Dave's PCF WIP: Paragraphs

Paragraphs

Actions	Application	Content	Paragraph Number	Notes	Modified
		Content		Paragraph Number	Notes	Any Field
View Edit Delete	PER-12	Advantageously, the osteotomy system 1900 can help a surgeon in positioning, placing, and/or orienting a resection guide accurately. Modern techniques may include preoperative planning, simulation, or even practice using computer models, virtual reality systems, augmented reality systems or the like. However, simulations and models are still different from positioning a resection guide on a patient’s bone, joint, or body part during the procedure. The osteotomy system 1900 can include a number of features to assist the surgeon with the positioning. In one embodiment, the resection guide 1920 can include one or more landmark registration features 1928.	287	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 in securing guides of the osteotomy system 1900, such as a resection guide, as well as how to readily remove the guide (e.g., resection guide) without disturbing a reduction, shifting, reorienting, or repositioning one or more bones or parts of bones while removing the guide. In certain embodiments, the osteotomy system 1900 is configured to permit removal of a guide while keeping temporary fasteners in place for use in subsequent steps of an osteotomy procedure. Alternatively, or in addition, the osteotomy system 1900 facilitates positioning of temporary fasteners during one step of the wedge osteotomy procedure for use in a subsequent step of the wedge osteotomy procedure. Removal of a guide during an osteotomy procedure can be particularly challenging where translation and/or rotation of the bones involved in the wedge osteotomy procedure is required for the success of the wedge osteotomy procedure. Advantageously, the osteotomy system 1900 accommodates translation and/or rotation of the bones during the wedge osteotomy procedure while facilitating a successful outcome for the wedge osteotomy procedure.	288	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Advantageously, the components of the osteotomy system 1900 can be specifically designed for a particular patient. Alternatively, or in addition, the components of the osteotomy system 1900 can be specifically designed for a class of patients. Each of the components of the osteotomy system 1900 can be designed, adapted, engineered and/or manufactured such that each feature, attribute, or aspect of the component is specifically designed to address one or more specific indications present in a patient. Advantageously, the cuts made for the osteotomy procedure can be of a size, position, orientation, and/or angle that provides from an optimal osteotomy with minimal risk of undesirable resection. In one embodiment, the components of the osteotomy system 1900 can be configured such that an osteotomy is performed that enables a correction in more than one plane in relation to the parts of the body of the patient. For example, cut channels in a resection guide 1920 can be oriented and configured such that when the bones are fused/fixated the correction results from translation, rotation, and/or movement of bones or bone parts in two or more planes (e.g., sagittal and transverse).	289	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	In certain embodiments, the components of the osteotomy system 1900 may be made as small as possible to minimize the amount of soft tissue that is opened in the patient for the osteotomy procedure. Alternatively, or in addition, walls and/or sides of the components may be beveled and/or angled to avoid contact with other hard tissue or soft tissues in the operating field for the osteotomy procedure.	290	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 for certain wedge osteotomy procedure a complementary components 1930 may not be needed or a given complementary components 1930 may be optional for use in the wedge osteotomy procedure. Similarly, those of skill in the art will appreciate that certain features of the fasteners 1910, resection guides 1920, and/or complementary components 1930 can be combined into one or more of apparatus or devices or may be provided using a plurality of separate devices.	291	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Dwyer osteotomy	292	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Figure 20 illustrates an exemplary osteotomy system 2000 for a Dwyer osteotomy, according to one embodiment. In one embodiment, an osteotomy system 2000 may include a resection guide 2020 (two embodiments 2020a, 2020b) and at least one complementary component 1930. In such an embodiment, the resection guide 2020 and/or the at least one complementary component 1930 may include a patient-specific feature. In one embodiment, the osteotomy system 2000 includes at least one complementary component 1930 selected from a group of complementary components 1930. Examples of members of the group, include, but are not limited to, an alignment guide, a rotation guide, a compression guide, a correction guide, a positioning guide, a pin guide, a fixation guide, and the like. One or more of the guides that are included in the at least one complementary component 1930 can include a patient-specific feature, including but not limited to, a bone engagement surface, a bone attachment feature, a resection feature, a landmark registration feature, a handle, or the like.	293	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	In certain embodiments, a single complementary component 1930 may be configured to perform functions of two or more other components in the group of at least one complementary component 1930. The other components may be combined because of aspects identified in one or more bone models of one or more bones of a patient and may be combined to form a patient-specific component. Alternatively, or in addition, other components may be combined to reduce the number of instruments used or required for a surgical procedure and/or to reduce the number of steps in a surgical procedure. Furthermore in certain embodiments, osteotomy system 2000 may be configured and designed first in a virtual environment together with a surgical technique that minimizes the number of complementary component 1930 used or needed and/or the number of steps in the surgical technique. For example, the resection guide 2020 and/or at least one fastener 2010 and/or complementary component 1930 may cooperate with each other to provide instruments (that may or may not include patient-specific aspects) and a surgical technique that provides a favorable outcome for the patient and places a least amount of pressure on the surgeon.	