The AO Innovation Translation Center (AO ITC) is delighted to announce a new phase in the evolution of the Distal Radius Intramedullary Nail (DRIM-Nail), an implant development project which is now in the early stages of clinical application. Clinical usage of the DRIM-Nail has been extended to further European regions to enable data collection around device performance, in collaboration with Disrad AG.

Approved by the AO in June 2022, the DRIM-Nail is an innovative treatment option for patients with extraarticular distal radius fractures. The design, development and certification of this new intramedullary nailing implant originally grew from a multi-partner collaboration between Disrad AG, a start-up founded at Balgrist University Hospital by the Balgrist Beteiligungs AG, the University of Zürich, the AO Technical Commission's Hand Expert Group, the AO's Innovation Funding, and 41medical.

Fig 1: The Distal Radius Intramedullary Nail (DRIM-Nail)

Disrad AG has recently invested in the availability of the DRIM-Nail to selected clinics in Germany, Switzerland and Austria, and to date, the device has been used in the treatment of over 30 distal radius fractures. In partnership with selected expert surgeons from the AO ITC, information gathering is underway in two key areas: outcomes for patients treated with the DRIM-Nail, and the user experience for surgeons. The findings from early clinical usage are expected to provide the framework for a future clinical study. It is anticipated that the DRIM-Nail will gain FDA approval in the near future, allowing expansion to US markets.

To showcase the ease of handling of the DRIM-Nail, the implant was presented at the AO’s Meet the Expert series at Davos in December 2024. Presented by expert surgeons Andreas Schweizer, Martin Langer and Alejandro Lluch — who were directly involved in the development of the new implant — the interactive stage show featured a practical demonstration of the surgical technique to insert the DRIM-Nail and an overview of the clinical benefits of this innovative device. The new implant will be further highlighted during a session at the AO ITC’s Innovation Hub at the AO Davos Courses in December 2025.

Fig 2: Exemplar case using the DRIM-Nail: (a) Lateral pre-operative radiograph after closed reduction showing a dorsal dislocation of 25° compared to the physiological palmar tilt and a dorsal comminution; (b) AP pre-operative radiograph following closed reduction; (c) AP and (d) lateral radiographs after 3 months with the distal radius fracture healed in anatomical position. (Case kindly provided by Ladislav Nagy, MD, Balgrist Universtity Hospital, Zurich, Switzerland).

Consistent with the AO TC’s ethos of harnessing innovation to improve patient care and outcomes, the new DRIM-Nail provides all the benefits of minimally invasive intramedullary fracture stabilization, including minimal trauma to the bone fragments and the protection of the adjacent soft tissue. This aims to achieve faster recovery, better and faster functional and cosmetic outcomes, and a lower economic burden compared to current treatment options.