Dave's PCF WIP: Paragraphs

Paragraphs

Actions	Application	Content	Paragraph Number	Notes	Modified
		Content		Paragraph Number	Notes	Any Field
View Edit Delete	PER-12	Referring to Figures 23C, 23D, 23E, and 23H, in certain embodiments, the positioning guide 2300 includes an offset feature 2308. The offset feature 2308 may also be referred to as a translation feature. The offset feature 2308 may be a structure that translates on bone or bone fragment in relation to another. In one embodiment, the offset feature 2308 can be used to translate a posterior bone fragment 2114 in relation to an anterior bone fragment 2116. Those of skill in the art will appreciate that the offset feature 2308 may drive one bone fragment in one direction while the other bone fragment remains stationary, may pull one bone fragment in one direction while the other bone fragment remains stationary, may pull one bone fragment in one direction while driving the other bone fragment in another direction, may drive one bone fragment in one direction while driving the other bone fragment in another direction, may drive both bone fragments in the same direction, or the like.	393	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	In one embodiment, the offset feature 2308 may include an offset distance 2338. The offset distance 2338 may determine how much translation is provided between two bone fragments. In one embodiment, the offset distance 2338 can range from about 0 millimeters (i.e., no translation) to about 10 millimeters. Advantageously, the magnitude of the offset distance 2338 can be set using a model of one or more bones of the patient and/or a model of the positioning guide 2300. In this manner, the offset feature 2308 and/or the offset distance 2338 can be a patient-specific feature that can be defined based, at least in part on a model of a bone of a patient. A surgeon, or other user, can define the offset distance 2338 based on a desired about of translation.	394	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Alternatively, or in addition, a plurality of positioning guide 2300 (either with or without a bone engagement surface 2310, which may also be patient-specific or may not be patient-specific) may be fabricated and provided to a surgeon for possible use during a surgical procedure. The plurality of positioning guides 2300 may be provided in a kit. In one embodiment, each positioning guide 2300 in the kit may include a standard and/or default offset distance 2338. For example, the offset distance 2338 may vary by 5 millimeters between positioning guides 2300 in the kit.	395	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	In this manner, a surgeon may use one positioning guide 2300 initially, may then check the translation and/or alignment and/or results and may opt to change to another different positioning guide 2300, for example, one having a different offset feature 2308 and/or offset distance 2338. In this manner, a surgeon may try different positioning guides 2300 intraoperatively until a positioning guide 2300 is found that provides a desired amount of translation and/or rotation and/or reduction and/or compression for two bones and/or bone fragments of a patient.	396	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	In one embodiment, the offset feature 2308 may be activated by sliding the positioning guide 2300 down along a posterior pin 2220 and an anterior pin 2222 until a medial side 2314 contacts a first bone fragment. Next, the positioning guide 2300 may be pressed against a bone and/or a pin may be pulled in an opposite direction from the direction the positioning guide 2300 is pressed until a second bone fragment engages the medial side 2314. In this manner, the offset feature 2308 can facilitate positioning of two bone fragments prior to fixation. In one embodiment, the offset feature 2308 is configured to translate a posterior bone fragment 2114 relative to an anterior bone fragment 2116. The posterior bone fragment 2114 and anterior bone fragment 2116 may be formed by way of a first osteotomy 2046 or a second osteotomy 2048.	397	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Advantageously, the offset feature 2308 can be designed prior to fabrication of the positioning guide 2300 and may include two offset surfaces of the medial side 2087. The amount of offset and/or configuration can be predefined and approved by a surgeon before fabrication of the positioning guide 2300. In one embodiment, the positioning guide 2300 may also include one or more drill guides for pilot holes or anchor holes for one or more fasteners of a fixation assembly. For example, holes extending from the lateral side 2086 to the medial side 2087 may be used for drill pilot holes and/or K-wires for deployment of bone screws and/or a bone plate.	398	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Figure 24A is a flowchart of an example method 2400. In some implementations, one or more method steps of Figure 24A may be performed by a surgeon using one or more of the systems, apparatuses, and/or components described herein.	399	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	As shown in Figure 24A, method 2400 may include accessing a lateral surface of a calcaneus (block 2402). For example, a surgeon may access a lateral surface of a calcaneus, by using conventional surgical approaches to access the bone and/or to perform a periosteal elevation.	