FDA Adverse Event Malfunction Summary report: N

2520274-2014-00897

MDR report key: 3648593 · Received February 26, 2014

Report

Report Number
2520274-2014-00897
Event Type
Malfunction
Date Received
February 26, 2014
Report Date
February 2, 2014
Manufacturer
SYNTHES USA
Product Code
HRS
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

DEVICE IS USED FOR TREATMENT, NOT DIAGNOSIS. ARTICLE: USING EXTERNAL AND INTERNAL LOCKING PLATES IN A TWO-STAGE PROTOCOL FOR TREATMENT OF SEGMENTAL TIBIAL FRACTURES; CHING-HOU MA, MD, YUA-KUN TU, MD, JIH-HIS YEH, MD, SHIH-CHIEH YANG, MD & CHIN-HSIEN WU, MD; THE JOURNAL OF TRAUMA, INJURY, INFECTION AND CRITICAL CARE, VOLUME 71, NUMBER 3, SEPTEMBER 2011; 614-619. THE JOURNAL OF TRAUMA, INJURY, INFECTION AND CRITICAL CARE, VOLUME 71, NUMBER 3, SEPTEMBER 2011; 614-619. DEVICE IS AN UNKNOWN PLATE, QUANTITY 1. CANNOT BE DETERMINED WITHOUT A PART NUMBER INVESTIGATION COULD NOT BE COMPLETED, NO CONCLUSION COULD BE DRAWN AS NO DEVICE WAS RETURNED AND NO LOT NUMBER WAS PROVIDED. MANUFACTURING RECORDS COULD NOT BE REVIEWED WITHOUT A LOT NUMBER. PLACEHOLDER.

