Dave's PCF WIP: Paragraphs

Paragraphs

Actions	Application	Content	Paragraph Number	Notes	Modified
		Content		Paragraph Number	Notes	Any Field
View Edit Delete	PER-32	In at least one embodiment, the complementary components 930 can include a trajectory guide, a guard, and one or more reduction guides 960, 1660a. In addition, the configuration and type of complementary components 930 can vary as well as the surgical technique in order to perform a surgical procedure for a particular patient. This may be due, at least in part, to challenges presented by certain components of the system 900,1000 (including complementary components 930, trajectory guides, guards, stops, and the like) and/or steps in the surgical technique.	256	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	FIG. 16E-16H illustrate examples of complementary components 930 for the system 1600 to address and/or remediate certain challenges. In one example embodiment, the system 1600 can include a resection guide 1020b having a proximal bone attachment feature 1058 that includes a first fastener 1602 that fits within a first hole 1604 and a second fastener 1606 that fits within a second hole 1608 (not shown in FIG. 16E) of the proximal bone attachment feature 1058. The resection guide 1020b includes a distal bone attachment feature 1060 that includes a third fastener 1610 that fits within a third hole 1612 of the distal bone attachment feature 1060.	257	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	Advantageously, the system 1600 includes resection guide 1020b that includes proximal bone attachment feature 1058 and distal bone attachment feature 1060 and resection feature 1022a and resection feature 1022b. Alternatively, or in addition, the system 1600 also includes one or more of a trajectory guide 1614 and/or a guard 1616.	258	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	A trajectory guide 1614 assists a surgeon by indicating what trajectory a cutting tool will take when used together with one or more resection features 1022 of the resection guide 1020. Said another way, the trajectory guide 1614 indicates a path for a resection that uses at least one of the resection features 1022.	259	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	In the illustrated embodiment, the third fastener 1610 serves as a trajectory guide 1614 and indicates that resection within the resection feature 1022b will result in a resection that travels medial to lateral starting plantar and advancing dorsally. Advantageously, the third fastener 1610 can be made of a radio-opaque material such as metal such that once the third fastener 1610 is deployed, a surgeon can take an x-ray or flouroscopy image of the ankle and visually see the trajectory the planned resection will take. By visually confirming the trajectory for a planned resection a surgeon can be assured that the surgical procedure is proceeding as expected.	260	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	The guard 1616, or stop, is an apparatus, device, or structure that serves to assist a surgeon by preventing resection of parts of tissue where resection is unplanned or undesired. Said another way, the guard prevents resection by a cutting tool beyond a boundary.	261	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	Advantageously, the third fastener 1610 can serve as a guard 1616. The third fastener 1610 can be made of a rigid and hard material such as metal that cannot be cut, or is not readily cut, by a surgical cutting tool. Once the third fastener 1610 is deployed, the third fastener 1610 serves as a guard 1616 or cutting boundary to prevent resection of a first bone through, or beyond, the position of the third fastener 1610. In the illustrated embodiment, the cutting tool may be a reciprocating saw blade that is wider than the third fastener 1610 such that the third fastener 1610 serves as an effective guard 1616.	262	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	Advantageously, the third fastener 1610 can serve as a fastener for the distal bone attachment feature 1060, as a trajectory guide 1614, and as a guard 1616. The features and advantages of using the system 1600 with the distal bone attachment feature 1060, trajectory guide 1614, and/or guard 1616 can greatly reduce stress or pressure a surgeon may experience in performing the surgical procedure. In addition, the distal bone attachment feature 1060, trajectory guide 1614, and/or guard 1616 can facilitate smooth and efficient and prompt execution of the surgical procedure and may improve outcomes from the surgical procedure.	263	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	FIG. 16E illustrates a potential obstacle to removing the resection guide 1020b once the resections are completed. Note that first fastener 1602 and second fastener 1606 extend perpendicular to a long axis of the tibia 224 and are parallel to each other. However, the third fastener 1610 extends at an angle relative to the long axis of the tibia 224 which prevents sliding the resection guide 1020b off without removing one or more of the fasteners.	264	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	FIG. 16F illustrates one way to remove the resection guide 1020b and utilize one or more reduction guides to assist a surgeon in performing an effective and successful reduction. FIG. 16F illustrates that the third fastener 1610 of the distal bone attachment feature 1060 can be and has been removed by the surgeon. Advantageously, the third fastener 1610 was deployed such that once removed, the third fastener 1610 leaves a passage 1618 in a distal bone fragment 224a. The first fastener 1602 and second fastener 1606 can remain in place.	