Dave's PCF WIP: Paragraphs

Paragraphs

Actions	Matter	Content	Para #	Notes	Modified
View Edit Delete	PER-20	The navigation guide 1000 may differ from the navigation guide 900 because the navigation guide 1000 may not include a specific coupler 942. Instead, the navigation guide 1000 may include another feature that enables the separation of guide pins in the set of proximal holes 924 and/or the set of distal holes 926 from each other. In the illustrated embodiment, this feature is a frangible section 1002 between the proximal end 902 and the distal end 904. The frangible section 1002 may be configured to separate the proximal end 902 from the distal end 904 by dividing the body 906 in response to a force delivered by a user to the frangible section 1002. Alternatively, or in addition, the frangible section 1002 may separate one or the other of the set of proximal holes 924 or the set of distal holes 926 from the body 906 in response to a force delivered by a user to the frangible section 1002.	263	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	Those of skill in the art will appreciate that a variety of techniques and/or technologies may be used to implement the frangible section 1002. For example, the body 906 in the frangible section 1002 may be made of a material that can readily broken and/or that is biocompatible for use in a body of a patient. Examples of such materials include, but are not limited to, Polylactic Acid (PLA), Polyglycolic Acid (PGA), Poly(lactic-co-glycolic acid) (PLGA), Magnesium Alloys, Bioabsorbable Metals, Biocompatible Ceramics, and the like.	264	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	Alternatively, or in addition, in the illustrated embodiment, the frangible section 1002 may also include structures that facilitate breaking apart the navigation guide 1000 when needed. For example, the frangible section 1002 may include openings 1004 (of a shape such as oval) that can facilitate breaking about the frangible section 1002.	265	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	FIG. 10B illustrates one example of a navigation guide 1000 that may not include an explicit coupler, but instead includes another aspect or feature that enables separation of the proximal end 902 and the distal end 904. The force required to break up the frangible section 1002 can be of a variety of different types such as a strike force, a prying force, a torque, cutting, drilling, or the like. Further, a variety of different instruments may be used to break the frangible section 1002 such as a cutting tool, a mallet, a clamp, a probe, an osteotome, a bone rongeur, or the like. In one embodiment, the breaking of the frangible section 1002 separates the proximal end 902 from the distal end 904 or the set of proximal holes 924 from the set of distal holes 926 in a manner that does not leave any shards or parts of the frangible section 1002 behind in the patient. Alternatively, or in addition, the frangible section 1002 is made of a material that can biodegrade safely in the patient if left behind. Of course, certain shards may be removed as part of the surgical procedure.	266	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	The navigation guide 1000 illustrates another difference from the embodiment of the navigation guide 900. The navigation guide 1000 includes a plurality of bone attachment features. The plurality of bone attachment features may be implemented on a proximal end 902 and/or a distal end 904. In the illustrated embodiment, the plurality of bone attachment features are implemented in a plurality of sets of distal bone attachment features 952a,b. The plurality of sets of bone attachment features are each configured to receive a set of distal guide pins 930. The plurality of sets of bone attachment features enable a surgeon to decide intraoperatively which bone attachment features to deploy guide pins into. Alternatively, or in addition, a surgeon may choose to deploy guide pins into multiple bone attachment features of the plurality of sets of bone attachment features.	267	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	As illustrated in FIG. 10B, each set of distal bone attachment features 952a,b are positioned radially about a plane perpendicular to a long axis 940 of the metatarsal at a different angle relative to the set of proximal bone attachment features 950. These different angles may be predetermined to provide different amounts of rotation of a metatarsal in a subsequent step of the surgical procedure. In certain embodiments, the different angles may differ by about 5 degrees relative to each other.	268	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	FIG. 11A illustrates a top perspective view of a proximal resection guide 820a according to one embodiment. In one embodiment, the proximal resection guide 820a is configured to address the deformity. The proximal resection guide 820a can be configured to engage the set of proximal guide pins 928 (e.g., K-wires) positioned using the navigation guide 900.	269	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	The proximal resection guide 820a includes a body 1102, a resection feature 1104, and one or more openings 1106. The resection feature 1104 guides resection of tissue such as a bone. In particular, the resection feature 1104 can guide a surgeon in performing an osteotomy. Advantageously, the position, size, depth, and angle of the resection feature 1104 relative to the a long axis of the tissue such as a bone can be preplanned, predetermined, such that forming a cut face using the resection feature 1104 will enable implementation of a correction that addresses a condition of a patient. Such planning and precision is possible because the proximal resection guide 820a can be designed based on medical imaging of the patient’s anatomy.	270	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	In the illustrated embodiment, the proximal resection guide 820a may be patient-specific and specifically designed for use in doing an osteotomy on a cuneiform of a patient. Consequently, the resection feature 1104 may be referred to as a cuneiform resection feature 1104. In one embodiment, the cuneiform resection feature 1104 may be configured to guide resection of the cuneiform to form a cut face of the cuneiform for a correction of a condition present in a patient’s foot.	271	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	The cuneiform resection feature 1104 may be specifically designed for one particular patient. Alternatively, or in addition, the cuneiform resection feature 1104 may be designed for use with all patients and may enable a predefined osteotomy such as forming a cut face perpendicular to a long axis of a bone being cut. In such an embodiment, another resection feature (e.g., distal resection guide 820b) may be angled in order to implement a desired correction.	