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Delete 		PER-24 Accordingly, to retain the advantages of parallel pins for the bone attachment features 1828 and provide a stable first resection guide 1822, the first resection guide 1822 can include one or more stabilizers 1892. In one embodiment, a stabilizer 1892 is an opening in the body 1902 configured to accept a pin deployed through the opening and into the bone(s). Advantageously, the opening extends through the body 1902 at an oblique angle relative to the angle that openings for one or more bone attachment features 1828 pass through the body. This angle pin of the stabilizer 1892 ensures that the body 1902 remains stable against the bone(s) for the osteotomy. Of course, the first resection guide 1822 can include one or more stabilizers 1892. 395 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 The sights 1894 serve to assist a surgeon in reviewing, confirming, and/or validating a position of the first resection guide 1822 relative to other anatomical structures of the patient (e.g., bones). In one embodiment, sights 1894 are used during a surgical procedure and can be used together with medical imaging to check position, alignment, trajectory, or the like. In one embodiment, a surgeon may provisionally position the first resection guide 1822 and then use flouroscopy to visually check or confirm a position of the first resection guide 1822 relative to another bone or other bones of the patient. In certain embodiments, the flouroscopy machine (e.g., C-arm) can include reference features that key off of certain markers or anatomical features of the patient to ensure that the flouroscopy image is the view desired for the surgeon. A surgeon may use the flouroscopy machine and locate a sight 1894 to determine whether or not the first resection guide 1822 is in a desired position. In one embodiment, the flouroscopy machine may include a scope or view finder or corresponding sight (e.g., cross hairs) that a surgeon can align with the sight 1894 to do a visual check and/or confirmation of the position of the first resection guide 1822. After this visual check, a surgeon may secure the first resection guide 1822 to one or more bones of the patient (i.e., deploy pins in bone attachment features 1828). 396 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 In the illustrated embodiment, the sights 1894 is implemented as an opening having a predefined diameter, an opening that is positioned in a predetermined location of the body 1902 and that extends from a lateral side 1910 to a medial side 1908 of the body 1902. In the illustrated embodiment, the sight 1894 also aligns with the alignment guide 1874 and/or a shaft 1878 deployed in the alignment guide 1874. In one embodiment, a sight 1894 can include cross-hairs positioned in the center of the sight 1894. 397 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 FIG. 19B illustrates that the first resection guide 1822 can include one or more bone engagement features 1830. These bone engagement features 1830 can each include a bone engagement surface 1832. As described herein, the number, size, and/or configuration of the bone engagement features 1830 can be determined based, at least in part, on a user instructions 604. 398 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 FIGs. 20A-20G illustrate different views of one example second resection guide 1824. In one embodiment, the second resection guide 1824 includes a body 2002 that includes an anterior side 2004, a posterior side 2006, a medial side 2008, a lateral side 2010, a superior side 2012, and an inferior side 2014. Generally, the sides of the second resection guide 1824 refer to the direction the sides face when the second resection guide 1824 is in use. FIG. 20A is lateral view of the example second resection guide 1824 of FIG. 20A. FIG. 20B is a medial view of the example second resection guide 1824 of FIG. 20A. FIG. 20C is a posterior view of the example second resection guide 1824 of FIG. 20A. FIG. 20D is an anterior view of the example second resection guide 1824 of FIG. 20A. FIG. 20E is a superior view of the example second resection guide 1824 of FIG. 20A. FIG. 20F is an inferior view of the example second resection guide 1824 of FIG. 20A. FIG. 20G is an anterior lateral perspective view of the example second resection guide 1824. FIG. 20H is an anterior medial perspective view of the example second resection guide 1824. 399 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 FIGs. 20B-20F and 20H include views of the bone engagement surface 1832. In certain embodiments, the second resection guide 1824 can include one or more landmark registration features 1834. 400 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 Those of skill in the art will appreciate that one objective in using the resection guides 1820 can be to form a curved osteotomy and/or an angled curved osteotomy. There are a number of ways to configure the resection guides 1820 to reach this objective. In one embodiment, a trajectory for resection of bone can be controlled and/or managed by an angle of the first resection feature 1864 and/or second resection feature 1866 through a body of the resection guide 1820. 