The Flower Ankle Plating Set is intended for use for fixation of the ankle in adults and adolescents (12-21) in whom the growth plates have fused, and particularly in osteopenic bone. Specifically, . Distal Medial and Lateral Tibia Plates are intended for fixation of osteotomies, fractures, nonunions, malunions, and replantations of bones and bone fragments of the diaphyseal and metaphyseal regions of the distal tibia, . Distal Tibia A-Plates are intended to buttress partial articular fractures and bone fragments of the distal tibia, and . Straight and Distal Lateral Fibula Plates are intended for fixation of osteotomies, fractures, nonunions, malunions, and replantations of bones and bone fragments of the diaphyseal and metaphyseal regions of the distal fibula.
Device Story
Flower Ankle Plating Set consists of metallic bone plates (distal medial/lateral tibia, distal tibia A-plate, straight/distal lateral fibula) and screws for orthopedic fixation. Used by surgeons in clinical settings to stabilize bone fragments in distal tibia and fibula. Device provides mechanical support for bone healing; intended for adults and adolescents with fused growth plates, especially in osteopenic bone. System utilizes locking and non-locking screws. Clinical benefit derived from stabilization of fractures, osteotomies, and nonunions to facilitate bone union.
Clinical Evidence
No clinical data. Evidence consists of bench testing and engineering analysis. Bench testing performed per ASTM F67, ISO 5832-2, ASTM F136, ISO 5832-3, ISO 7153-1, ISO 10993-1, ISO 10993-5, and ISO 11137-1 to verify material properties, biocompatibility, and sterilization.
Technological Characteristics
Components: distal medial/lateral tibia plates, distal tibia A-plate, straight/distal lateral fibula plates. Material: pure titanium (ASTM F67). Compatible with locking/non-locking screws (K123562, K131657). Sterilization: radiation (ISO 11137-1).
Indications for Use
Indicated for fixation of ankle in adults and adolescents (12-21) with fused growth plates, particularly in osteopenic bone. Includes fixation of osteotomies, fractures, nonunions, malunions, and replantations of distal tibia and fibula, and buttressing of partial articular distal tibia fractures.
Regulatory Classification
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.
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# NOV 1 8 2013
Page 1 of 3
# K133102
### 510(k) SUMMARY
#### Flower Orthopedics Corporation's Ankle Plating Set
#### Submitter's Name, Address, Telephone Number, Contact Person and Date Prepared
Flower Orthopedics Corporation 7715 Crittenden Street, #413 Philadelphia, PA 19118
Phone: (267) 437 3063 (267) 437 3072 Facsimile:
Contact Person: Oliver Burckhardt, Chief Executive Officer Date Prepared: September 30, 2013
#### Name of Device
Flower Ankle Plating Set
#### Common or Usual Name/Classification Name
The Flower Ankle Plating Set consists of bone ankle plates classified under product code HRS (21 C.F.R. 888.3030, Single/multiple component metallic bone fixation appliance and accessories: Class II) and bone fixation screws classified under product code HWC (21 C.F.R. 888.3040, Smooth or threaded metallic bone fixation fastener; Class II).
### Predicate Devices
Synthes USA, Synthes 2.7mm/3.5mm LCP Distal Fibula Plates (K083213) Synthes USA, Synthes Variable Angle LCP Ankle Trauma System (K120854) Synthes USA, Synthes 2.7/3.5mm Variable Angle LCP Ankle Trauma System-Anterolateral Distal Tibia Plates (K121601) Flower Orthopedics Corporation, Flower Small and Medium Implants Set (K123562 and K131657)
#### Intended Use / Indications for Use
The Flower Ankle Plating Set is intended for use for fixation of the ankle in adults and adolescents (12-21) in whom the growth plates have fused, and particularly in osteopenic bone. Specifically.
- . Distal Medial and Lateral Tibia Plates are intended for fixation of osteotomies, fractures, nonunions, malunions, and replantations of bones and bone fragments of the diaphyseal and metaphyseal regions of the distal tibia,
- . Distal Tibia A-Plates are intended to buttress partial articular fractures and bone fragments of the distal tibia, and
- . Straight and Distal Lateral Fibula Plates are intended for fixation of osteotomies, fractures, nonunions, malunions, and replantations of bones and bone fragments of the diaphyseal and metaphyseal regions of the distal fibula.
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# Device Description
The Flower Ankle Plating Set consists of the following components and accessories: distal medial tibia plates, distal lateral tibia plates, distal tibia A-plate, straight fibula plate, distal lateral fibula plate, all made of pure titanium compliant with ASTM F67. The system accepts locking and non-locking screws cleared via K123562 and K131657. The device is provided with general purpose instruments.
