ZNN Bactiguard Retrograde Femoral Nails PMCF Study

Study Overview
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Brief Summary
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Post-market clinical follow-up (PMCF) study to confirm the safety, performance, and clinical benefits of the intra-medullary retrograde femoral nail Zimmer Natural Nail (ZNN) Bactiguard (implants and instrumentation) when used for the temporary internal fixation and stabilization of femoral fractures.

Detailed Description
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The objective of this prospective PMCF study is to collect data to confirm safety, performance and clinical benefits of the Zimmer Natural Nail (ZNN) Bactiguard Retrograde Femoral Nail (implants and instrumentation) when used for the temporary internal fixation and stabilization of femoral fractures. The primary endpoint is the assessment of performance by analyzing fracture healing. The secondary endpoints are the assessment of safety, clinical benefit and post-op fracture related infection (FRI). Safety will be evaluated by recording and analyzing the incidence and frequency of complications and adverse events. Relation of the events to implant, instrumentation and/or procedure should be specified. Clinical benefit will be assessed by recording patient-reported outcome measures (PROMs). FRIs will be classified according to the updated diagnostic algorithm defined by the FRI Consensus Group.

Official Title
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Post-Market Clinical Follow-up Study on the ZNN™ Bactiguard ® Retrograde Femoral Nails (Implants and Instrumentation)

Conditions
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Femoral Fracture

Intervention / Treatment
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* Device: ZNN Bactiguard Retrograde Femoral Nail


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients must be 18 years or older. Patient must have a femoral fracture (open, closed, monolateral or bilateral) requiring surgical intervention and be eligible for fixation by intramedullary nailing. Patients with delayed treatment (initial treatment by external fixation due to swelling / high energy trauma followed by definitive treatment by intramedullary nail) can also be included. Patient has been or is scheduled to be treated with the ZNN Bactiguard System Retrograde Femoral Nail. Patient must be able and willing to complete the protocol required follow-up. Patient must have a signed EC approved consent. Patients capable of understanding the surgeon's explanations and following his instructions. Exclusion Criteria: Skeletally immature patients A medullary canal obliterated by a previous fracture or tumor Bone shaft having excessive bow or a deformity Lack of bone substance or bone quality, which makes stable seating of the implant impossible All concomitant diseases that can impair the operation, functioning or the success of the implant Insufficient blood circulation Infection Patient is unwilling or unable to give consent. Patient is a vulnerable subject (prisoner, mentally incompetent or unable to understand what participation to the study entails, alcohol/drug addiction, known to be pregnant or breast feeding). Patient anticipated to be non-compliant and/or likely to have problems with maintaining follow-up program (e.g. patient with no fixed address, long distance, plans to move during course of study). Not expected to survive the duration of the follow-up program

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| ZNN Bactiguard Retrograde Femoral Nail<br>Patients implanted with a ZNN Bactiguard Retrograde Femoral Nail for fixing and stabilizing a femoral fracture. | Device: ZNN Bactiguard Retrograde Femoral Nail<br>* Femoral fracture internal fixation.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rate of fracture healing 12 months after fracture fixation | Fracture healing is assessed with x-ray imaging and clinical examination. Radiographic Union-Scale in Tibial fractures (RUST) score adapted for the femur, A/P and lateral views. Range: 4 - 12. Fracture healing is defined as RUST scores greater than or equal to 6. Fix-IT score (clinical examination). Range 0 - 12, higher scores indicate better limb function. | 3, 6, and 12 months after fracture fixation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Oxford Knee Score (limb function) | Range: 0 - 48, higher scores indicate better function. Patient-reported outcome to evaluate the function of the limb treated with ZNN Bactiguard Femur Retrograde. | 3, 6, and 12 months after fracture fixation | 
| EQ-5D-5L score (patient's quality of life) | Range: 0 - 100, higher scores indicate better quality of life. Patient-reported outcome to evaluate quality of life. | pre-surgery (retrospectively), 3, 6, and 12 months after fracture fixation | 
| Adverse events frequency | The incidence and frequency of adverse events occurring during the study will be reported. | 12 months after fracture fixation | 
| Rate of fracture-related infections | Fracture-related infections are diagnosed in accordance with the algorithm described in M McNally,G Govaert, M Dudareva, M Morgenstern, W J Metsemakers, EFORT Open Rev 2020;5:614-619. | 12 months after fracture fixation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Bactiguard, Femur fracture, Intramedullary nailing, Infection control