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Distal Targeting System

TRIGEN SURESHOT Distal Targeting system

Product Information

The TRIGEN SURESHOT system is a safe, convenient, and cost effective technology for fracture repair in the OR.

Problem: Current Methods of Distal Locking
Current Solution: Perfect Circles

  • Surgeon reliant on staff expertise
  • Fluoroscopy - Radiation exposure
  • Technique dependent - Learning curve
  • Position dependent - Potential for fracture misalignment

What is it?

  • Electromagnetic field tracking technology
  • Sensor on probe inserted into the nail
  • Projects virtual image of distal end of nail on screen
  • Provides real time feedback without fluoroscopy
  • Green and red concentric circles = perfect circles

Technology that puts you in full command of distal locking

  • A virtual real-time imaging system for distal locking
  • For years, distal locking with the free-hand fluoroscopic method has been the standard of care—now there's a new standard
  • Not a new technique, but a technology that offers full surgeon control, a reduction in fluoroscopic radiation exposure 1
  • Works seamlessly with the proven TRIGEN Nail family: META-NAIL, TAN, FAN, Humeral, Pediatric and Adolescent nails

TRIGEN SURESHOT system: At your command


1. Computer-based calibrated software provides perfect circle targeting
2. Continuous visual real-time feedback of drill position ensures correct direction and angle
3. All under your direct control; requires no fluoroscopy during distal locking


  • Safety
  • Control

Download the TRIGEN SURESHOT Product Brochure


Moore, Chris, MS; Heeckt, Peter, MD. Reducing Radiation Risk in Orthopaedic Trauma Surgery, Bone&Joint Science. Vol 02, No 07 - July 2011.

Design and Technology

TRIGEN SURESHOT Design Rationale

Screw targeting during intramedullary nailing of long bone fractures can be a laborious process and is highly dependent upon fluoro technicians, often becoming the most frustrating and time-consuming step of the procedure. The vast majority of surgeons use a fluoroscopic method reliant upon obtaining ‘perfect circles'. This technique requires assistance to hold the extremity in a specific position and expertise from the radiology technician. Additionally, this technique is characterized by a moderate learning curve with variable accuracy, the potential for screw malalignment and exposes the patient and surgical staff to radiation.

The TRIGEN SURESHOT Distal Targeting System utilizes an electromagnetic field generator, a probe inserted into the nail, and virtual imaging to facilitate distal locking without fluoroscopy. This system is ionizing radiation free, position independent, and provides 3D real time feedback of location and orientation of the drill relative to the nail interlocking hole to provide unsurpassed accuracy. The TRIGEN SURESHOT Distal Targeting System was designed to mimic the ‘perfect circle' technique and has virtually no learning curve.

In combination with the TRIGEN IM Nail System, the TRIGEN SURESHOT Distal Targeting System allows surgeons to exercise operating room control, benefitting everyone including the patient and OR staff. TRIGEN SURESHOT delivers outcomes by providing the surgeon with maximum command during intramedullary nailing and by reducing radiation exposure, anesthesia time and time in the OR, all while increasing accuracy.

The TRIGEN SURESHOT Distal Targeting System is the approach to distal locking and further establishes the TRIGEN IM Nail System as the driving force in advancing and improving the efficacy of intramedullary nailing.



The Smith & Nephew TRIGEN SURESHOT Distal Targeting System is intended to be an intraoperative image-guided localization system. It is a computer-assisted orthopaedic surgery tool to aid the surgeon with drill positioning for screws during intramedullary nail implantation. It provides information to the surgeon that is used to place surgical instruments during surgery utilizing intraoperatively obtained electromagnetic tracking data. The Smith & Nephew TRIGEN SURESHOT Targeting System is indicated for long bone fractures treated with intramedullary nails in which the use of stereotactic surgery may be appropriate. An example of a surgical procedure includes but is not limited to locating and drilling the distal holes in an intramedullary nail.

The screw targeting software application for this system is contraindicated for all IM nails other than Smith & Nephew TRIGEN META-NAIL, TAN, FAN, Humeral, Pediatric and Adolescent nails. Do not operate the TRIGEN SURESHOT Targeter within 200mm of an installed pacemaker. The magnetic field produced by the Targeter may interfere with the operation of the pacemaker.

Intended use
The TRIGEN SURESHOT Distal Targeting System is only designed for use with the indicated implants and instruments. Implants and instruments must be used in accordance with the instructions, as described in this manual and/or in the non-navigated surgical procedure.

Only trained operators are allowed to use the TRIGEN SURESHOT Distal Targeting System. The various operating instructions must be fully read and understood as part of the training. If any part of the instructions is not clear, please contact your local representative.

Download the TRIGEN SURESHOT User Manual