Dave's PCF WIP: Paragraphs

Paragraphs

Actions	Matter	Content	Para #	Notes	Modified
View Edit Delete	PER-23	FIG. 9F illustrates a resection guide 720f that, like resection guide 720e, includes an auxiliary bone attachment feature 752. Of course, other embodiments of the resection guide 720f may not include an auxiliary bone attachment feature 752.	301	Added by DJM Jan 2024	1/6/24, 9:56 PM
View Edit Delete	PER-23	In the illustrated embodiment, the resection guide 720f may include one or more alternative variations on a resection feature 722. For example, the resection guide 720e may include resection feature 722c. The resection feature 722c may enable a surgeon to resect or dissect in both a dorsal direction and in a plantar direction using the same resection feature 722c. The resection feature 722c can be described as a single slot having two open ends 729, with a connector 754 that spans the slot.	302	Added by DJM Jan 2024	1/6/24, 9:56 PM
View Edit Delete	PER-23	In one embodiment, the resection feature 722c includes an open dorsal end 755 and an open plantar end 757 with a connector 754 between them. Alternatively, or in addition, the resection feature 722c can be described as two resection features 722 that are aligned with each other. In one embodiment, a first resection feature of the resection feature 722c and a second resection feature of the resection feature 722c are aligned with each other (each extends from the connector 754 at about a 180-degree angle from each other). In another embodiment, the first resection feature of the resection feature 722c and the second resection feature of the resection feature 722c may each extend from the connector 754 at an angle greater than or less than 180 degrees.	303	Added by DJM Jan 2024	1/6/24, 9:56 PM
View Edit Delete	PER-23	Having an open dorsal end 755 and an open plantar end 757 can assist a surgeon in performing an osteotomy because the resection feature 722c supports a dorsally directed resection and a plantarly directed resection. Depending at least in part on needs or preferences of patients, the nature of the deformity, and/or surgeon preferences a resection guide 720f can be used that includes a resection feature 722c. In certain embodiments, a resection guide 720f can be designed and/or fabricated for a user that includes a resection feature like resection feature 722c and a resection feature 722 like resection features 722b. Of course, each of the resection features 722 can be like resection feature 722c or resection feature 722b.	304	Added by DJM Jan 2024	1/6/24, 9:56 PM
View Edit Delete	PER-23	FIG. 9G illustrates a resection guide 720g that, like resection guide 720e, includes an auxiliary bone attachment feature 752. Of course, other embodiments of the resection guide 720g may not include an auxiliary bone attachment feature 752. In the illustrated embodiment, the resection guide 720g includes a resection window 756. The resection window 756 is configured to show one or more bones on one side of the resection guide 720g when the resection guide 720g is in use. In the illustrated embodiment, the resection window 756 is positioned between the resection features 722. The resection window 756 can be made up of a single opening, a pair of openings, or a plurality of openings. In one embodiment, the resection window 756 includes a plurality of openings that extend from the medial side 744 to the lateral side 746. In the illustrated embodiment, the plurality of openings have a hexagonal shaped longitudinal cross section. In the illustrated embodiment, the resection window 756 is made up of a plurality of honeycomb openings (e.g., hexagons). Of course, the resection window 756 may have a variety of forms, shapes, sizes, and/or configurations. In one embodiment, the resection window 756 may be a rectangular or other polygonal opening. The resection window 756 may enable a surgeon to view past the resection guide 720 to visualize progress before, during or after one or more dissection or resection steps.	305	Added by DJM Jan 2024	1/6/24, 9:56 PM
View Edit Delete	PER-23	FIGS. 9H-9I illustrate views of alternative embodiments of a patient-specific guide, according to one embodiment. FIG. 9H is a plantar side view of resection guide 720a. This view shows at least two landmark registration features 728a, b. The landmark registration features 728 are connected to the body 732 and configured to contact one or more bones of the patient. Advantageously, the landmark registration feature 728 is defined from the bone model 404. Consequently, the landmark registration feature 728 is sized, shaped, and/or configured to engage particular landmarks of one or more bones, one or more surfaces, and/or one or more joints of the bones of the patient.	306	Added by DJM Jan 2024	1/6/24, 9:56 PM