# Technological Characteristics
The Flower Ankle Plating Set consists of the following components/configurations:
- Distal Medial Tibia Plates with a width of 11mm and a length range of 107mm-� 179mm:
- Distal Lateral Tibia Plates with a width of 11mm and a length range or 81mm-. 141mm;
- . Distal Tibia A-Plate with a width of 11mm and length of 65mm;
- Straight Fibula Plates with a width of 11mm and a length range of 45mm-86mm; and .
- Distal Lateral Fibula Plates with a width of 11mm and length range of 84mm-180mm. .
# Performance Data
The Flower Ankle Plating Set was tested (worse case) according to the following standards:
- . ASTM F67, Standard Specification for Unalloyed Titanium for Surgical Implant Applications
- . ISO 5832-2. Implants for Surgery, Metallic Materials. Part 2: Unalloyed Titanium
- . ASTM F136, Standard Specification for Wrought Titanium- 6 Aluminum- 4 Vanadium ELI Allov for Surgical Implant Applications
- ISO 5832-3, Implants for Surgery. Metallic materials. Part 3: Wrought titanium 6-. aluminium 4-vanadium allov:
- ISO 7153-1. Surgical instruments Metallic materials Part 1: Stainless steel (ISO . 7153-1:1991, including Amendment 1:1999); German version EN ISO 7153-1:2000;
- . ISO 10993-1. Biological evaluation of medical devices - Part 1: Evaluation and testing within a risk management process;
- . ISO 10993-5, Biological evaluation of medical devices - Part 5: Tests for in vitro cytotoxicity;
- ISO 11137-1. Sterilization of health care products Radiation Part 1: . Requirements for development, validation and routine control of a sterilization process for medical devices. (Sterility)
In addition, an engineering analysis was performed to demonstrate that the subject ankie plates provide appropriate mechanical strength for the claimed intended use.
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# K133102
In all instances, the Flower Ankle Plating Set functioned as intended and test results, as well as an engineering analysis, demonstrate substantial equivalence with the cited predicate devices.
# Substantial Equivalence
The Flower Ankle Plating Set is substantially equivalent to the identified predicate devices. The subject devices have the same intended uses/indications, technological characteristics, and principles of operation as the predicate devices. An engineering analysis was performed to demonstrate that the components in the Flower Ankle Plating Set provide appropriate mechanical strength for the claimed intended use. Thus, the subject ankle plates are substantially equivalent.
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Image /page/3/Picture/0 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo features a stylized eagle with three stripes representing the department's mission. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" is arranged in a circular pattern around the eagle.
### DEPARTMENT OF HEALTH & HUMAN SERVICES
Public Health Service
Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002
Flower Orthopedics Corporation % Ms. Janice M. Hogan Regulatory Counsel Hogan Lovells US LLP 1835 Market Street, 29th Floor Philadelphia, Pennsylvania 19103 November 18, 2013
Re: K133102
Trade/Device Name: Flower Ankle Plating Set Regulation Number: 21 CFR 888.3030 Regulation Name: Single/multiple component metallic bone fixation appliances and accessories Regulatory Class: Class II Product Code: HRS. HWC Dated: September 30, 2013 Received: September 30, 2013
Dear Ms. Hogan:
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. The general controls provisions of the Act include requirements for annual registration. Iisting 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
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### Page 2 - Ms. Janice M. Hogan
CFR Part 807); labeling (21 CFR Part 801); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.
If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Division of Small Manufacturers, International and Consumer Assistance at its tollfree number (800) 638-2041 or (301) 796-7100 or at its Internet address
http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR 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 the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.
You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.
Sincerely vours.
# Mark Nighterson -S
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 Statement
K133102 510(k) Number (if known):
Device Name: Flower Ankle Plating Set
Indications for Use:
The Flower Ankle Plating Set is intended for use for fixation of the ankle in adults and adolescents (12-21) in whom the growth plates have fused, and particularly in osteopenic bone. Specifically,
- Distal Medial and Lateral Tibia Plates are intended for fixation of osteotomies, . fractures, nonunions, malunions, and replantations of bones and bone fragments of the diaphyseal and metaphyseal regions of the distal tibia,
- Distal Tibia A-Plates are intended to buttress partial articular fractures and bone . fragments of the distal tibia, and
- . Straight and Distal Lateral Fibula Plates are intended for fixation of osteotomies, fractures, nonunions, malunions, and replantations of bones and bone fragments of the diaphyseal and metaphyseal regions of the distal fibula.
