Dave's PCF WIP: Paragraphs

Paragraphs

Actions	Matter	Content	Para #	Notes	Modified
View Edit Delete	PER-24	In one embodiment, the bone probe 1528 can have a superior surface 1530 and an inferior surface 1532. In one embodiment, one or the other or both of the superior surface 1530 and the inferior surface 1532 can include a bone engagement surface 832. In one embodiment, the bone engagement surface 832 can be configured to match and/or substantially match a corresponding surface of the first bone (e.g., tibia 226) and/or the second bone (e.g., talus 222).	337	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	Those of skill in the art will appreciate that just as the resection guide 1502 can be designed to include a bone probe 1528, a body of the tibial resection guide 1522, the talus resection guide 1524, and/or a resection guide 1402 can include additional features that extend anteriorly from an anterior surface (the one facing away from the bone(s) when the device is in use with an anterior approach surgical procedure). These additional features can be referred to as resection guards or resection retractors and may serve to retain soft tissue around the edges of one or more incisions for the surgical procedure. In particular, these resection guards or resection retractors can be configured to extend anteriorly from the resection guide 1502 and of a distance sufficient to meet or exceed a skin surface for the patient during the surgical procedure. The resection guards or resection retractors may keep soft tissue from moving to close the incision(s) and obscuring a view for a surgeon and/or interfering with any cutting tools or other instruments during a surgical procedure.	338	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	FIG. 15B illustrates an anterior view of a positioning guide 1534 of an osteotomy system, according to one embodiment. In one embodiment, the osteotomy system 800 include one or more guide anchors. The positioning guide 1534 may use the guide anchors.	339	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	A guide anchor is an anchor for a resection guide 820 (e.g., tibial resection guide 822, talus resection guide 824, resection guide 1402, resection guide 1502, etc.). The guide anchor serves to hold a resection guide in place during an osteotomy. In one embodiment, the guide anchor is implemented by way of a pin (e.g., fastener) and an opening in the resection guide 820. In the illustrated embodiment, the pins may be the pins of the bone attachment feature 828 and/or the pins of the resection guard 870 and/or the pins of the fastener guides 890.	340	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In one embodiment, the pins of the fastener guides 890 may enter the tibia 226 in parallel to each other which enables the tibial resection guide 822 to be slid off of the pins of the fastener guides 890 once an osteotomy of the tibia 226 is completed with the pins remaining in the tibia 226. These pins may be referred to as tibia pins. Similarly, the pins of the bone attachment features 828 of the talus resection guide 824 may be deployed parallel to each other and may remain when the talus resection guide 824 is removed. These pins may be referred to as talus pins. The tibia pins and/or talus pins may be referred to as reference features.	341	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	Advantageously, because the surgical procedure is preplanned using medical imaging of bones of a patient the same pins that serve as reference features can also serve as guide anchors. Those of skill in the art will appreciate that a reference feature can serve as an alignment feature or a resection guide anchor or both depending on the embodiment.	342	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	The positioning guide 1534 engages the guide anchors, reference features (e.g., tibia pins and/or talus pins) to position the talus 222 relative to the tibia 226 for a reduction of osteotomies of each of these bones. Alternatively, or in addition, the positioning guide 1534 holds the reduction closed and stable once the positioning guide 1534 has been slid to contact one of the other or both of the bones.	343	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	The positioning guide 1534 includes an anterior side 1536, posterior side 1538 (not shown), a medial side 1540, and a lateral side 1542. The positioning guide 1534 also includes a first proximal opening 1544, a second proximal opening 1546, first distal opening 1548, and a second distal opening 1550.	344	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In one embodiment, a surgeon uses the positioning guide 1534 after a first osteotomy of a first bone and a second osteotomy of a second bone. In one embodiment, the two bones are a tibia 226 and a talus 222 and the positioning guide 1534 is configured to have a size that extends along a superior-inferior axis across the resection interface, the reduced osteotomies. In one embodiment, a surgeon has retained the tibia pins in the tibia 226 and the talus pins in the talus 222. These pins may come from a tibial bone attachment feature and a talus bone attachment feature. The positioning guide 1534 is configured to cooperate with one of the tibial bone attachment feature and the talus bone attachment feature to abut a first osteotomy against a second osteotomy in a stable relationship to close the resection interface.	345	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	At this stage, a surgeon is prepared to reduce the osteotomies and prepare for provisional and/or permanent fixation. Next, a surgeon slips the first proximal opening 1544 and the second proximal opening 1546 over the tibia pins and the first distal opening 1548 and second distal opening 1550. Next, the surgeon slides the positioning guide 1534 towards the bones. As the positioning guide 1534 slides towards the bones, the osteotomies are reduced and the two resected surface of the bones are brought together. In one embodiment, the talus 222 may be translated toward the tibia 226 until the talus 222 abuts the tibia 226. At this stage, the positioning guide 1534 may be in contact with or near the surface of the bones. The positioning guide 1534 is in its final position and the resection interface is closed. A surgeon can now prepare for a subsequent step such as fixation.	