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TriMed Volar Plates and Radial Peg Plates
The following fracture configurations may be applicable for treatment using the TriMed Volar Plates and Radial Peg Plates:

1. Fractures, non-unions or osteotomies of the distal radius.
   TriMed Ulnar Peg Plates
   Fractures, non-unions and osteotomies of the distal end of the ulna.
   TriMed Pin Plates
   The following fracture configurations may be applicable for treatment using the TriMed Pin Plates:
2. Fractures of the radial column of the wrist.
3. Fractures of the dorsal ulnar cortex of the distal radius.
   TriMed Wire Forms and Hook Plates
   Fragments of the distal radius large enough to allow intraosseous support from the device with an adjacent stable corex of cortical bone.

TriMed Volar Plates consist of anatomically shaped plates used for fractures, non-unions or osteotomies of the distal radius. TriMed Bearing plates utilize distal bearings to allow peg angulation up to 30 degrees. Fixed Angle Volar Plates have pre-defined peg-hole trajectories. TriMed Fixed Angle and Bearing Plates are compatible with 2.4mm locking pegs and 2.4mm non-locking cortical bone screws distally and 3.2mm screws proximally.
TriMed Wrist Hook Plates are anatomically shaped plates used for fragments of the distal radius large enough to allow intraosseous support from the device with an adjacent stable cortex of cortical bone. TriMed Wrist Hook Plates are compatible with 2.4mm screws and locking pegs.
TriMed Radial Peg Plates are anatomically shaped for the radial column used for fractures, nonunions or osteotomies of the distal radius. TriMed Radial Peg Plates are compatible with 2.4mm screws and locking pegs.
TriMed Ulnar Peg Plates are semi-tubular straight plates used for fractures, non-unions and osteotomies of the distal end of the ulna. TriMed Ulnar Peg Plates are compatible with 2.4mm screws and locking pegs.
TriMed Pin Plates are anatomically shaped plates used for the treatment of fractures of the radial column of the wrist and fractures of the dorsal ulnar cortex of the distal radius. TriMed Pin Plates are compatible with 1.1mm k-wires and 2.4mm screws.
TriMed Buttress Pins are wire forms that are contoured to be used for fragments of the distal radius large enough to allow intraosseous support from the device with an adjacent stable cortex of cortical bone. TriMed buttress pins are used with washers and 2.4mm threaded pegs and 2.4mm screws.
All TriMed Wrist Fixation System implants are made from 316L Stainless Steel per ASTM F138/139 and are supplied non-sterile.

The provided text describes a medical device submission (K222637) for the TriMed Wrist Fixation System 3, which is a metallic bone fixation appliance.

The information provided does not pertain to an AI/ML medical device, but rather to a traditional orthopedic implant. Therefore, the questions related to AI/ML device performance, such as acceptance criteria for AI models, sample sizes for test/training sets, expert qualifications, adjudication methods, MRMC studies, standalone performance, and ground truth establishment for AI models, are not applicable to this document.

The document focuses on demonstrating substantial equivalence to predicate devices through non-clinical evidence (mechanical testing and engineering analyses) and states that clinical testing was not necessary.

Here's an analysis of the provided text with respect to the questions, noting the inapplicability to AI/ML:

1. A table of acceptance criteria and the reported device performance

The document describes several non-clinical tests performed on the TriMed Wrist Fixation System 3, comparing them to predicate devices or established standards. However, it does not present a table with explicit acceptance criteria and corresponding performance for each test in a clear, summarized format. It generally states that results were "compared to the acceptance criteria" or showed "substantial equivalence."

• Construct Cyclic endurance (Volar and Peg Plates): Compared to predicates.
• Construct Static load displacement (Volar and Peg Plates): Compared to predicates.
• 4-point bending (Longest Volar Plate): Conducted according to ASTM F382; results compared to acceptance criteria in FDA guidance document, "Orthopedic Fracture Fixation Plates - Performance Criteria for Safety and Performance Based Pathway."
• Engineering analysis: To predicates (Hook Plates, Pin Plates and Buttress Pins).
• Cytotoxicity, Sensitization and Irritation testing: In accordance with ISO 10993-1:2018 (All implants).
• System screws testing (per ASTM F543-17):
  • Torsional Strength
  • Driving Torque
  • Axial Pullout Strength Calculation
  • Results compared to acceptance criteria in FDA guidance document "Orthopedic Non-Spinal Metallic Bone Screws and Washers - Performance Criteria for Safety and Performance Based Pathway."

2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

This question is not applicable as the submission is for a physical orthopedic implant, not an AI/ML diagnostic or prognostic device requiring a test set of data. The "tests" mentioned are mechanical and biocompatibility tests on the physical device components.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

This question is not applicable. "Ground truth" in the context of expert consensus is relevant for AI/ML performance evaluation based on human interpretation (e.g., image reading). For this device, "ground truth" (or accepted standards) is established by recognized engineering and biocompatibility standards (e.g., ASTM, ISO guidelines) and comparison to predicate devices, not by medical experts interpreting data for an algorithm.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

This question is not applicable. Adjudication methods like 2+1 or 3+1 are used for resolving discrepancies among expert readers in AI/ML performance studies. This is not relevant for the mechanical and material testing described for the TriMed Wrist Fixation System 3.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

This question is not applicable. An MRMC study assesses the impact of an AI tool on human performance. This submission is for an implant, not an AI assistance tool.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

This question is not applicable. "Standalone performance" refers to the performance of an AI algorithm without human input or review. This device is a physical implant.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.)

The "ground truth" for the non-clinical tests mentioned would be the established acceptance criteria within the referenced ASTM and ISO standards, and the performance characteristics of the predicate devices. For example, for 4-point bending, the "ground truth" is passing the specified load and displacement requirements as per ASTM F382 and the FDA guidance document. For biocompatibility, it's meeting the criteria of ISO 10993-1:2018.

8. The sample size for the training set

This question is not applicable as this is not an AI/ML device.

9. How the ground truth for the training set was established

This question is not applicable as this is not an AI/ML device.

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