400	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	As also shown in Figure 24A, method 2400 may include positioning a resection guide onto the lateral surface of the calcaneus. The resection guide may include: a body having an anterior side, a posterior side, a medial side, a lateral side, a dorsal side, and a plantar side; a posterior resection feature configured to guide a cutting tool to form a first osteotomy in the calcaneus, the posterior resection feature extending through the resection guide from the lateral side to the plantar medial side along a first trajectory determined based on a calcaneus model of the calcaneus based on medical imaging of the patient’s foot, the calcaneus model configured to match the anatomy of the patient's foot; an anterior resection feature configured to guide a cutting tool to form a second osteotomy that connects with the first osteotomy to form a wedge bone fragment from the calcaneus, the anterior resection feature extending through the resection guide from the lateral side to the plantar medial side along a second trajectory determined based on the calcaneus model; a first bone attachment feature configured to engage the wedge bone fragment after formation of the wedge bone fragment; a second bone attachment feature configured to engage the wedge bone fragment after formation of the wedge bone fragment; a plantar landmark registration feature that extends from the plantar side of the body and is configured to contact a plantar surface of the calcaneus; and a bone engagement surface on the medial side of the body, the bone engagement surface configured to match a contour of the calcaneus when the body is positioned on the calcaneus (block 2404). For example, a surgeon may position a resection guide onto the lateral surface, the resection guide, as described herein.	401	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	As further shown in Figure 24A, method 2400 may include deploying a first fastener into the first bone attachment feature and a second fastener into the second bone attachment feature such that the first fastener and second fastener are parallel relative to each other and enter a portion of the calcaneus that will form the wedge bone fragment (block 2406). For example, a surgeon may deploy a first fastener into the first bone attachment feature and a second fastener into the second bone attachment feature such that the first fastener and second fastener are parallel relative to each other and enter a portion of the calcaneus that will form the wedge bone fragment, as described herein.	402	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	As also shown in Figure 24A, method 2400 may include inserting the cutting tool into the posterior resection feature to a depth predefined in a preoperative plan designed based on the calcaneus model to form the first osteotomy (block 2408). For example, a surgeon may insert the cutting tool into the posterior resection feature to a depth predefined in a preoperative plan designed based on the calcaneus model to form the first osteotomy, as described above.	403	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	As further shown in Figure 24A, method 2400 may include inserting the cutting tool into the anterior resection feature to a depth predefined in a preoperative plan designed based on the calcaneus model to form the second osteotomy, the second osteotomy forming a posterior bone fragment and an anterior bone fragment (block 2410). For example, a surgeon may insert the cutting tool into the anterior resection feature to a depth predefined in a preoperative plan designed based on the calcaneus model to form the second osteotomy, the second osteotomy forming a posterior bone fragment and an anterior bone fragment, as described herein.	404	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	As also shown in Figure 24A, method 2400 may include engaging a posterior pin guide with the posterior resection feature and deploying a posterior pin into a bone attachment feature of the posterior pin guide and engaging an anterior pin guide with the anterior resection feature and deploying an anterior pin into a bone attachment feature of the anterior pin guide (block 2412). For example, a surgeon may engage a posterior pin guide with the posterior resection feature and deploy a posterior pin into a bone attachment feature of the posterior pin guide and engage an anterior pin guide with the anterior resection feature and deploy an anterior pin into a bone attachment feature of the anterior pin guide, as described herein.	405	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	As further shown in Figure 24A, method 2400 may include removing the posterior pin guide and the anterior pin guide and the resection guide (block 2414). For example, a surgeon may remove the posterior pin guide and the anterior pin guide and the resection guide, as described herein.	406	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	In certain embodiments, the bone engagement surface 1926 are patient-specific – contoured to match a surface of one or more bones the resection guide 1920 contacts during the osteotomy procedure. Alternatively, or in addition, the bone engagement surface 1926 may not be patient-specific and may, or may not, contact a bone surface during use of the resection guide 1920. Those of skill in the art appreciate that one or more sides of any of the members of the osteotomy system 1900 may include one or more bone engagement surfaces 1926. Consequently, one or more sides of the fasteners 1910, the resection guide(s) 1920, the complementary components 1930, one or more pin guides 1994, and/or the implants 1996 may include one or more bone engagement surfaces 1926.	