401 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 Alternatively, whereas in the present disclosure, a resection guide 1820 can be fabricated with a bone facing side (e.g., medial side 2008) that is contoured to a shape, size, contour, and configuration of a surface of the bone, those of skill in the art will appreciate that first resection feature 1864 and/or second resection feature 1866 may extend perpendicular through a body of the resection guide 1820. However, a change in the resection trajectory can be accomplished by changing a distance between a non-bone facing side (e.g., lateral side 2010) surface and a bone facing side (e.g., medial side 2008) surface of a body of the resection guide 1820 such that one end of a resection guide 1820 is closer to the bone than the other side when the resection guide 1820 is deployed. Thus, by varying the depth of the body across the bone facing side (e.g., medial side 2008) of the body, a designer can cause the a resection feature to contact the bone at a desired angle (e.g., first angle 1896 and/or second angle 1898). 402 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 One example of this variation in a depth of the body can be seen in the example resection guide 1820 (i.e., second resection guide 1824) in FIG. 20C. FIG. 20C illustrates a left side view (posterior side 2006, because the second resection guide 1824 is configured for use on a lateral side of a patient’s ankle) of the second resection guide 1824. Note that the body 2002 is shorter near the superior side 2012 than near the inferior side 2014. In other words, the posterior side 2006 is wider at or near the inferior end than at or near the superior end. This difference in width can be used to set a trajectory for the second resection feature 1866 relative to one or more bones. 403 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 FIGs 20A-20C illustrate that the example second resection guide 1824 includes one or more sights 1894. The second resection guide 1824 may not need stabilizers 1892 because pins for the bone attachment features 1828 may be deployed at oblique angles relative to each other. 404 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 The sights 1894 serve to assist a surgeon in reviewing, confirming, and/or validating a position of the second resection guide 1824 relative to other anatomical structures of the patient (e.g., bones). In one embodiment, sights 1894 are used during a surgical procedure and can be used together with medical imaging to check position, alignment, trajectory, or the like. In one embodiment, a surgeon may provisionally position the second resection guide 1824 and then use flouroscopy to visually check or confirm a position of the second resection guide 1824 relative to another bone or other bones of the patient. In certain embodiments, the flouroscopy machine (e.g., C-arm) can include reference features that key off of certain markers or anatomical features of the patient to ensure that the flouroscopy image is the view desired for the surgeon. A surgeon may use the flouroscopy machine and locate a sight 1894 to determine whether or not the second resection guide 1824 is in a desired position. In one embodiment, the flouroscopy machine may include a scope or view finder or corresponding sight (e.g., cross hairs) that a surgeon can align with the sight 1894 to do a visual check and/or confirmation of the position of the second resection guide 1824. After this visual check, a surgeon may secure the second resection guide 1824 to one or more bones of the patient (i.e., deploy pins in bone attachment features 1828). 405 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 In the illustrated embodiment, the sights 1894 is implemented as an opening having a predefined diameter, an opening that is positioned in a predetermined location of the body 2002 and that extends from a lateral side 2010 to a medial side 2008 of the body 2002. In one embodiment, a sight 1894 can include cross-hairs positioned in the center of the sight 1894. 406 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 FIGs. 20A, 20B illustrate that the second resection guide 1824 can include one or more bone engagement features 1830. These bone engagement features 1830 can each include a bone engagement surface 1832. As described herein, the number, size, and/or configuration of the bone engagement features 1830 can be determined based, at least in part, on a user instructions 604. 407 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 The insert 2016 is a structure that is configured to extend into a space such as a curved osteotomy. In another embodiment, an insert 2016 is configured to extend into a space between bones of a joint. Advantageously, the insert 2016 assists a surgeon in confirming that the second resection guide 1824 is in a desired position, prior to securing the second resection guide 1824 to one or more bones and/or performing an osteotomy. 