Dave's PCF WIP: Paragraphs

Paragraphs

Actions	Application	Content	Paragraph Number	Notes	Modified
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View Edit Delete	PER-12	Referring now to Figure 22A, in one embodiment, while the coupler 2212 and bone engagement feature 2208 may extend from the body 2210 in parallel, a fastener 2216 deployed using the pin guide 2200 may deploy at a non-perpendicular angle in relation to the bone. In the illustrated embodiment, this is because as the pin guide 2200 engages with the resection feature 2022 (e.g., posterior resection feature 2022a and/or anterior resection feature 2022b) the coupler 2212 can assume the same angle in relation to the body 2028 as the opening of the resection feature 2022. Consequently, the fastener 2216 deployed using the bone engagement feature 2208 enters the bone at substantially the same angle as an opening of the resection feature 2022. Since the angle of the opening of the resection feature 2022 can be patient-specific, the angle of deployment for one or more fasteners 2216 can also be patient-specific.	373	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Those of skill in the art will appreciate that varies aspects of the pin guide 2200 can be configured and/or customized to meet the needs of a particular patient, surgeon for a surgical procedure. Alternatively, or in addition, at least one of the arm 2206 and the bone engagement feature 2208 can include one or more patient-specific features. These patient-specific features may be defined at least in part based on a bone model of the bone the pin guide 2200 will be used with. For example, a distance of a fastener 2216 from an osteotomy can be controlled and/or set by defining a length of the body 2210. An angle of entry for a fastener 2216 can be controlled by way of an angle of a resection feature 2022 and/or an angle of a coupler 2212 and/or a fin 2218 relative to an angle of a bone engagement feature 2208 used for deployment of the fastener 2216. Advantageously, each of these angles, configurations, aspects, and/or features can be customized and designed in a model of the pin guide 2200 before the pin guide 2200 is fabricated for use. These angles, configurations, aspects, and/or features may be patient-specific features for a pin guide 2200.	374	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Referring still to Figure 22A, in one embodiment, the resection guide 2020a includes a posterior resection feature 2022a and an anterior resection feature 2022b. The osteotomy system 2000 may include a posterior pin guide 2202 and an anterior pin guide 2204. The posterior resection feature 2022a is configured to receive an arm 2206 of the posterior pin guide 2202 and the anterior resection feature 2022b is configured to receive an arm 2206 of the anterior pin guide 2204. The posterior pin guide 2202 includes an arm 2206 that connects a planar fin (e.g., fin 2218) to a bone engagement feature 2208 that includes an opening, such as hole 2214, and a posterior pin 2220. The anterior pin guide 2204 includes an arm 2206 that connects a planar fin (e.g., fin 2218) to a bone engagement feature 2208 that includes an opening, such as hole 2214, and an anterior pin 2222.	375	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	In the embodiment of Figure 22a, the posterior pin guide 2202 is configured to guide the posterior pin 2220 into a posterior bone fragment 2114 (See Figure 21J) parallel to an osteotomy (e.g., first osteotomy 2046) formed using the posterior resection feature 2022a. The anterior pin guide 2204 is configured to guide the anterior pin 2222 into an anterior bone fragment 2116 (See Figure 21J) parallel to an osteotomy (e.g., second osteotomy 2048) formed using the anterior resection feature 2022b. Alternatively, or in addition, the anterior pin guide 2204 is configured to guide the anterior pin 2222 into an anterior bone fragment 2116 (See Figure 21J) substantially parallel to an osteotomy (e.g., second osteotomy 2048) formed using the anterior resection feature 2022b. The anterior pin 2222 may be deployed at an angle that is not parallel to the osteotomy (e.g., second osteotomy 2048) such that when the osteotomy is reduced a predetermined degree of compression is applied to the cut faces of the osteotomy.	376	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Advantageously, fasteners 2216 (e.g., posterior pin 2220 and/or anterior pin 2222) deployed using the pin guide(s) 2200 may be used for subsequent steps in a surgical procedure. In one embodiment, the osteotomy system 2000 may include a positioning guide 2300 as one of the complementary components 1930. In one embodiment, for example, a posterior pin 2220 deployed by way of a posterior pin guide 2202 and an anterior pin 2222 deployed by way of an anterior pin guide 2204 are configured to receive a positioning guide 2300. In certain embodiments, depending on how various components of the osteotomy system 2000 are designed and/or fabricated a positioning guide 2300 may serve to position a posterior bone fragment 2114 and/or an anterior bone fragment 2116, reduce an osteotomy, and/or compress two bone fragments together. Alternatively, or in addition, the positioning guide 2300 may also serve as a correction guide, a rotation guide, an alignment guide, and/or the like.	377	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	The positioning guide 2300 may be similar in form and/or function to the positioning guide 1980 described herein. Alternatively, or in addition, the positioning guide 2300 may be configured differently. In one embodiment, the positioning guide 2300 facilitates positioning one or more bones, bone fragments, implants, and/or instruments for one or more steps of a surgical procedure.	