346	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	FIG. 16 is a flowchart diagram depicting a method for remediating a bone condition, according to one embodiment. FIG. 16 is a flowchart of an example method 1600. In some implementations, one or more method steps of FIG. 16 may be performed by a surgeon using one or more of the apparatuses, systems, and/or components described here.	347	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	As shown in FIG. 16, method 1600 may include positioning a tibial resection guide onto an anterior surface of a distal end of the tibia. The tibial resection guide includes a body having an anterior side, a posterior side, a medial side, a lateral side, a superior side, and an inferior side; a tibia resection feature configured to guide a cutting tool to prepare the tibia for fusion to a talus; a tibial bone attachment feature configured to secure the tibial resection guide to the tibia; a bone engagement feature having a bone engagement surface configured to at least partially match a contour of a portion of the anterior surface of the distal end of the tibia when the tibial resection guide is positioned for use. The tibial resection guide is defined based at least partially on user directions and at least partially on a bone model of at least a portion of the tibia, the bone model based on medical imaging of a patient’s foot (block 1602). For example, a surgeon may position a tibial resection guide onto an anterior surface of a distal end of the tibia, as described above.	348	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	As also shown in FIG. 16, method 1600 may include deploying a set of fasteners as part of the tibial bone attachment feature to secure the tibial resection guide to the tibia (block 1604).	349	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	As further shown in FIG. 16, method 1600 may include deploying an alignment guide that includes a shaft directed towards a proximal end of the tibia (block 1606).	350	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	As also shown in FIG. 16, method 1600 may include inserting the cutting tool into the tibia resection feature and cutting the tibia to form a first osteotomy (block 1608).	351	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	As further shown in FIG. 16, method 1600 may include positioning a talus resection guide onto an anterior surface of the proximal end of the talus. The talus resection guide includes: a body having an anterior side, a posterior side, a medial side, a lateral side, a superior side, and an inferior side; a talus resection feature configured to guide the cutting tool to prepare the talus for fusion to the tibia; a talus bone attachment feature configured to secure the talus resection guide to the talus; a bone engagement feature having a bone engagement surface configured to at least partially match a contour of a portion of the anterior surface of the proximal end of the talus when the talus resection guide is positioned for use; where the talus resection guide is defined based at least partially on user directions and at least partially on a bone model of at least a portion of the talus, the bone model based on medical imaging of the patient’s foot (block 1610). For example, a surgeon may position a talus resection guide onto an anterior surface of the proximal end of the talus, as described above.	352	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	As also shown in FIG. 16, method 1600 may include deploying a set of fasteners as part of the talus bone attachment feature to secure the talus resection guide to the talus (block 1612).	353	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	As further shown in FIG. 16, method 1600 may include inserting the cutting tool into the talus resection feature and cutting the talus to form a second osteotomy (block 1614).	354	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	As also shown in FIG. 16, method 1600 may include deploying fixation across the first osteotomy and the second osteotomy to enable fusion of the tibia and the talus (block 1616).	355	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	Method 1600 may include additional implementations, such as any single implementation or any combination of implementations described herein and/or in connection with one or more other methods or processes described elsewhere herein. A first implementation, method 1600 further includes accessing an anterior surface of a distal end of a tibia and an anterior surface of a proximal end of a talus of a patient’s foot; deploying a set of stops within the tibia resection feature to manage the cutting tool; verifying the position of the tibial resection guide by comparing the shaft to a mechanical axis of the tibia and a set of fasteners deployed using the tibial resection guide; and reducing the first osteotomy and the second osteotomy by abutting the resected distal end of the tibia and the resected proximal end of the talus. When verifying the position, the surgeon may leverage one or more shafts 878 positioned in one or more alignment guides 874, one or more bone attachment features 828 (i.e., pins in bone), and/or one or more resection guards 870 (e.g., reference features) that may be configured to have a trajectory and/or orientation relative to axes of bones of the patient’s foot such that a surgeon can used these reference features to verify that instruments are desired positions.	356	Added by DJM Jan 2024	1/6/24, 10:01 PM

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