I don't have a dog in the fight but this is what I have seen being in orthopedics a long time. Most surgeons move to a territory from residency trained on Synthes. Most Synthes reps have seen a lot of trauma cases and can be a resource for those surgeons in the OR. There are always exceptions to this but it is what you typically see. Large volume trauma surgeons typically use Synthes and don't need a rep other to make sure their sets are complete and on the shelf for them. You will also see surgeons who use Synthes for everything except for nails and possible one various plate that they don't like. If you are selling Stryker trauma you are selling your nails and leaning on surgeons with strong relationships on the joint side to try some of your plates. If you are selling Smith and Nephew you are doing the same. Smith and nephew does seen to have a better plate system than Stryker but I haven't seen anything to suggest it is better than Synthes and I almost never see the trauma rep. Zimmer has a decent nail system and a few NCB/periarticular plates that look good. I would think that in markets with a strong joint presence that they could leverage those relationships into some trauma business. The problem in market is they took trauma from the joint reps, hired two young reps with little experience who both left within a year. I haven't seen a Zimmer trauma rep since. I also think you will have a hard time converting accounts who own Synthes trauma carts and everyone techs and surgeons are comfortable with. Synthes is for guys taking trauma call what Arthrex is for guys doing sports cases. They are the safe bet for guys starting out and as they get more experience they will be more willing to try something else as they gain experience. Synthes nails do need an upgrade though.