272	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	The one or more openings 1106 are positioned and/or angled through the body 1102 to slide over, engage, or accept guide pins. In particular, the one or more openings 1106 may be configured to engage with the set of proximal guide pins 928. In certain embodiments, the set of proximal guide pins 928 may be positioned prior to deploying the proximal resection guide 820a and the one or more openings 1106 may engage a set of proximal guide pins 928 already secured to a bone, such as a cuneiform.	273	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	FIG. 11B illustrates a bottom perspective view of a proximal resection guide 820a according to one embodiment. Advantageously, in certain embodiments, the proximal resection guide 820a can also include a bone engagement surface 1110. FIG. 11B illustrates one example of a bone engagement surface 1110. The bone engagement surface 1110 can facilitate proper positioning/registering of the proximal resection guide 820a to a desired location on one or more bones and/or transverse to a joint, such as a TMT. The bone engagement surface 1110 may cooperate with the guide pins (e.g., set of proximal guide pins 928) to ensure secure positioning of the proximal resection guide 820a. Advantageously, the fidelity of the medical imaging and modeled surface of the bone as well as the fidelity of the bone engagement surface 1110 enable the surgeon to accurately position the proximal resection guide 820a.	274	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	FIG. 11C illustrates a top perspective view of a distal resection guide 820b according to one embodiment. In one embodiment, the distal resection guide 820b is configured to address the deformity. The distal resection guide 820b can be configured to engage the set of distal guide pins 930 (e.g., K-wires) positioned using the navigation guide 900 or another guide or manually.	275	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	The distal resection guide 820b includes a body 1112, a resection feature 1114, and one or more openings 1116. The resection feature 1114 guides resection of tissue such as a bone. In particular, the resection feature 1114 can guide a surgeon in performing an osteotomy. Advantageously, the position, size, depth, and angle of the resection feature 1114 relative to the a long axis of the tissue such as a bone can be preplanned, predetermined, such that forming a cut face using the resection feature 1114 will enable implementation of a correction that addresses a condition of a patient. Such planning and precision is possible because the distal resection guide 820b can be designed based on medical imaging of the patient’s anatomy.	276	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	In the illustrated embodiment, the distal resection guide 820b may be patient-specific and specifically designed for use in doing an osteotomy on a metatarsal of a patient, such as a proximal end of a metatarsal. Consequently, the resection feature 1114 may be referred to as a metatarsal resection feature 1118. In one embodiment, the metatarsal resection feature 1118 may be configured to guide resection of the metatarsal to form a cut face of the metatarsal for a correction of a condition present in a patient’s foot.	277	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	The metatarsal resection feature 1118 may be specifically designed for one particular patient. Alternatively, or in addition, the metatarsal resection feature 1118 may be designed for use with all patients and may enable a predefined osteotomy such as forming a cut face perpendicular to a long axis of a bone being cut. In such an embodiment, another resection feature (e.g., proximal resection guide 820a) may be angled in order to implement a desired correction.	278	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	A resection feature can take a variety of forms. Often the resection feature includes one or more openings that are sized to receive a cutting tool and provide clearance and/or allowance for the cutting tool to cut tissue of the patient.	279	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	The one or more openings 1116 are positioned and/or angled through the body 1112 to slide over, engage, or accept guide pins. In particular, the one or more openings 1116 may be configured to engage with the set of distal guide pins 930. In certain embodiments, the set of distal guide pins 930 may be positioned prior to deploying the distal resection guide 820b and the one or more openings 1116 may engage a set of distal guide pins 930 already secured to a bone, such as a metatarsal.	280	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	FIG. 11D illustrates a bottom perspective view of a distal resection guide 820b according to one embodiment. Advantageously, in certain embodiments, the distal resection guide 820b can also include a bone engagement surface 1120. FIG. 11B illustrates one example of a bone engagement surface 1120. The bone engagement surface 1120 can facilitate proper positioning/registering of the distal resection guide 820b to a desired location on one or more bones and/or transverse to a joint, such as a TMT. The bone engagement surface 1120 may cooperate with the guide pins (e.g., set of distal guide pins 930) to ensure secure positioning of the distal resection guide 820b. Advantageously, the fidelity of the medical imaging and modeled surface of the bone as well as the fidelity of the bone engagement surface 1120 enable the surgeon to accurately position the distal resection guide 820b.	281	Added by DJM Jan 2024	1/6/24, 10:06 PM
View Edit Delete	PER-20	Referring to FIGS. 11A-11D, embodiments of the present disclosure may use one or the other or both of the proximal resection guide 820a and the distal resection guide 820b for a surgical procedure. In certain embodiments, using two separate resection guides 820 may be advantageous because use of separate resection guides 820 provide for space/clearance within an opening in the skin of the patient for placement and use of each separate guide 820. For example, each guide 820 may be used in sequence separately one after the other with the first removed while the second is in use. This can provide more room for performing each osteotomy on two adjacent bones.	282	Added by DJM Jan 2024	1/6/24, 10:06 PM

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