378	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Figures 23A-23G illustrate views of a positioning guide 2300 of an osteotomy system, according to one embodiment. In one embodiment, the positioning guide 2300 includes a body 2302, an anterior alignment feature 2304, and a posterior alignment feature 2306. In another embodiment, the positioning guide 2300 includes the body 2302, the anterior alignment feature 2304, the posterior alignment feature 2306, and an offset feature 2308. In another embodiment, the positioning guide 2300 includes the body 2302, the anterior alignment feature 2304, the posterior alignment feature 2306, the offset feature 2308, and a bone engagement surface 2310.	379	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	The body 2302 may include a lateral side 2312, a medial side 2314, a posterior side 2316, an anterior side 2318, a dorsal side 2320, and a plantar side 2322. Figures 23A-23H illustrate different views of one embodiment of a positioning guide 2300 and the sides of the body 2302.	380	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	The posterior alignment feature 2306 and/or anterior alignment feature 2304 assist a surgeon in aligning and/or positioning and/or orienting a first bone fragment (e.g., posterior bone fragment 2114) and a second bone fragment (e.g., anterior bone fragment 2116). In one embodiment, the surgeon seeks to reduce an osteotomy and bring the first bone fragment and second bone fragment in contact with each other to encourage the two bone fragments to grow together and heal an osteotomy closed. The posterior alignment feature 2306 and/or anterior alignment feature 2304 give a surgeon a secure, reliable, and stable tool to control and/or manipulate the bone fragments, which now may be mostly separated (but for a living hinge, opposite segment of cortical bone) or completely separated.	381	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	In one embodiment, the posterior alignment feature 2306 may include the posterior pin 2220 and the anterior alignment feature 2304 may include the anterior pin 2222. Together with the posterior pin 2220 and the anterior pin 2222, the posterior alignment feature 2306 and/or anterior alignment feature 2304 give a surgeon “handles” for translating and/or rotating the bone fragments. In another embodiment, the posterior alignment feature 2306 is independent of the posterior pin 2220 and the anterior alignment feature 2304 is independent of the anterior pin 2222.	382	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	In the illustrated embodiment, the posterior alignment feature 2306 may be embodied as a slot 2324 that includes a dorsal end 2326, a plantar end 2328, and a length 2330 between the dorsal end 2326 and the plantar end 2328. The slot 2324 may be configured to receive a posterior pin 2220.	383	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	In one embodiment, the length 2330 is patient-specific and may be determined prior to fabricating the positioning guide 2300. In one embodiment, the length 2330 is a predetermined length based on a bone model (e.g., a model of a calcaneus 224). The predetermined length may be set or defined to permit a user such as a surgeon to rotate a first bone fragment (e.g., posterior bone fragment 2114) relative to a second bone fragment (e.g., anterior bone fragment 2116). In certain embodiments, a prescription may include a number of degrees of rotation a surgeon desires for a posterior bone fragment 2114 and a system or apparatus may translate that number of degrees into the predetermined length for the length 2330.	384	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	The anterior alignment feature 2304 may be embodied as a hole 2332 or opening that extends from the lateral side 2312 to the medial side 2314.	385	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	In one embodiment, the slot 2324 and/or the hole 2332 may extend through the body 2302 perpendicular to a planar surface of the lateral side 2312. Alternatively, or in addition, one or the other, or both of the slot 2324 and/or the hole 2332 may extend through the body 2302 at an angle that is not perpendicular to a planar surface of the lateral side 2312. Advantageously, the embodiments of the present disclosure enable a user or surgeon to specifically design the positioning guide 2300 with a desired angle relationship for the slot 2324 and/or the hole 2332 through the body 2302.	386	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	During use of the positioning guide 2300, a surgeon may slide the slot 2324 over the posterior pin 2220 and the anterior pin 2222 over the hole 2332. As the positioning guide 2300 slides down the pins (e.g., posterior pin 2220 and anterior pin 2222) the distance between the slot 2324 and the hole 2332 longitudinally may reduce the osteotomy and bring the two bone fragments into contact with each other. Initially, the posterior pin 2220 may be near the dorsal end 2326. A surgeon can then move the posterior pin 2220 toward the plantar end 2328 to rotate the bone fragment engaged by the posterior pin 2220 about its longitudinal axis. The surgeon determines whether the posterior pin 2220 should be moved to near the plantar end 2328, remain near the dorsal end 2326, or some position in between. With the bone fragments connected to the posterior pin 2220 and/or the anterior pin 2222 translated, reduced, and/or rotated, surgeon can then connect the two bone fragments using temporary or permanent fixation hardware and/or techniques. In such an example, a surgeon can predefine (e.g., the length 2330 and/or the slot 2324) how much rotation is desired and/or adjust the amount of rotation intraoperatively to achieve a desired orientation during the surgery.	