Dave's PCF WIP: Paragraphs

Paragraphs

Actions	Application	Content	Paragraph Number	Notes	Modified
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View Edit Delete	PER-20	While specific embodiments and applications of the present disclosure have been illustrated and described, it is to be understood that the scope of this disclosure is not limited to the precise configuration and components disclosed herein. Various modifications, changes, and variations which will be apparent to those skilled in the art may be made in the arrangement, operation, and details of the methods and systems of the present disclosure set forth herein without departing from it spirit and scope.	326	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	What is claimed is:	327	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	FIG. 12C illustrates a perspective view of a positioning guide 1200 from a lateral side according to one embodiment.	296	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	In another embodiment, the resection guide is designed to approach and engage a metatarsal from the medial side of the bone. Furthermore, a surgeon can define a length and width for the bone engagement surface 1110, 1120. Advantageously, a surgeon can define, alter, or adjust the bone engagement surface 1110, 1120 to suit their preferences, the needs of the patient, or the like. By adjusting the bone engagement surface 1110, 1120, a surgeon can impact how the resection guide 820a,b seats on the bones during the surgical procedure. In one embodiment, a surgeon may want a loose fit while another surgeon may want a tighter fit. Alternatively, or in addition, a surgeon can choose to position the resection guide 820 at another position on a particular surface of a bone. Those of skill in the art will appreciate that changing the position of the resection guide 820 can change the makeup and configuration of bone engagement surface 848 because the surface contacting the resection guide 820 will change. In one embodiment, the surgeon may alter predefined configurations or choose a configuration from a set of optional configurations. Alternatively, or in addition, a surgeon may define a resection guide 820 from scratch.	286	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	One challenge in performing osteotomies on such small bones as those of a hand or foot, is how to make accurate and precise cuts on such small bones/structures. Embodiments such as the resection guide 820a,b, can be used to help address this challenge. For example, the resection guide 820a,b may include a landmark registration feature that facilitates positioning the resection guide in a predetermined position on a bone.	287	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	FIG. 12A illustrates a top perspective view of a positioning guide 1200 from a medial side according to one embodiment. The positioning guide 1200 may be similar to or the same as the positioning guide 880. The positioning guide 1200 serves to position one or more bones in relation to another anatomical structure. For example, the positioning guide 1200 may position a metatarsal and/or a cuneiform relative to each other, in particular following an osteotomy to each these bones. Advantageously, a positioning guide 1200 can facilitate placing both bones into a precise relationship relative to each other that matches or sufficiently satisfies the arrangement predetermined in a preoperative plan. Used as designed, a positioning guide 1200 can provide a surgeon with assurance that the repositioning and/or reduction of the bones as planned is being implemented.	288	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	A positioning guide 1200 can include a positioning guide body 1202 having a proximal end 1204, a distal end 1206, a superior side 1208, an inferior side 1210, a medial side 1212, a lateral side 1214, a proximal side 1216, and a distal side 1218. In one embodiment, the positioning guide 1200 may also include a set of proximal holes 1220, a set of distal holes 1222, a bone engagement surface 1224, and/or a registration key 1226 (or landmark registration feature).	289	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	The set of proximal holes 1220 may extend from the superior side 1208 to the inferior side 1210. The set of proximal holes 1220 are configured to accept and/or slide over a proximal alignment feature 944. The set of distal holes 1222 may extend from the superior side 1208 to the inferior side 1210. The set of distal holes 1222 are configured to accept and/or slide over a distal alignment feature 946. Advantageously, in one embodiment, a surgeon may use the positioning guide 1200 after performing an osteotomy on two bones of a TMT joint. The set of proximal holes 1220 and the set of distal holes 1222 are positioned in the positioning guide body 1202 and relative to each other such that as the positioning guide 1200 slides along the proximal alignment feature 944 and distal alignment feature 946 towards the bones (e.g., a cuneiform and a metatarsal) one or both of these bones move (translate and/or rotate) in a way that closes an osteotomy that has been performed on one of the bones. In certain embodiments, deploying the positioning guide 1200 on the proximal alignment feature 944 and the distal alignment feature 946 closes an osteotomy on a cuneiform and a metatarsal of a TMT joint. In this manner, the positioning guide 1200 facilitates translating and/or rotating the bones for a reduction and in preparation for permanent fixation.	290	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	Alternatively, or in addition, the set of proximal holes 1220 and the set of distal holes 1222 are positioned in the positioning guide body 1202 and relative to each other such that bone fragments connected to the proximal alignment feature 944 and distal alignment feature 946 are not only brought into contact with each other, they are also compressed against each other. In one embodiment, moving the positioning guide 1200 along the proximal alignment feature 944 and distal alignment feature 946 towards the metatarsal and the cuneiform compresses a cut face of the metatarsal against a cut face of the cuneiform. For example, to provide sufficient compression for a successful union of the two bones through the healing process.	291	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	FIG. 12B illustrates a bottom perspective view of a positioning guide 1200 according to one embodiment. FIG. 12B illustrates the bone engagement surface 1224 of the positioning guide 1200. In certain embodiments, the bone engagement surface 1224 is designed and/or fabricated in a similar manner to the other bone engagement surfaces described herein (e.g., bone engagement surface 922, bone engagement surface 1110, bone engagement surface 1120). Those of skill in the art will appreciate that any of the components of the systems (e.g., system 400, system 500, system 800) of the present disclosure may include a bone engagement surface while one or more other components may not. In one embodiment, at least one of a navigation guide 900, a proximal resection guide 820a, a resection guide 820b, and a positioning guide 1200 (e.g., positioning guide 880) comprises a bone engagement surface configured to register to an anatomical structure of a patient’s foot.	292	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	In the illustrated embodiment, the positioning guide 1200 is configured to span an osteotomy of a TMT and includes a bone engagement surface 1224 that engages a surface of a cuneiform and a bone engagement surface 1224 that engages a surface of a metatarsal. These may be two separate bone engagement surfaces or a single bone engagement surface 1224 that extends to both bones.	