Prescription Use × (Part 21 CFR 801 Subpart D)
AND/OR
Over-The-Counter Use (21 CFR 801 Subpart C)
______________________________________________________________________________________________________________________________________________________________________________
### (PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)
Concurrence of CDRH, Office of Device Evaluation (ODE)
# Elizabeth L. Frank -S
Division of Orthopedic Devices
Page 1 of 1
41
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1. Search: exact and fuzzy
Type a phrase like "coronary artery calcification" into the search box. You get two kinds of results. Exact results match the literal phrase — prefix searches work ("coronary artery calcificati") but suffix searches do not. Fuzzy results match on the meaning and intent of your phrase rather than the exact words, and are sorted by relevance score. Hover over the Exact or Fuzzy badge on any row to see exactly why it matched.
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Exact vs. fuzzy search: what's the difference?
Exact matches on the literal phrase (prefix search works, suffix does not). Fuzzy matches on the meaning and intent of the phrase rather than the exact words. Hover over the badge on any row to see why it matched.
You search "coronary artery calcification" and want only software devices with AI. What two filters do you apply?
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Scroll right in the results table. The intended use is extracted for you — no need to open the PDF. The device story gives a high-level snapshot of what the device does and how it's used. The AI Performance sub-table shows each output name, acceptance criteria, observed values, and development/test dataset descriptions — the same format Innolitics uses for regulatory strategy outputs, and the fastest high-level fingerprint of an AI device. It is AI-generated but has been very reliable in practice.
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Scroll right in the search results table. The intended use column is extracted for you; no need to dig into the 510(k) summary PDF.
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Output name, acceptance criteria, observed values, development dataset description, and test dataset description. It's the same format we use for regulatory strategy output and Fast 510(k) input, and the fastest high-level fingerprint of an AI device. AI-generated but reliable in practice.
3. Judging fuzzy relevance
Fuzzy results trail off in relevance as you scroll. Use three signals to decide how far down to go: the fuzzy badge explanations, the intended use column, and whether your target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, you're past the relevant zone. A top hit with a low score (~0.4) and a stretched explanation is a hint the closest predicates are far away — the project may be headed for De Novo. Note the fuzzy search is a pattern match: it doesn't handle negation ("not") well, and hardware devices can appear — filter by SaMD/AI ML to cut them.
How do you judge how far down fuzzy search results to go?
Use the relevancy signals: the fuzzy badge explanations, the intended use column, and whether the target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, results are trailing off in relevancy.
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Reading rule for every project: how many summaries do you read in full?
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Select multiple rows in the results table (aim for under ~10), then open the PDF Viewer tab. Ask one question — it goes to all selected devices in parallel, each with citations. This is the fastest way to compare and contrast devices: training data, PCCP scope, how they handled adding new scanners, and so on.
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Select multiple devices, open the PDF viewer tab, and ask one question (e.g., "Describe the training data"). It queries all selected devices simultaneously with citations, so you can compare and contrast quickly.
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Browse product codes and regulation numbers, read the identification text and special controls, browse sibling product codes, open device PDFs on the right, and search by product code or regulation number at the top of the tree.
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Click Show Chart and segment by regulation number (or product code) to see which regulations dominate your result set. Clicking a regulation takes you into the regulations tree. Great for spotting that most matches are, say, hardware laparoscopic devices — a cue to go back and filter.
How do you see which regulations dominate a search result set?
Click "Show Chart" and segment by Regulation Number. Clicking a regulation takes you to the regulations tree.
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Open the Predicates tab for a family-tree view of predicate relationships. Click a node to trace its parents and children; selections from search carry over pre-selected. Commonly predicated devices are worth reading — a lot of people predicated them for a reason. The visual lineage is also handy on client calls, e.g. to show how a predicate family evolved and justify why your predicate still holds.
In the predicate graph, why are commonly predicated devices worth reading?
A lot of people predicated them for a reason. Clicking a node traces parents and children, and selections from search carry over pre-selected.
10. Embeddings: the galaxy map
The Embeddings tab plots every matching document in a 2-D "galaxy map" where semantically similar devices cluster together. Hover or click clusters to explore, and let AI label the clusters for you. Embeddings beat product codes for grouping: two devices can carry different product codes (LLZ vs. QIH) yet do the same thing — the embedding captures the meaning of the intended use and device story. This is also exactly how retrieval-augmented generation (RAG) works under the hood, and it makes a great visual on client calls.
Try it yourself
Head to the search page and work through a few of these AI/ML fuzzy searches to build intuition: perivascular fat on CT · aortic valve calcification opportunistic screening on noncontrast CT · breast cancer prediction on digital pathology slides · autism detection · gestational age prediction · a hearing aid that can also detect a pulse · foundation model based analysis of ECG · large language models · penetration test. Watch how the relevance scores, intended use, and AI Performance tables tell you when results stop being meaningful.