387	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	In another embodiment, the anterior alignment feature 2304 may include a slot 2324 and the posterior alignment feature 2306 may include a hole 2332. Alternatively, or in addition, both the anterior alignment feature 2304 and the posterior alignment feature 2306 may each include slot 2324. Alternatively, or in addition, both the anterior alignment feature 2304 and the posterior alignment feature 2306 may each include hole 2332.	388	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Referring to Figures 23B, 23G, and 23H, in one embodiment, a positioning guide 2300 may include a bone engagement surface 2310. The bone engagement surface 2310 may be on the medial side 2314 of the body 2302. The bone engagement surface 2310 may be configured to register to a lateral surface of the posterior bone fragment 2114 and the anterior bone fragment 2116. In certain embodiments, this can mean that the bone engagement surface 2310 contacts and/or engages with the lateral surface of the bone fragments. In particular, recesses of the bone engagement surface 2310 engage with protrusions on the lateral surface and protrusions of the bone engagement surface 2310 engage with recesses on the lateral surface.	389	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	In the illustrated embodiment, the positioning guide 2300 serves to reduce the osteotomy and bring two bone fragments together for fixation and eventual fusion. Accordingly, the bone engagement surface 2310 can be configured to account for a portion of each of the bone fragments (e.g., posterior bone fragment 2114 and anterior bone fragment 2116) after one or more of these bone fragments has been translated and/or rotated to a position below the positioning guide 2300. Advantageously, in certain embodiments, the bone engagement surface 2310 can be defined, at least in part, based a lateral surface of a one or more bone models of bones involved in a surgical procedure. In addition, the bone engagement surface 2310 can be defined, at least in part, based on a planned reduced position of a posterior bone fragment 2114 and/or an anterior bone fragment 2116. The planned reduced position may represent a desired final position of the bone fragment prior to fixation. Advantageously, the bone engagement surface 2310 is configured to resemble, substantially resemble, and/or match the surface of the bone fragments in this condition. In certain embodiments, the bone engagement surface 2310 may engage the lateral surface of the bone fragments such that a surgeon can “feel” the positioning guide 2300 register into place and “feel” that the positioning guide 2300 is in the position planned before the surgical procedure.	390	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	For example, suppose the bone is a calcaneus 224 and the surgical procedure and/or surgeon plans to retain the position of that anterior bone fragment 2116 and to translate and/or rotate the posterior bone fragment 2114 to correct a deformity. For example, a surgeon may perform the osteotomy of the calcaneus 224 to correct a varus deformity of the calcaneus 224. Consequently, the surgeon can plan to perform a superolateral (upward and lateral) translation of the posterior bone fragment 2114. Alternatively, or in addition, the surgeon may plan to rotate the posterior bone fragment 2114 to address a bone condition of the patient. Advantageously, the osteotomy system 2000 enables a surgeon to preplan the procedure and visualize how the procedure can address the condition. Furthermore, a surgeon can define a bone engagement surface 2310 for the positioning guide 2300 that will engage with the surfaces of the posterior bone fragment 2114 and/or the anterior bone fragment 2116 which will confirm intraoperatively that the bone fragments are in the predefined positions relative to each other. Advantageously, the bone engagement surface 2310 is defined, at least in part, based a lateral surface of a calcaneus model of the calcaneus 224. In addition, the bone engagement surface 2310 is defined, at least in part, based on a planned reduced position of the posterior bone fragment 2114 and/or the anterior bone fragment 2116.	391	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	In certain embodiments, where, for example, the positioning guide 2300 includes an offset feature 2308, the bone engagement surface 2310 may include a posterior surface 2334 and an anterior surface 2336. The posterior surface 2334 is configured to engage a surface of a posterior bone fragment 2114 and the anterior surface 2336 is configured to engage a surface of an anterior bone fragment 2116. Advantageously, one or both of the posterior surface 2334 and/or anterior surface 2336 can be configured to include a contour that resembles, substantially resembles, and/or matches a contour of a lateral surface of a posterior bone fragment 2114 and/or anterior bone fragment 2116 after one or the other or both of the bone fragments (e.g., posterior bone fragment 2114 and/or anterior bone fragment 2116) are positioned in preparation for fixation of the bone fragments.	392	Added by DJM Jan 2024	1/6/24, 10:03 PM

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