510(k) Report

510(k) · Cleared

Cleared

Monkey Rings External Ring Fixation System

K253613510(k) SpecialCleared Dec 19, 202531-day reviewClass II21 CFR 888.3030

Data to Oct 25, 2026 (FDA decisions) Oct 12, 2026 (recalls) Sep 30, 2026 (MAUDE) refreshed weekly, last Nov 3, 2026

Paragon 28, Inc. · KTT Appliance, Fixation, Nail/Blade/Plate Combination, Multiple Component

Cleared on Dec 19, 2025 as substantially equivalent to K212895 (Paragon 28, Inc., 2021) after a 31-day review. Its family tree reaches back 11 generations to 2000.

Decided
Dec 19, 2025
Review
31 days
Class
Class II
Product code
KTT
Recalls
None
Predicates
1

Its longest line of descent runs back 11 generations to K994143 (2000). 15 ancestors in all, the oldest K970748 (1997). No later device cites it as a predicate yet.

  1. Root · 11 generations backK994143 Smith & Nephew External Fixation System [Unilateral (Linear) &…Smith & Nephew, Inc. · 2000 · Recalled
  2. 7 generations between
  3. 3 generations backK182968 Hoffmann LRF SystemStryker GmbH · 2019
  4. 2 generations backK203568 Hoffmann LRF SystemStryker GmbH · 2021
  5. 1 generation backK212895 Paragon 28 External Ring Fixation SystemParagon 28, Inc. · 2021
  6. This deviceK253613 Monkey Rings External Ring Fixation SystemParagon 28, Inc. · 2025
Show all 11 generations
  1. Root · 11 generations backK994143 Smith & Nephew External Fixation System [Unilateral (Linear) &…Smith & Nephew, Inc. · 2000 · Recalled
  2. 10 generations backK031181 External Fixation SystemsSmith & Nephew, Inc. · 2003
  3. 9 generations backK113327 Hoffmann LRF (Limb Reconstruction Frame) SystemStryker Corp. · 2012 · Recalled
  4. 8 generations backK130334 Hoffmann LRF (Limb Reconstruction Frame System)Stryker Trauma AG · 2013
  5. 7 generations backK140961 Hoffmann LRF (Limb Reconstruction Frame) SystemStryker Trauma AG · 2014
  6. 6 generations backK153377 Hoffmann LRF (Limb Reconstruction Frame) SystemStryker GmbH · 2016 · Recalled
  7. 5 generations backK161753 Hoffman LRF SystemStryker GmbH · 2016
  8. 4 generations backK163656 Hoffmann LRF SystemStryker GmbH · 2017 · Recalled
  9. 3 generations backK182968 Hoffmann LRF SystemStryker GmbH · 2019
  10. 2 generations backK203568 Hoffmann LRF SystemStryker GmbH · 2021
  11. 1 generation backK212895 Paragon 28 External Ring Fixation SystemParagon 28, Inc. · 2021
  12. This deviceK253613 Monkey Rings External Ring Fixation SystemParagon 28, Inc. · 2025
View FIG. 1 as a table

Line of descent and top descendants

GenerationNumberDeviceApplicantDecidedRecalls
−11K994143Smith & Nephew External Fixation System [Unilateral (Linear) & Multilateral…Smith & Nephew, Inc.200019
−10K031181External Fixation SystemsSmith & Nephew, Inc.2003—
−9K113327Hoffmann LRF (Limb Reconstruction Frame) SystemStryker Corp.20123
−8K130334Hoffmann LRF (Limb Reconstruction Frame System)Stryker Trauma AG2013—
−7K140961Hoffmann LRF (Limb Reconstruction Frame) SystemStryker Trauma AG2014—
−6K153377Hoffmann LRF (Limb Reconstruction Frame) SystemStryker GmbH20162
−5K161753Hoffman LRF SystemStryker GmbH2016—
−4K163656Hoffmann LRF SystemStryker GmbH20175
−3K182968Hoffmann LRF SystemStryker GmbH2019—
−2K203568Hoffmann LRF SystemStryker GmbH2021—
−1K212895Paragon 28 External Ring Fixation SystemParagon 28, Inc.2021—
0 (this device)K253613Monkey Rings External Ring Fixation SystemParagon 28, Inc.2025—

Other ancestors by year cleared

Year clearedDevicesWith a Class I recall
199710
200010
200410
201310
FIG. 1 — Lineage of K253613, 2000–2025Source: FDA 510(k) summaries, read by 510(k) Report · How lineage is built

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Notable FDA decisions, review times and new Class I recalls. See an issue.

Sources: FDA 510(k) database (decision fields), the FDA summary (predicates and indications), FDA recall and enforcement reports, and MAUDE; processed by 510(k) Report. Verify on FDA.gov · Methodology and accuracy.

Planning a device in KTT? A 510(k) Report weighs predicate choices, recall history and review times for a new device like this one.

Top candidate predicates for a new KTT device

  1. #1 K242861 TrueLok Elevatescore 21.3 · 14 generations · no Class I recall
  2. #2 Held for the reportin the report
  3. #3 Held for the reportin the report
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What was it cleared against? (1)

Devices the submitter claimed this one is substantially equivalent to (*), and reference devices cited for a specific test or feature (†), as written in the FDA summary.

