), and pin/wire caps (silicone, PVC) are also included.
  • . The Smart Correction System includes reusable surgical instruments to facilitate surgical assembly of the fixator construct. The non-sterile implants and other fixator elements are contained within sterilization cases, along with the reusable instruments Intended Use of the Device The WishBone Medical Smart Correction System is intended for use in pediatric subgroups (except newborns) and adult patients for the treatment of open and closed fractures, arthrodesis and pseudoarthrosis of long bones, limb lengthening, deformity and angular correction, bony or soft

5

Image /page/5/Picture/1 description: The image shows the logo for WishBone Medical. The logo consists of a blue circle with a white wishbone inside on the left. To the right of the circle is the text "WishBone" in a sans-serif font, with the word "MEDICAL" in smaller letters below.

| Indications for Use | radiographic measurements, the software provides a schedule of
adjustments for the fixator frame.
The Smart Correction System is indicated for pediatric subpopulations
(excluding newborns) and adults for the following:
Joint contracture resulting in loss of range of motion. Fractures and disease which generally may result in joint contractures
or loss of range of motion. Fractures requiring distraction. Open and closed fracture fixation, including fractures of long bones
(intracapsular, intertrochanteric, supracondylar, condylar). Correction of bony or soft tissue defects. Correction of bony or soft tissue deformities. Joint arthrodesis. Infected fractures or nonunion. Limb Lengthening by epiphyseal or metaphyseal distraction. Pseudoarthrosis of long bones. |

----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

SUMMARY OF TECHNOLOGICAL CHARACTERISTICS COMPARED TO THE PREDICATE DEVICE

The rationale for substantial equivalence is based on consideration of the following characteristics:

  • a. Intended Use: The subject device and predicate systems have the same intended use. No new or increased risks are identified.
    • b. Indications for Use: The subject device and predicate systems have the same intended use. No new or increased risks are identified
    • c. Materials: The subject device is manufactured from similar materials. No new or increased risks have been identified.
    • d. Design Features: The subject device design is similar to the predicates. No new or increased risks are identified.
    • e. Sterilization: The Smart Correction System is supplied nonsterile for the end user to sterilize in the provided sterilization cases. While the predicate system offers some pins sterile, there are pins that are provided nonsterile. The subject system has the same sterilization method for similar elements as the predicate. Therefore, no new or increased risks have been identified.

PERFORMANCE DATA NON-CLINICAL TESTING

Engineering analyses were conducted in compliance with ASTM 1541-17: Standard Specification and Test Methods for External Skeletal Fixation Devices. Evaluations conducted include:

  • Ring Compressive Stiffness Justification
  • Construct Stiffness Test Justification
  • Construct Fatigue & Load to Failure Test Justification

Engineering analyses were also conducted for the following:

  • . Clinical Cleaning & Sterilization Validation Justification
  • Cleaning for Biocompatibility Test Justification
  • Biocompatibility Assessment Justification

CLINICAL TESTING

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Image /page/6/Picture/2 description: The image shows the logo for WishBone Medical. The logo consists of a blue circle with a white wishbone inside, followed by the text "WishBone" in a sans-serif font. Below the word "WishBone" is the word "MEDICAL" in a smaller, sans-serif font.

Clinical testing was not deemed necessary to demonstrate substantial equivalence.

CONCLUSIONS DRAWN FROM NON-CLINICAL AND CLINICAL DATA

The subject device has the same intended use and indications as the predicate Smart Correction System (K193368). It also has similar technological characteristics as the predicate device, and the performance data and analyses demonstrate that any differences do not raise new questions of safety and effectiveness. Therefore, we conclude that the proposed device is at least as safe and effective and performs as well or better than the legally marketed predicate device.