Description of Event or Problem · 1

THIS REPORT IS BEING FILED AFTER THE SUBSEQUENT REVIEW OF THE FOLLOWING JOURNAL ARTICLE: USING EXTERNAL AND INTERNAL LOCKING PLATES IN A TWO-STAGE PROTOCOL FOR TREATMENT OF SEGMENTAL TIBIAL FRACTURES. THE TIBIAL SEGMENTAL FRACTURES USUALLY FOLLOW HIGH-ENERGY TRAUMA AND ARE OFTEN ASSOCIATED WITH MANY COMPLICATIONS. WE DESIGNED A TWO-STAGE PROTOCOL FOR THESE COMPLEX INJURIES. THE AIM OF THIS STUDY WAS TO ASSESS THE OUTCOME OF TIBIAL SEGMENTAL FRACTURES TREATED ACCORDING TO THIS PROTOCOL. A PROSPECTIVE SERIES OF (B)(4) CONSECUTIVE SEGMENTAL TIBIAL FRACTURES WERE TREATED USING A TWO-STAGE PROCEDURE. IN THE FIRST STAGE, A LOW-PROFILE LOCKING PLATE WAS APPLIED AS AN EXTERNAL FIXATOR TO TEMPORARILY IMMOBILIZE THE FRACTURES AFTER ANATOMIC REDUCTION HAD BEEN ACHIEVED FOLLOWED BY SOFT-TISSUE RECONSTRUCTION. THE SECOND STAGE INVOLVED DEFINITIVE INTERNAL FIXATION WITH A LOCKING PLATE USING A MINIMALLY INVASIVE PERCUTANEOUS PLATE OSTEOSYNTHESIS TECHNIQUE WITH THE LOCKING COMPRESSION PLATE (LCP,) TIBIAL METAPHYSEAL PLATE (SYNTHES) OR AN LISS-PLT PLATE (SYNTHES) THE MEDIAN FOLLOW-UP WAS 32 MONTHS (RANGE, 20-44 MONTHS). ALL FRACTURES ACHIEVED UNION. THE MEDIAN TIME FOR THE PROXIMAL FRACTURE UNION WAS 23 WEEKS (RANGE, 12-30 WEEKS) AND THAT FOR DISTAL FRACTURE UNION WAS 27 WEEKS (RANGE, 12-46 WEEKS). USE OF THE TWO-STAGE PROCEDURE FOR TREATMENT OF SEGMENTAL TIBIAL FRACTURES IS RECOMMENDED. SURGEONS CAN ACHIEVE GOOD REDUCTION WITH STABLE TEMPORARY FIXATION, SOFT-TISSUE RECONSTRUCTION, EASE OF SUBSEQUENT DEFINITIVE FIXATION, AND HIGH UNION RATES. OUR PATIENTS OBTAINED EXCELLENT KNEE AND ANKLE JOINT MOTION, GOOD FUNCTIONAL OUTCOMES, AND A COMFORTABLE CLINICAL COURSE. FROM APRIL 2006 TO MARCH 2008, 25 CONSECUTIVE PATIENTS (15 MEN AND 10 WOMEN), AGED FROM 15 YEARS TO 67 YEARS (MEDIAN AGE, 38 YEARS), WITH SEGMENTAL TIBIAL FRACTURES. IN STAGE ONE, AFTER REDUCTION AND LIMITED FIXATION OF THE FRAGMENTS, A LESS INVASIVE STABILIZATION SYSTEM (LISS)-DISTAL FEMUR PLATE (SYNTHES, PAOLI, PA) OR AN EXTERNAL LOCKED PLATE (E-DA, KAOHSIUNG, TAIWAN) WAS APPLIED AS AN EXTERNAL FIXATOR. THE AUTHORS IN THE ARTICLE DISCUSS MULTIPLE SYNTHES DEVICES WHICH HAVE BEEN CAPTURED IN THREE SYNTHES FILES. SYNTHES FILE # (B)(4) DISCUSSES THE (LISS)-DISTAL FEMUR PLATE. SYNTHES FILE # (B)(4) CAPTURES THE LOCKING COMPRESSION PLATE (LCP), TIBIAL METAPHYSEAL PLATE (SYNTHES) AND LISS-PLT PLATE (SYNTHES). THE AUTHORS CITE A SUMMARY OF POSTOPERATIVE FINDINGS FROM OTHER PUBLISHED ARTICLES, WHICH WAS DOCUMENTED IN SYNTHES FILE # (B)(4). THIS SYNTHES FILE IS FOR # (B)(4) ON 13-HOLE LISS PLATES. THE ARTICLE STATES THE FOLLOWING: REYNDER5 REPORTED ON 23 TYPE 42-C2 FRACTURES TREATED WITH 13-HOLE LISS PLATES USING THE MIPO TECHNIQUE. IN THAT SERIES, FIVE PATIENTS DEVELOPED POSTFIXATION NEURAL PALSY OF THE EXTENSOR HALLUCIS LONGUS MUSCLE AFTER INSERTION OF THE LONG LISS PLATE AND THREE PATIENTS DEVELOPED COMPARTMENT SYNDROME AFTER IMMEDIATE PLATE FIXATION. REYNDER RECOMMENDED THAT LOCKING OF THE DISTAL LISS PLATE UNDER DIRECT VISUALIZATION AND IMMEDIATE FIXATION SHOULD BE AVOIDED. LONG LISS PLATES CANNOT BE USED TO STABILIZE THE DISTAL SEGMENT IN PATIENTS WITH SHORT DISTAL SEGMENTAL FRACTURE OF THE TIBIA. NON-UNION OF DISTAL FRACTURES HAS BEEN REPORTED BY MANY AUTHORS 1,14. IN OUR STUDY, ALL FRACTURES ACHIEVED UNION, ALTHOUGH DELAYED UNION OF DISTAL FRACTURES OCCURRED IN THREE PATIENTS. THERE WAS NO SIGNIFICANT DIFFERENCE IN TIME TO UNION BETWEEN DISTAL FRACTURES AND PROXIMAL FRACTURES. THIS REPORT IS FOR AN UNKNOWN PLATE. THIS IS REPORT 1 OF 1 FOR SYNTHES FILE (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
117813 HRS SYNTHES USA

Patients

Seq Age Sex Outcome Treatment
1