Dave's PCF WIP: Paragraphs

Paragraphs

Actions	Application	Content	Paragraph Number	Notes	Modified
		Content		Paragraph Number	Notes	Any Field
View Edit Delete	NXT-5PROV NXT-5, 6, 7, 8	Those of skill in the art will recognize that the features, functions, and advantages of the offset section 116 can be integrated into an intramedullary nail such as intramedullary nail 100, can be integrated into an adapter 204 such as the adapter 204 used with the example intramedullary nail 202 described above, can be integrated into an inserter used to insert an intramedullary nail into an intramedullary canal of a patient, or can be implemented in whole, or in part, in both the intramedullary nail and/or an adapter or an inserter. For example, in one embodiment, an adapter, or driver of an inserter, may include a second bend angled anteriorly from a longitudinal axis the intramedullary nail and a distal end of an intramedullary nail may include a first bend angled posteriorly from a longitudinal axis the intramedullary nail, with a suitable coupling between the first bend and the second bend. Each of these embodiments and other variations thereof are considered within the scope of the present disclosure.	72	Added by DJM 8 2021	8/16/21, 12:00 AM
View Edit Delete	NXT-5PROV NXT-5, 6, 7, 8	Those of skill in the art will also recognize that the features, functions, and advantages of the offset section 116 are not limited to one or more bends in an anterior and/or posterior direction and can be used for prostheses, adapters, and/or instruments to provide one or more offset sections 116 that bend in other directions, including, but not limited to, medial/lateral, anterior/posterior, superior/inferior, cephalad/caudal, and the like. The offset section 116 enables use of prostheses in procedures to avoid existing tissue or structures that a surgeon desires to not disturb.	73	Added by DJM 8 2021	8/16/21, 12:00 AM
View Edit Delete	NXT-5PROV NXT-5, 6, 7, 8	In certain embodiments, various names and/or labels may be used for the section 116 and/or an adapter 204 used with embodiments of the present disclosure. For example, the section 116 may also be referred to as an offset section, a detour section, a routing section, a rerouting section, an “S-shaped” section, or the like. Alternatively, or in addition, the section 116 may be referred to as an accessibility section or accommodation section because the section enables an operator to access the medullary cavity when an arthroplasty implant is deployed or because the section accommodates deployment of an intramedullary nail even when an arthroplasty implant is deployed. Alternatively, or in addition, the adapter 204 (or inserter driver) may also be referred to as an offset adapter, a detour adapter, a routing adapter, a rerouting adapter, an “S-shaped” adapter, or the like. Alternatively, or in addition, the adapter 204 may be referred to as an accessibility adapter or accommodation adapter because the adapter enables an operator to access the medullary cavity when an arthroplasty implant is deployed or because the adapter accommodates deployment of an intramedullary nail even when an arthroplasty implant is deployed.	74	Added by DJM 8 2021	8/16/21, 12:00 AM
View Edit Delete	NXT-5PROV NXT-5, 6, 7, 8	The intramedullary nail 100, offset section 116, intramedullary nail 202, and/or adapter 204 may be made from a variety of materials. In one embodiment, the materials used have sufficient flexibility to enable the intramedullary nail 100 or intramedullary nail system 200 to be deployed into the intramedullary canal either retrograde or antegrade. For example, in one embodiment, intramedullary nail 100, offset section 116, intramedullary nail 202, and/or adapter 204 may be made from a shape memory alloys such as Nitinol. Accordingly, such components may bend during deployment and then return to an original shape after deployment.	75	Added by DJM 8 2021	8/16/21, 12:00 AM
View Edit Delete	NXT-5PROV NXT-5, 6, 7, 8	Figure 3A is a perspective view of an inserter 300a connected to one of the intramedullary nail 100 of FIG. 1A or the intramedullary nail 202 and adapter 204 of FIG. 2A deployed within a long bone, such as a femur 102, according to one embodiment. The inserter 300a is a tool or instrument that enables and/or facilitates deployment and/or retraction of the intramedullary nail 100 and/or intramedullary nail system 200 (e.g., intramedullary nail 202 and adapter 204).	76	Added by DJM 8 2021	8/16/21, 12:00 AM
View Edit Delete	NXT-5PROV NXT-5, 6, 7, 8	Figure 3B is a perspective view of an inserter 300a and one of the intramedullary nail of FIG. 1A and/or the intramedullary nail system of FIG. 2A, according to one embodiment. The inserter 300a is disconnected from the intramedullary nail of FIG. 1A and/or the intramedullary nail system of FIG. 2A. The inserter 300a may include a handle 310, a driver 320, and a guide 330.	77	Added by DJM 8 2021	8/16/21, 12:00 AM