View Edit Delete	PER-23	It should be noted that landmark registration feature 728b is formed near the resection feature 722a. In addition, the landmark registration feature 728b divides a bone engagement surface 726 into two parts. One part on the lateral side 746 that extends from the landmark registration feature 728b to the proximal bone attachment feature 766 and one part on the lateral side 746 that extends from the landmark registration feature 728b to the distal bone attachment feature 768. Also, not that the part of the bone engagement surface 726 that extends from the landmark registration feature 728b to the distal bone attachment feature 768 includes a part that extends up a side of the landmark registration feature 728b.	307	Added by DJM Jan 2024	1/6/24, 9:56 PM
View Edit Delete	PER-23	FIG. 9I illustrates an alternative version of the resection guide 720a, that is also a plantar side view. In FIG. 9I, the bone engagement surface 726 does not span all of the lateral side 746. Instead, the bone engagement surface 726 spans a percentage of the surface area of the lateral side 746. For example, in the illustrated embodiment, the bone engagement surface 726 extends or spans at least sixty percent of the surface area of one side (e.g., the lateral side 746) of the resection guide 720a.	308	Added by DJM Jan 2024	1/6/24, 9:56 PM
View Edit Delete	PER-23	In certain embodiments, the bone engagement surface 726 can include a plurality of sections such as proximal section 942, intermediate section 944, and distal section 946. In certain embodiments, each of these sections 942, 944, 946 together or separately can be specifically configured based on the patient anatomy, surface topography, and/or surgeon preferences to facilitate positioning and/or placement of the resection guide 720a. In one embodiment, one section can have a different level of detail and/or fidelity than others. This can be helpful in reducing the complexity and/or fabrication costs for the resection guide 720a.	309	Added by DJM Jan 2024	1/6/24, 9:56 PM
View Edit Delete	PER-23	FIG. 9I illustrates a portion 948 that, in the illustrated embodiment, does not include a bone engagement surface 726. The portion 948 is on the lateral side 746. In certain embodiments, the portion 948 may be sized and/or configured to provide clearance so that the surface of the portion 948 does not interfere with other structures of the bones and/or tissue of a patient.	310	Added by DJM Jan 2024	1/6/24, 9:56 PM
View Edit Delete	PER-23	FIG. 10A illustrates a plantar side view of patient-specific guide 720a according to one embodiment. FIG. 10A also illustrates a three-dimensional axis 1000, oriented based on how a medial patient-specific guide is oriented during use. The three-dimensional axis 1000 includes a medial-lateral axis 1002, a dorsal-plantar axis 1004, and an anterior-posterior axis 1006.	311	Added by DJM Jan 2024	1/6/24, 9:56 PM
View Edit Delete	PER-23	FIGs. 10A, 10B illustrate the position and/or angles (e.g., orientation) of one, or both of the resection features 722 based on patient imaging data. In the illustrated embodiment, the proximal resection feature 758 is positioned between the posterior side 736 and the distal resection feature 762. The proximal resection feature 758 is oriented based on a desired angle for mitigating the condition of the patient.	312	Added by DJM Jan 2024	1/6/24, 9:56 PM
View Edit Delete	PER-23	In one example, the proximal resection feature 758 is angled relative to the medial-lateral axis 1002. In the illustrated embodiment, the proximal resection feature 758 extends anteriorly from the medial-lateral axis 1002 at a desired angle, labeled angle A. This orientation of the proximal resection feature 758 enables a first cut surface to extend from the body 732 toward the bone to form a cut surface that is also at angle A relative to the medial-lateral axis 1002. In certain embodiments, angle A can range between about 0 degrees to about 80 degrees. In certain embodiments, angle A may start at 0 degrees and then increase to a positive number of degrees as illustrated or decrease to a negative number of degrees depending on how a surgeon may prescribe adjustments for a correction.	313	Added by DJM Jan 2024	1/6/24, 9:56 PM