281	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	The complementary components 1930 serve to assist a surgeon during one or more steps of an osteotomy procedure. Those of skill in the art appreciate that a number of components can serve as complementary components 1930. Examples of complementary components 1930 include, but are not limited to, an alignment guide 1940, a rotation guide 1950, a correction guide 1960, a compression guide 1970, a positioning guide 1980, a fixation guide 1990, one or more pin guides 1994, and one or more implants 1996. In general, the complementary components 1930 serve to assist a surgeon in performing the function included in the name of the complementary component 1930. Thus, an alignment guide 1940 can help a surgeon align bones, parts of bones, or other parts of a patient as part of an osteotomy procedure. A rotation guide 1950 can help a surgeon rotate one or more bones, parts of bones, or other parts of a patient as part of an osteotomy procedure.	282	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	A correction guide 1960 can help a surgeon position and/or orient one or more bones, parts of bones, or other parts of a patient as part of an osteotomy procedure in order to reduce the bone, bones, bone parts, or other parts and/or in order to correct a position and/or orientation of the bone, bones, bone parts, or other parts. A compression guide 1970 can help a surgeon compress one or more bones, parts of bones, or other parts of a patient together or against an implant as part of an osteotomy procedure. A positioning guide 1980 can help a surgeon position one or more bones, parts of bones, or other parts of a patient as part of an osteotomy procedure. In certain embodiments, the positioning guide 1980 may be designed and fabricated to be patient-specific. The patient-specific aspects can include a patient-specific bone engagement surface, a predefined angle for reorienting one or more bone or bone parts within one or more planes, a predefined position for bone attachment features 1924 or fasteners 1910, or the like. Alternatively, or in addition, the positioning guide 1980 may be selected from a kit, collection, or repository of a number of positioning guides 1980: each having a different configuration for one or more aspects/attributes of the positioning guide 1980. For example, each member of the repository/kit may include a different positioning angle (repositioning or correction angle), the angles may differ by 2 degrees for example. In such an embodiment, each positioning guide 1980 may not be patient-specific to a particular patient, but may provide the desired amount of positioning to meet the goals of the surgeon. In certain embodiments, a preoperative plan generated based on the present disclosure may include a recommendation for the positioning guide 1980 to be used, even if the recommended positioning guide 1980 is not patient-specific to the particular patient.	283	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	A fixation guide 1990 can help a surgeon in completing one or more temporary or permanent fixation steps for one or more bones, parts of bones, or other parts of a patient as part of an osteotomy procedure. One or more pin guides 1994 serve to guide a surgeon in deployment of one or more pins (e.g., K-wires) for use in a surgical procedure. In one embodiment, the one or more pin guides 1994 may engage with, and/or reference for position and/or trajectory off of one or more resection guides 1920 and/or any of the complementary components 1930. In one embodiment, one or more pin guides 1994 may be configured to enable (or facilitate) deployment of one or more pins at a predefined distance, offset, and/or trajectory relative to another component of the osteotomy system 1900 and/or one or more osteotomies formed during a surgical procedure. In another embodiment, one or more pin guides 1994 may be configured to enable (or facilitate) deployment of one or more pins at a patient-specific distance, offset, and/or trajectory relative to another component of the osteotomy system 1900 and/or one or more osteotomies formed during a surgical procedure. The patient-specific distance, offset, and/or trajectory may be predetermined to satisfy the needs of a patient and/or a surgeon.	284	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	One example of a complementary components 1930 may include the compressor / distractor 1000. The compressor / distractor 1000 can be used to compress or distract bones or parts of bones involved in an osteotomy procedure.	285	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Advantageously, the osteotomy system 1900 can help a surgeon overcome one or more of the challenges in performing an osteotomy procedure, particularly on bones of a foot of a patient, such as on the forefoot, midfoot, or hindfoot. One challenge during an osteotomy procedure can be maintaining control of and/or position and/or orientation of a bone, one or more bones, and/or bone pieces/fragments, particular once a resection is performed. Advantageously, the fasteners 1910, resection guide 1920, and/or complementary components 1930 can be configured to assist in overcoming this challenge.	286	Added by DJM Jan 2024	1/6/24, 10:03 PM

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