409 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 FIGs. 20B, 20G, and 20H illustrate an example embodiment of the second resection guide 1824 illustrated in FIG. 20. The second resection guide 1824 includes a particular type of bone engagement feature 1830’. In the illustrated embodiment, the bone engagement feature 1830’ includes an insert 2016 and a bone engagement surface 2018. 408 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 While specific embodiments of complementary components 730 are not specifically shown here in relation to the osteotomy system 2200, those of skill in the art will appreciate that complementary components 730 can be similar in feature, design, implementation, configuration, and purpose as those described in relation to the osteotomy system 700 and can be used for the osteotomy system 2200. Thus, the osteotomy system 2200 can include one or more alignment guides 740, rotation guides 750, correction guides 760, compression guides 770, positioning guides 780, fixation guides 790, navigation guides 792, implants 794, or the like. 430 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 The osteotomy system 2200 can include one or more fasteners 810 and/or two or more sets of fasteners (810a, 810b, 810c), one or more resection guides 2220, and zero or one or more complementary components 730. In the illustrated embodiment, the resection guides 2220 include a first resection guide 2222 and a second resection guide 2224. The resection guides 2220 may also include one or more of resection features 2226, bone attachment features 2228, bone engagement feature 2230, and/or landmark registration feature 2234. In certain embodiments, a bone engagement feature 2230 can include a bone engagement surface 2232. 429 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 FIG. 22 illustrates an exemplary system for an osteotomy 2200 using a medial approach, according to one embodiment. In one embodiment, the exemplary ankle fusion osteotomy system 2200 is specifically designed for use on a medial side of the patient’s ankle (e.g., using a medial approach). Those of skill in the art will appreciate that the same or a similar exemplary ankle fusion osteotomy system 2200 can be used on a lateral side of the patient’s ankle (e.g., using a lateral approach). Those of skill in the art will also appreciate that a surgical procedure that conducts an ankle fusion on an ankle from a medial or lateral approach generally includes steps to perform an osteotomy on the malleolus (medial or lateral depending on the approach) and retracting or holding a distal end of the malleolus out of the way for the osteotomy steps on the tibia 226 and/or talus 222. 428 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 FIG. 21E illustrates that the first angle 1896 and second angle 1898 have been selected, determined, defined (e.g., using bone models of the patient) such that reduction of the curved osteotomy and the angled curved osteotomy remediates a deformity of the patient. Note that in comparing FIGs. 21D to 21E, the alignment and/or position of the calcaneus 224 has been changed and the calcaneus 224 has been translated more in line with the mechanical axis 880 of the tibia 226. A first dome osteotomy (i.e., curved osteotomy) and a second dome osteotomy (i.e., angled curved osteotomy) have been brought together to provide a deformity correction. Those of skill in the art will appreciate that forming the curved osteotomy and/or the angled curved osteotomy without the aid of the first resection guide 1822 and/or second resection guide 1824 may have required resection of the bone(s) by manual free-hand. Advantageously, the reduction and subsequent fusion using the first resection guide 1822 and/or second resection guide 1824 can result in a more satisfactory fusion of an ankle joint. 427 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 In one embodiment, FIG. 21E illustrates a stage in which a first resection guide 1822 and a second resection guide 1824 have been removed. A curved osteotomy (e.g., first osteotomy) has been formed at the proximal end of the talus 222 and an angled curved osteotomy (e.g., second osteotomy) has been formed at the distal end of the tibia 226. The curved osteotomy and the angled curved osteotomy are reduced at the resection interface 884. Advantageously, a minimal amount of bone of the talus 222 and/or the tibia 226 has been removed and a stable, complete reduction is achieved. Note reference features, fixation pins, permanent and/or temporary fixation is omitted from the view in FIG. 21E but may be included in certain embodiments and/or may be added to hold the reduction place for healing and fusion. 426 Added by DJM Jan 2024 1/6/24, 10:01 PM

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