View Edit Delete	PER-23	Similarly, the distal resection feature 762 is angled relative to the medial-lateral axis 1002. In the illustrated embodiment, the distal resection feature 762 extends posteriorly from the medial-lateral axis 1002 at a desired angle, labeled angle B. This orientation of the distal resection feature 762 enables a first cut surface to extend from the body 732 toward the bone to form a cut surface that is also at angle B relative to the medial-lateral axis 1002. In certain embodiments, angle B can range between about 0 degrees to about 80 degrees. In certain embodiments, angle B may start at 0 degrees and then increase to a positive number of degrees as illustrated or decrease to a negative number of degrees depending on how a surgeon may prescribe adjustments for a correction.	314	Added by DJM Jan 2024	1/6/24, 9:56 PM
View Edit Delete	PER-23	As with the orientation of the proximal resection feature 758 described above, both the proximal resection feature 758 and the distal resection feature 762 can be oriented relative to the medial-lateral axis 1002, dorsal-plantar axis 1004, and/or the anterior-posterior axis 1006 and/or relative to each other. Thus, the proximal resection feature 758 and/or distal resection feature 762 can be angled in one or more planes to provide a biplanar correction. In this manner, a surgeon can proscribe the dimensions of the resection shape the procedure will form and/or remove.	315	Added by DJM Jan 2024	1/6/24, 9:56 PM
View Edit Delete	PER-23	Similarly, those of skill in the art will appreciate that just as the angle of orientation for the resection features 722 can be predefined and determined, the orientation of one or more holes 764 of one or more bone attachment features 724 can be predefined and determined.	316	Added by DJM Jan 2024	1/6/24, 9:56 PM
View Edit Delete	PER-23	In one embodiment, the hole 764 closest to the proximal resection feature 758 may extend into the body at the same, or a similar, angle as angle A. Alternatively, or in addition, the hole 764 closest to the distal resection feature 762 may extend into the body at the same, or a similar, angle as angle B. The angled holes 764 cause the fasteners 710 to enter the bone at substantially the same angle as the hole extends into the body 732. Where one or more holes 764 extend into the body 732 at an angle other than perpendicular to the one or more bones, one or more fasteners 710 in the holes 764 may need to be removed in order to remove the resection guide 720 once resection cuts are completed. In one embodiment, one or more holes 764 closest to the resection feature 762 may be oriented perpendicular to a bone surface. Alternatively, or in addition, one or more holes 764 closest to the resection feature 758 may be oriented perpendicular to a bone surface.	317	Added by DJM Jan 2024	1/6/24, 9:56 PM
View Edit Delete	PER-23	In certain embodiments, a surgeon may use medical imaging to confirm that the trajectories of deployed fasteners 710 into the bone(s) using the holes 764 are where the surgeon had planned them and/or wants them, and that the surgeon still wants to proceed with the resections. If the surgeon is not comfortable proceeding with the procedure with the given resection guide 720, in certain embodiments, the surgeon may deploy an alternative resection guide 720 that is configured to provide a different trajectory for one or more resection cuts into one or more bones.	318	Added by DJM Jan 2024	1/6/24, 9:56 PM
View Edit Delete	PER-23	In certain embodiments, each bone attachment features 724 may include one or more holes 764. More than two holes 764 for each bone attachment features 724 can be advantageous because additional holes 764 can provide a more stable placement of the resection guide 720. More holes 764 may be included for particular surgical procedures such as a Charcot procedure where the quality of the bones, its stability and stiffness and integrity may be inferior and limited. Fasteners 710 in the additional holes 764 can provide greater stability for the resections which can result in more favorable outcomes.	319	Added by DJM Jan 2024	1/6/24, 9:56 PM
View Edit Delete	PER-23	FIG. 10A illustrates a proximal resection feature 758 extending through the resection guide 720a from a medial side 744 to a lateral side 746 along a first trajectory 1010. A distal resection feature 762 extends through the resection guide 720a from a medial side 744 to a lateral side 746 along a second trajectory 1012.	320	Added by DJM Jan 2024	1/6/24, 9:56 PM

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