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The positioning guides 3810 (e.g., positioning guide 3810a and/or positioning guide 3810b) are configured to engage with fastener 2010a and fastener 2010b such that the bone fragments connected to the fasteners remain connected, stable, and positioned in a desired position, until a surgeon takes steps to change the position. This stability can be very helpful to a surgeon to achieve a desired positioning and desired eventual patient outcome. In one embodiment, with the positioning guide 3810b seated and the bone fragments translated and/or rotated, a surgeon can confirm that the bone fragments are in a desired position. This may be done using medical imaging such as flouroscopy. Advantageously, the osteotomy system 3800 (e.g., positioning guide 3810b and fasteners 2010a,b) retains the bone fragments in the same position prior to, during, and after capturing imaging using flouroscopy. This can be a great help to a surgeon as their hands are free during the flouroscopy check and they are assured that the bone fragments have not moved during the flouroscopy check.  The surgeon can have confidence that bone fragments are in a desired position and will maintain that position until either repositioned and/or fixation is deployed to secure the bone fragments in place. Such reliability and assurance can greatly assist a surgeon because once fixation is deployed, repositioning of the bone fragments may be very challenging and may lead to less than desirable outcomes. Therefore, a surgeon may strive to ensure that the bone fragments are in a desired position and maintain that position up until permanent fixation is deployed. The embodiments of the present disclosure provide this advantage to the surgeon.

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