View Edit Delete	NXT-5PROV NXT-5, 6, 7, 8	Those of skill in the art will recognize that the intramedullary nail 202 adapter 204 and adapter 204 can be adapted to engage a first coupling 216 at a proximal end 206 and/or the distal end 208. Alternatively, or in addition, the intramedullary nail 100 can be manufactured with the section 116 on either or both the proximal end 106 and/or the distal end 104. In this manner the benefits of an offset section 116 can be gained on either end of the intramedullary nail 100 or intramedullary nail 202 or on both ends.	67	Added by DJM 8 2021	8/16/21, 12:00 AM
View Edit Delete	NXT-5PROV NXT-5, 6, 7, 8	In one embodiment, the driver 320 includes a threaded distal end 322, a shaft 324, and a thumb-screw 326. The threaded distal end 322, shaft 324, and thumb-screw 326 can be used to connect the driver 320 to the coupling 110/third coupling 220. The thumb-screw 326 is connected to the shaft 324 such that rotation of the thumb-screw 326 about the longitudinal axis of the shaft 324 turns the threaded distal end 322 to engage or disengage with the coupling 110/third coupling 220. The thumb-screw 326 can be rotated by an operator.	79	Added by DJM 8 2021	8/16/21, 12:00 AM
View Edit Delete	NXT-5PROV NXT-5, 6, 7, 8	In the illustrated embodiment, the driver 320 includes a straight shaft 324 and straight driver 320. However, as described above, different features of the section 116 and/or adapter 204 may be coupled, connected, or integrated into the driver 320 of the inserter 300a. For example, the distal end 322 may include an adapter 204 with two bends 224, 226 as described above that engage a first coupling 216 of an intramedullary nail 202. In another example, the distal end 322 may include a bend such as second bend 226 and an adapter 204 or an intramedullary nail 202 may include a first bend 224. Such variations on the position and location of the bends 118/120/224/226 between the driver 320, an adapter 204, and an intramedullary nail 202/100 are within the scope of this present disclosure.	80	Added by DJM 8 2021	8/16/21, 12:00 AM
View Edit Delete	NXT-5PROV NXT-5, 6, 7, 8	The guide 330 provides a visual indicator for a surgeon or other user regarding where features of an intramedullary nail 100 or intramedullary nail system 200 are physically during deployment or retraction. In one embodiment, the guide 330 includes a section 332 and a shaft 334. The section 332 and shaft 334 may extend from the inserter 300a parallel to, and aligned with, the section 116 and shaft 108/210 of the intramedullary nail 100 or intramedullary nail system 200. Similarly, the section 332 and shaft 334 may include openings 336 positioned in alignment with openings 132 of the intramedullary nail 100 or intramedullary nail system 200. In this manner, a surgeon can visually see the progression and position of the intramedullary nail 100 or intramedullary nail system 200 and/or adapter 204 within the patient during a deployment or retraction.	81	Added by DJM 8 2021	8/16/21, 12:00 AM
View Edit Delete	NXT-5PROV NXT-5, 6, 7, 8	Referring now to FIG. 3A, the intramedullary nail 100 or intramedullary nail system 200 facilitates retrograde deployment of an IMDF for patients who already have an arthroplasty implant. Suppose a patient has suffered a fracture 340 near the distal metaphysis of the femur 102. Patients who have received an implant in an arthroplasty procedure may have a greater risk of periprosthetic fractures (e.g., fracture 340).	82	Added by DJM 8 2021	8/16/21, 12:00 AM
View Edit Delete	NXT-5PROV NXT-5, 6, 7, 8	Suppose further that a surgeon has decided to use the intramedullary nail 100 or intramedullary nail system 200 for fixation of the femur 102. The surgeon may reduce the parts of the femur 102 around the fracture 340 using either an open reduction or a closed reduction. Next, a surgeon may create an entry point posterior to the medial and lateral condyles of the femur 102, within the intercondylar fossa. Advantageously, the entry point is posterior to an arthroplasty implant of the patient. Next, a surgeon may ream an opening to connect the entry point through the soft tissue to the intramedullary cavity. In one embodiment, the reamed opening may connect to the intramedullary cavity at about the same angle as the first bend 118 in relation to the longitudinal axis 114.	83	Added by DJM 8 2021	8/16/21, 12:00 AM
View Edit Delete	NXT-5PROV NXT-5, 6, 7, 8	Following reaming, a surgeon may use the inserter 300a to deploy the intramedullary nail 100 or intramedullary nail system 200 by passing the nail through the entry point and reamed opening and into the intramedullary cavity. The proximal end 106 of the intramedullary nail may fit tight as it passes through the reamed opening and into the intramedullary cavity. However, once the nail slides more distally into the intramedullary cavity the section 116 reaches the reamed opening and intramedullary cavity at which point pressure and stress on the nail being deployed is relieved and the nail fits snuggly within the femur 102 with the section 116 positioned as illustrated in FIG 3A.	84	Added by DJM 8 2021	8/16/21, 12:00 AM