265	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	With the third fastener 1610 removed, the resection guide 1020b can be slid off of the first fastener 1602 and second fastener 1606, as illustrated in FIG. 16F. Next, to facilitate reduction, a surgeon may reinsert the third fastener 1610 into the passage 1618, the same location the third fastener 1610 was originally deployed in. Now, the surgeon has the third fastener 1610 that can be used to position and reorient the distal bone fragment 224a and the first fastener 1602 and second fastener 1606 that can be used to position and reorient the proximal bone fragment 224b. In certain embodiments, the resection guide 1020b and/or a preoperative plan that includes proposed cutting depths within each of the resection features 1022 can be configured to leave a portion of bone 1620 in place, a living hinge, that can also facilitate manipulation and orientation of the bone fragments for the reduction.	266	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	Having stable and reliable access and control of the distal bone fragment 224a and proximal bone fragment 224b can provide important peace of mind for a surgeon prior to and during the surgical procedure. With the first fastener 1602, second fastener 1606, and third fastener 1610 in place within the bone fragments, a surgeon can proceed with the reduction. The system 1600 may include a reduction guide 1660b. The reduction guide 1660b is configured to guide reduction of one or more bone fragments to a reduced condition. In the illustrated embodiment, the reduction guide 1660b guides reduction of the distal bone fragment 224a and the proximal bone fragment 224b.	267	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	In the illustrated embodiment, the reduction guide 1660b includes a reduction anchor 1630 and a reduction stabilizer 1650. The reduction anchor 1630 and reduction stabilizer 1650 may cooperate to provide a stable and completed reduction of the distal bone fragment 224a and proximal bone fragment 224b.	268	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	The reduction anchor 1630 serves to engage one or more fasteners of a first bone fragment, such as proximal bone fragment 224b. In the illustrated embodiment, the reduction anchor 1630 includes a first hole 1632 and a second hole 1634 each configured to engage the first fastener 1602 and the second fastener 1606. The reduction anchor 1630 may also include an open end slot 1636 configured to receive the third fastener 1610.	269	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	In certain embodiments, a resection guide 920 may include one or more bone engagement surfaces 926 and/or one or more landmark registration features 928. In certain embodiments, a landmark registration feature 928 may extend from one or more sides of the resection guide 920 and engage with one or more landmarks of a bone of a patient. Registration of the landmark registration feature 928 to the landmark of the bone can serve to confirm that a surgeon has located a desired placement and/or orientation for a resection guide 920.	143	Added by DJM Jan 2024	1/6/24, 9:48 PM
View Edit Delete	PER-32	In certain embodiments, the bone engagement surfaces 926 are patient-specific: contoured to match a surface of one or more bones the resection guide 920 contacts during the procedure. Alternatively, or in addition, the bone engagement surface 926 may not be patient-specific and may, or may not, contact a bone surface during use of the resection guide 920. Those of skill in the art appreciate that one or more sides of any of the members of the system 900 may include one or more bone engagement surfaces 926. Consequently, one or more sides of the fasteners 910, the resection guide(s) 920, the complementary components 930, and/or the implants 996 may include one or more bone engagement surfaces 926.	144	Added by DJM Jan 2024	1/6/24, 9:48 PM
View Edit Delete	PER-32	The complementary components 930 serve to assist a surgeon during one or more steps of a procedure. Those of skill in the art appreciate that a number of components can serve as complementary components 930. One or more of the features, functions, or aspects of the complementary components 930 can include patient-specific features.	145	Added by DJM Jan 2024	1/6/24, 9:48 PM
View Edit Delete	PER-32	Examples of complementary components 930 include, but are not limited to, an alignment guide 940, a rotation guide 950, a reduction guide 960, a compression guide 970, a positioning guide 980, a fixation guide 990, and/or one or more implants 996. In general, the complementary components 930 serve to assist a surgeon in performing the function included in the name of the complementary component 930. Thus, an alignment guide 940 can help a surgeon align bones, parts of bones, or other parts of a patient as part of a procedure. A rotation guide 950 can help a surgeon rotate one or more bones, parts of bones, or other parts of a patient as part of a procedure.	146	Added by DJM Jan 2024	1/6/24, 9:48 PM
View Edit Delete	PER-32	A reduction guide 960 can help a surgeon position and/or orient one or more bones, parts of bones, or other parts of a patient as part of a procedure in order to reduce the bone, bones, bone parts, or other parts and/or in order to position and/or orient the bone, bones, bone parts, or other parts to a desired position and/or orientation. A compression guide 970 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 a procedure. A positioning guide 980 can help a surgeon position one or more bones, parts of bones, or other parts of a patient as part of a procedure.	147	Added by DJM Jan 2024	1/6/24, 9:48 PM
View Edit Delete	PER-32	In certain embodiments, the positioning guide 980 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 924 or fasteners 910, or the like. Alternatively, or in addition, the positioning guide 980 may be selected from a kit, collection, or repository of a number of positioning guides 980: each having a different configuration for one or more aspects/attributes of the positioning guide 980. 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 980 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 980 to be used, even if the recommended positioning guide 980 is not patient-specific to the particular patient.	148	Added by DJM Jan 2024	1/6/24, 9:48 PM

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