294	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	In the illustrated embodiment, the osteotomy system 2000 includes at least one fastener 2010, a resection guide 2020 (two embodiments 2020a, 2020b), one or more pin guides 2200, and a positioning guide 2300.	295	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Figures 21A-21J illustrate views of a resection guide 2020 of the osteotomy system of Figure 20, according to one embodiment. In one embodiment, the resection guide 2020a includes one or more resection features 2022 (e.g., posterior resection feature 2022a, anterior resection feature 2022b), one or more bone attachment features 2024 (e.g., first bone attachment feature 2024a, second bone attachment feature 2024b), one or more handles 2026 (e.g., handles 2026a,b), a body 2028, and a bone engagement surface 2033.	296	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Figure 21A illustrates a perspective plantar-posterior view of one embodiment of a resection guide 2020a that includes posterior resection feature 2022a, anterior resection feature 2022b. The illustrated embodiment includes two resection features 2022 and two bone attachment features 2024.	297	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	The body 2028 includes a lateral side 2030, a medial side 2032, an anterior side 2034, a posterior side 2036, a dorsal side 2038, and a plantar side 2040. See Figures 21A-21I. Generally, the sides of the body 2028 refer to the direction the sides face when a resection guide 2020 is in use. The medial side 2032 faces the bone of the patient and in the medial direction relative to the patient. The lateral side 2030 faces away from the patient and in the lateral direction. The anterior side 2034 faces in the anterior direction and the posterior side 2036 faces in the posterior direction relative to the patient.	298	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Resection features 2022 facilitate performing an osteotomy on a bone of a patient. The resection features 2022 may serve as a template or guide for manipulating a cutting tool to create the osteotomy. In one embodiment, the resection features 2022 guide a cutting tool along a predetermined trajectory to cut into and/or through the bone.	299	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Figure 21B illustrates an embodiment of a resection guide 2020a that includes a posterior resection feature 2022a and an anterior resection feature 2022b. Figure 21B illustrates a perspective dorsal-posterior view of one embodiment of a resection guide 2020a. In certain embodiments, the posterior resection feature 2022a and anterior resection feature 2022b may be parallel to each other at a surface of the lateral side 2030 of the body 2028. Alternatively, or in addition, the posterior resection feature 2022a and anterior resection feature 2022b may be non-parallel with respect to each other at the surface of the lateral side 2030 of the body 2028.	300	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Figure 21C illustrates a posterior perspective view of a resection guide 2020a.	301	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Figure 21D illustrates an anterior perspective view of a resection guide 2020a.	302	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Referring to Figures 21C and 21D, the resection guide 2020a may include one or more one or more bone attachment features 2024. The one or more bone attachment features 2024 secure the resection guide 2020a to the bone for one or more osteotomies. In one embodiment, a single bone attachment feature 2024 may be sufficient to secure the resection guide 2020a for a surgical procedure.	303	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	In the illustrated embodiment, a bone attachment feature 2024 is embodied in the form of an opening that extends from the lateral side 2030 to the medial side 2032. The opening is sized to receive and securely engage (e.g., by way of a friction fit) with a fastener 2010 deployed through the opening and into the bone. In one embodiment, a single bone attachment feature 2024. In another embodiment, a bone attachment feature 2024 may be made up of two or more bone attachment features (e.g., bone attachment feature 2024a and bone attachment feature 2024b) In the illustrated embodiment, the bone attachment features 2024 includes a first bone attachment feature 2024a and a second bone attachment feature 2024b. Using two bone attachment features 2024 can be advantageous because two bone attachment features 2024 secured to the bone can prevent the resection guide 2020a from rotating about one single bone attachment feature 2024.	304	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	One challenge in performing an osteotomy may be in how to control bone fragments formed by the osteotomy. Great effort is made to perform a surgical procedure with the smallest incisions to reduce the disruption of tissue and expedite healing and recovery. However, such efforts may increase the challenges of controlling bone fragments formed by the osteotomy. For example, suppose the resection guide 2020a is used for a wedge osteotomy. Upon successful completion of the osteotomy, a wedge bone fragment may be created below the resection guide 2020a. Advantageously in the illustrated embodiment, at least one bone attachment feature 2024 is positioned between the posterior resection feature 2022a and the anterior resection feature 2022b. Consequently, when an osteotomy using both the posterior resection feature 2022a and the anterior resection feature 2022b is completed, the resulting wedge bone fragment remains secured to the at least one bone attachment feature 2024. Of course, a fastener 2010 for the at least one bone attachment feature 2024 may extend into the bone to a depth such that the fastener 2010 does not interfere with completion of the wedge osteotomy. After the wedge osteotomy a surgeon can remove the wedge bone fragment, if desired, using the fastener 2010.	305	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	In the illustrated embodiment, the bone attachment features 2024 are aligned with each other. In another embodiment, the bone attachment features 2024 may be unaligned with each other. In certain embodiments, the bone attachment features 2024 are configured such that fasteners 2010 that used with the bone attachment features 2024 are parallel to each other. In this way, the resection guide 2020a can be readily slid off of the fasteners 2010 while the fasteners 2010 remain in the bone. Advantageously, the remaining fasteners 2010 can be reused in subsequent steps of a surgical procedure.	306	Added by DJM Jan 2024	1/6/24, 10:03 PM

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