TypeNumberDeviceApplicantDecidedRecalls
*K212895Paragon 28 External Ring Fixation System
Summary page 7
…previously cleared and remain unchanged in design and function. Primary Predicate: Paragon 28 External Ring Fixation System (K212895) Reference Device: Taylor Spatial Frame (K201253)…
Paragon 28, Inc.2021—
†K201253Modular Rail System, TAYLOR SPATIAL FRAME External Fixator, JET-X Fixator, ILIZAROV…Smith & Nephew2020—

Also cleared against K212895: 1 other device →

What descends from it?

No later submission names this one as a predicate yet.

Has anything in its family been recalled? (0 Class I)

No FDA recall names this device.

No ancestor or descendant has a Class I recall.

What does this lineage say?

  • The line of descent spans 25 years and passes through 5 companies; a new generation was cleared every 1.5 years on median.
  • 5 of the 15 ancestors have a recall of any class.
  • 1 other device also cites its predicate K212895.

How does its category compare?

All KTT devices

KTT Appliance, Fixation, Nail/Blade/Plate Combination, Multiple Component: FDA decisions, review times, recalls and adverse event reports over 20 years. 2025, this device’s year, is highlighted.

FDA decisions per year · KTT

10in 2025

2007: 92008: 112009: 112010: 122011: 102012: 92013: 72014: 142015: 122016: 102017: 112018: 62019: 82020: 92021: 102022: 32023: 72024: 52025: 102026 (partial year): 5
2007high 14 (2014) · low 3 (2022)2026

2026 to Oct 25, outlined.

Median 510(k) review, days · KTT

88in 2025

2007: 55 days median2008: 73 days median2009: 94 days median2010: 148 days median2011: 157 days median2012: 140 days median2013: 87 days median2014: 129 days median2015: 60 days median2016: 142 days median2017: 184 days median2018: 149 days median2019: 110 days median2020: 200 days median2021: 83 days median2022: 25 days median2023: 29 days median2024: 90 days median2025: 88 days median2026 (partial year): 68 days median
2007high 200 (2020) · low 25 (2022)2026

Receipt to decision; years with fewer than 3 clearances left blank.

Recalls per year · KTT

2in 2021

2007: 22008: 12009: 22010: 12012: 42013: 72017: 12018: 142019: 32021: 22026 (partial year): 11
2007high 14 (2018) · low 0 (2011)2026

Class I (0 since 2007) Class II/III not classified

Adverse event reports per year · KTT

673in 2025

2007: 452008: 662009: 452010: 1212011: 1962012: 5272013: 8982014: 4452015: 4012016: 4002017: 4852018: 5972019: 8002020: 9422021: 9612022: 6272023: 5542024: 5232025: 673
2007high 961 (2021) · low 45 (2007)2025

MAUDE reports naming product code KTT, not matched to any one device; reports are not rates.

View these four charts as a table
YearDecisionsMedian 510(k) review, daysRecalls (Class I)MAUDE reports
2007955245
20081173166
20091194245
2010121481121
2011101570196
201291404527
20137877898
2014141290445
201512600401
2016101420400
2017111841485
2018614914597
201981103800
202092000942
202110832961
20223250627
20237290554
20245900523
202510880673
202656811—

What is it indicated for?

The Monkey Rings TM External Fixation System is intended to be used in adults and pediatric patients that are children aged 2 years to less than 12 years and adolescents aged 12 through 21 years (up to but not including the 22nd birthday). The Monkey Rings External Ring Fixation System is intended to treat the following patient indications in pediatric patients and adults for the treatment and fixation of: • Open and closed fractures • Post-traumatic…

Read the full statement (222 words)

The Monkey Rings TM External Fixation System is intended to be used in adults and pediatric patients that are children aged 2 years to less than 12 years and adolescents aged 12 through 21 years (up to but not including the 22nd birthday).

The Monkey Rings External Ring Fixation System is intended to treat the following patient indications in pediatric patients and adults for the treatment and fixation of:

• Open and closed fractures

• Post-traumatic joint contracture which has resulted in loss of range of motion

• Fractures and disease which generally may result in joint contractures or loss of range of motion and fractures requiring distraction

• Pseudoarthrosis, infected union, non-union, or malunion of long bones

• Limb lengthening by epiphyseal, diaphyseal, or metaphyseal distraction

• Correction of bony or soft tissue deformity (e.g., orthoplastic surgery)

• Correction of segmental bony or soft tissue defects

• Joint arthrodesis

• Management of comminuted intra-articular fractures

• Bone transport

The Monkey Rings External Ring Fixation System is indicated in adults for:

• Osteotomy

• Revision procedure where other treatments or devices have been unsuccessful

• Bone reconstruction procedures

• Fusions and replantations of the foot

• Charcot foot reconstruction

• Offloading and/or immobilization of ulcers and/or wounds of the foot and ankle

• Lisfranc dislocations

• Ankle distraction (arthrodiastasis)

• Septic fusion

Indications for use as stated in the FDA summary.

Cite this page

510(k) Report. “K253613: Monkey Rings External Ring Fixation System.” Lineage record from FDA 510(k) data and the FDA summary. Updated Nov 3, 2026. Accessed Nov 5, 2026. https://510kreport.com/device/K253613

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Record history
  • FDA decision record loaded May 2, 2026
  • Summary read Oct 13, 2026 (extraction version 9eaa42aa01ed)
  • Lineage and recalls computed Nov 3, 2026
  • Page last updated Nov 3, 2026