View Edit Delete	NXT-5PROV NXT-5, 6, 7, 8	In certain instances, the fracture 340 displacement and/or angulation may be so great that femur fragments can be moved a great degree relative to each other. In such instances, the pressure on the intramedullary nail during deployment is minimal since the fragments can be positioned during intramedullary nail deployment and reduced to proper alignment, position, and angulation after the deployment.	85	Added by DJM 8 2021	8/16/21, 12:00 AM
View Edit Delete	NXT-5PROV NXT-5, 6, 7, 8	Figure 3C is a perspective view of an inserter 300b and the intramedullary nail system of FIG. 2A, according to one embodiment. The inserter 300b is disconnected from the intramedullary nail of FIG. 1A and/or the intramedullary nail system of FIG. 2A. The inserter 300b may include a handle 310, a driver 320, and a guide 330 similar to those discussed in relation to inserter 300a.	86	Added by DJM 8 2021	8/16/21, 12:00 AM
View Edit Delete	NXT-5PROV NXT-5, 6, 7, 8	The inserter 300b differs from inserter 300a in that the distal end 322 of inserter 300b, in the illustrated embodiment, includes an offset section 116. In one embodiment, the distal end 104 of the intramedullary nail 202 includes a coupling configured to engage the intramedullary nail 202. In the illustrated embodiment, the intramedullary nail 202 is straight and does not include an offset section 116.	87	Added by DJM 8 2021	8/16/21, 12:00 AM
View Edit Delete	NXT-5PROV NXT-5, 6, 7, 8	The intramedullary nail 100 or intramedullary nail system 200 may be used as primary fixation or secondary/supplemental fixation together with other fixation devices/techniques for fixation regardless of a position of a fracture (i.e., mid, distal, proximal sections of a long bone). Similarly, the intramedullary nail 100 or intramedullary nail system 200 can be used in relation to any type of fracture on any type of long bone, such as a femur, humerus, and/or tibia and from either end (antegrade or retrograde). In addition, the intramedullary nail 100 or intramedullary nail system 200 may be used for deployment of an antegrade intramedullary nail or a retrograde intramedullary nail.	88	Added by DJM 8 2021	8/16/21, 12:00 AM
View Edit Delete	NXT-5PROV NXT-5, 6, 7, 8	Advantageously, the fixation system 1200 includes an intramedullary nail 1202 and fixation plate 1204 that, each deployed alone, do not provide sufficient fixation of the long bone, but when deployed together do provide a desired level of fixation of the long bone. Because the intramedullary nail 1202 and fixation plate 1204 are part of a fixation system 1200 that provides sufficient fixation when deployed, one or the other or both of the intramedullary nail 1202 and the fixation plate 1204 can be made from more light weight, thinner, less expensive, lighter, and less rigid materials than if one or the other or both of the intramedullary nail 1202 and fixation plate 1204 were used alone to provide fixation of the long bone.	144	Added by DJM 8 2021	8/16/21, 12:00 AM
View Edit Delete	NXT-5PROV NXT-5, 6, 7, 8	In one embodiment, the proximal extender 640 may also include a multi-position slot 642 that passes through a proximal extender part 644. The multi-position slot 642 may serve to accept a fastener that secures the proximal extender part 644 to a corresponding proximal extender part 644 when the lateral bone plate 600 and proximal extender 640 are deployed together. In one embodiment, the proximal extender 640 and proximal extender part 644 can be secured to each other through the multi-position slot 642 and a set screw (see FIG. 14A) that may engage threads of a fastener opening or another opening in the proximal plate part 620. Advantageously, the multi-position slot 642 enables an operator to position the proximal extender 640 relative to the lateral bone plate 600 using one or more predefined positions along the multi-position slot 642. In this manner, a user can adapt a particular lateral bone plate 600 and proximal extender 640 to particular needs of a patient and/or a fixation scenario.	134	Added by DJM 8 2021	8/16/21, 12:00 AM
View Edit Delete	NXT-5PROV NXT-5, 6, 7, 8	Figure 10C illustrates one example of how the proximal extender part 644 can slidably engage with the proximal plate part 620. The proximal extender part 644 can include a pair of lips 632 that slidably engage the proximal plate part 620 when the two parts are joined.	135	Added by DJM 8 2021	8/16/21, 12:00 AM

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