293	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	Advantageously, the bone engagement surface 1224 is configured to match the surface of the two bones when reduced and prepared for permanent fixation. Those of skill in the art will appreciate that the composition of the bone engagement surface 1224 after one or more osteotomies can be very different and unique from a composition of the surface of both bones prior to an osteotomy and/or prior to translation or rotation of the bones into a final position for fixation. Because the bone engagement surface 1224 can match the surfaces of the two bones in a corrected relationship, a surgeon can be assured that the bones are where desired when the bone engagement surface 1224 engages a surface of both bones in the reduced condition.	294	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	Furthermore, the registration key 1226 is fabricated to match any protrusions and/or recesses that are formed by the osteotomy (ies) and the repositioning of the bones. Thus, the seating and/or registration of the registration key 1226 to the bone(s) can confirm and/or assure a surgeon that the bones are where desired and the surgical procedure is prepared for a fixation stage.	295	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	In particular, a unique resection guide can be designed, developed and fabricated for each patient (e.g. patient-specific). The ability of a surgeon and/or technician to predetermine where, and how to orient the resection feature(s) provides for an infinite number of different combinations for making a variety of different osteotomies in a bone. Consequently, a surgeon can predetermine an angle to the osteotomy to define or set to achieve a desired type and/or amount of correction for a bone. Furthermore, the surgeon can make this predetermination based on medical imaging taken of the patient’s foot such that the resection guide is unique to a particular patient. In one embodiment, a surgeon may specify aspects of the resection guide in a prescription for the design and/or fabrication of the resection guide. Depending on the nature of the correction to be performed a surgeon and/or a technician may define a resection guide to produce one of a uniplanar correction, a biplanar correction, and a triplane correction.	285	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	FIG. 13 is a flowchart diagram depicting a method for remediating a condition, according to one embodiment. FIG. 13 is a flowchart of an example method 1300. In some implementations, one or more method steps of FIG. 13 may be performed by a surgeon using one or more of the components described herein. As shown in FIG. 13, method 1300 may include deploying a navigation guide onto a cuneiform and a metatarsal across a tarsometatarsal (TMT) joint of a patient, the navigation guide including: two proximal holes configured to accept and identify a location for two proximal guide pins that provide a proximal reference feature on the cuneiform for a proximal model reference on a cuneiform model of the cuneiform; two distal holes configured to accept and identify a location for two distal guide pins that provide a distal reference feature on the metatarsal for a distal model reference on a metatarsal model of the metatarsal; a coupler configured to connect the two proximal holes and the two distal holes across the TMT until an user operates the coupler to separate the two proximal holes and the two distal holes (block 1302). For example, a surgeon may deploy a navigation guide onto a cuneiform and a metatarsal across a tarsometatarsal ("TMT") joint of a patient, the navigation guide including: two proximal holes configured to accept and identify a location for two proximal guide pins that provide a proximal reference feature on the cuneiform for a proximal model reference on a cuneiform model of the cuneiform; two distal holes configured to accept and identify a location for two distal guide pins that provide a distal reference feature on the metatarsal for a distal model reference on a metatarsal model of the metatarsal; a coupler configured to connect the two proximal holes and the two distal holes across the TMT joint until an user operates the coupler to separate the two proximal holes and the two distal holes, as described above.	297	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	As also shown in FIG. 13, method 1300 may include deploying the two proximal guide pins into the two proximal holes and the two distal guide pins into the two distal holes (block 1304). For example, a surgeon may deploy the two proximal guide pins into the two proximal holes and the two distal guide pins into the two distal holes, as described above.	298	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	As further shown in FIG. 13, method 1300 may include operating the coupler to separate the two proximal holes and the two distal holes (block 1306). For example, a surgeon may operate the coupler to separate the two proximal holes and the two distal holes, as described above.	299	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	As also shown in FIG. 13, method 1300 may include removing the navigation guide (block 1308). For example, a surgeon may remove the navigation guide once proximal guide pins are separated from distal guide pins, as described above.	300	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	As further shown in FIG. 13, method 1300 may include sliding a proximal resection guide over the two proximal guide pins until the proximal resection guide contacts the cuneiform, the proximal resection guide having a cuneiform resection feature configure to guide resection of the cuneiform (block 1310). For example, a surgeon may slide a proximal resection guide over the two proximal guide pins until the proximal resection guide contacts the cuneiform, the proximal resection guide having a cuneiform resection feature configure to guide resection of the cuneiform, as described above.	301	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	As also shown in FIG. 13, method 1300 may include inserting a cutting tool into the cuneiform resection feature to create an osteotomy of the cuneiform (block 1312). For example, a surgeon may insert a cutting tool into the cuneiform resection feature to create an osteotomy of the cuneiform, as described above.	302	Added by DJM Jan 2024	1/6/24, 10:06 PM

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