Dave's PCF WIP: Paragraphs

Paragraphs

Actions	Matter	Content	Para #	Notes	Modified
View Edit Delete	PER-32	Conventional surgical procedures on the foot and ankle can be done to address a variety of pathologies and/or conditions of a patient’s anatomy. Furthermore, a variety of wedge resections, opening wedge, closing wedge, and the like can be performed to address varus, valgus, dorsiflexion, plantarflexion, bone shortening, bone lengthening, and other orientation conditions of the ankle or foot generally and/or particular bones of the foot. Advantageously, the patient-specific apparatus, methods, and systems of the present disclosure can be implemented based on patient imaging data to address these various conditions. In addition, the medical techniques that incorporate the patient-specific apparatus, methods, and systems of the present disclosure can include certain conventional steps and stages and new stages or steps that are enabled by the present disclosure.	314	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	For example, in certain medial ankle and/or lateral ankle surgical procedures a surgeon may prefer to deploy one or more fasteners at a predetermined angle or trajectory into one or more bones of the midfoot prior to making any resection. In certain embodiments, these fasteners 1010 may be deployed into bone attachment features 1024 of a resection guide 920. The surgeon may then use imaging techniques such as fluoroscopy to verify that the fasteners are in the desired position and have the desired trajectory and/or have a desired depth. If the imaging indicates the fasteners are in not a desired position with a desired orientation, a surgeon may re-deploy one or more fasteners and then re-check the position using medical imaging equipment.	315	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	If the imaging confirms the fasteners are in a desired position with a desired orientation, a surgeon may resect one or more bones by moving a cutting tool within one or more resection features 1022 and between and/or along the deployed fasteners. In this manner the fasteners may serve as a stop or guide to prevent resection beyond the position of the fasteners.	316	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	Advantageously, the present disclosure can facilitate conventional surgical techniques by using the systems disclosed herein. As explained above, the bone attachment features 1024 may be configured to facilitate using fasteners 1010 deployed in holes 1056 to serve the same purpose as the fasteners used in conventional foot and ankle surgical procedures. Alternatively, or in addition, the holes 1056 can be angled to have the same trajectory a surgeon desires for the resection of bone, such as a resection of a wedge. In this manner, the fasteners 1010 in the holes 1056 of the bone attachment features 1024 can serve to guide a surgeon to ensure a surgeon that they do not resect beyond the position of the fasteners 1010. Advantageously, the embodiments of the resection guide 920 and/or the preoperative planning of the present disclosure can provide a surgeon with the confidence that resection using the resection features 1022 will be as planned and thus costly intraoperative medical imaging may be avoided. This can save costs for the surgical procedures and time and minimize patient exposure to radiation emitted by the medical imaging equipment.	317	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	Advantageously, the apparatuses, systems, and methods of the present disclosure can be used to plan these osteotomies, determine the desired angles (in one, two, or three planes) for cuts for a wedge segment, a desired depth for the cuts, define suitable resection guides 920 for the surgical procedure, manufacture suitable resection guides 920 for the surgical procedure, and demonstrate how the anatomy will look or reduce once the osteotomies are completed, the bones are positioned, and the surgical procedure is completed.	318	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	In the illustrated embodiment, a distal tibia resection guide 1420a,b and a distal fibula resection guide 1410a,b may be designed, developed, and/or fabricated for the procedure. Or course, each of the distal tibia resection guide 1420a,b and the distal fibula resection guide 1410a,b may have one or more resection features 1022 and each of the one or more resection features 1022 may have a different angle relative to one or more references planes of the foot and/or in relation to each other.	319	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	Of course, at the discretion of the surgeon, each of the distal tibia resection guide 1420a,b and the distal fibula resection guide 1410a,b may be placed and secured in one stage of the procedure. Or, each of the distal tibia resection guide 1420a,b and the distal fibula resection guide 1410a,b may be positioned and secured in sequence. Furthermore, resections may be performed using one or more of the distal tibia resection guide 1420a,b and the distal fibula resection guide 1410a,b in series, again at the discretion of the surgeon.	320	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	By using two or more wedge segments, a surgeon may combine the effect of the two or more wedge segments to create one or more correction angles that are in a single plane, in two planes, in three planes, or the like. Accordingly the exemplary system 900 may include multiple resection guides 920, fasteners 910, and/or complementary components 930.	321	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	Additionally, a surgeon may use one or more components in an exemplary system 900 to make multiple cuts and/or adjustments in the bone(s). The multiple cuts may be centered over or around an apex of a deformity or positioned at other locations within the foot such that when the multiple cuts are made, any resected segments removed, or added bone void fillers introduced, and/or bones and/or bone fragments translated and/or rotated the combined angles, surfaces, removed segments, and/or added portions cooperate to provide a desired correction. Each of the components of the exemplary system 900 can be identified, defined, and reviewed using the apparatuses, systems, and/or methods of the present disclosure.	322	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	Any methods disclosed herein comprise one or more steps or actions for performing the described method. The method steps and/or actions may be interchanged with one another. In other words, unless a specific order of steps or actions is required for proper operation of the embodiment, the order and/or use of specific steps and/or actions may be modified.	323	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	Reference throughout this specification to "an embodiment" or "the embodiment" means that a particular feature, structure or characteristic described in connection with that embodiment is included in at least one embodiment. Thus, the quoted phrases, or variations thereof, as recited throughout this specification are not necessarily all referring to the same embodiment.	324	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	Similarly, it should be appreciated that in the above description of embodiments, various features are sometimes grouped together in a single embodiment, Figure, or description thereof for the purpose of streamlining the disclosure. This method of disclosure, however, is not to be interpreted as reflecting an intention that any claim require more features than those expressly recited in that claim. Rather, as the following claims reflect, inventive aspects lie in a combination of fewer than all features of any single foregoing disclosed embodiment. Thus, the claims following this Detailed Description are hereby expressly incorporated into this Detailed Description, with each claim standing on its own as a separate embodiment. This disclosure includes all permutations of the independent claims with their dependent claims.	325	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	Recitation in the claims of the term "first" with respect to a feature or element does not necessarily imply the existence of a second or additional such feature or element. Elements recited in means-plus-function format are intended to be construed in accordance with 35 U.S.C. §112 Para. 6. It will be apparent to those having skill in the art that changes may be made to the details of the above-described embodiments without departing from the underlying principles set forth herein.	326	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	While specific embodiments and applications of the present disclosure have been illustrated and described, it is to be understood that the scope of this disclosure is not limited to the precise configuration and components disclosed herein. Various modifications, changes, and variations which will be apparent to those skilled in the art may be made in the arrangement, operation, and details of the methods and systems of the present disclosure set forth herein without departing from it spirit and scope.	327	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32		328	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	What is claimed is:	329	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	Furthermore, customized guides can be placed over strategically placed pins used with bone attachment features 1024 and these pins can be used for the purposes of pre-drilling fixation components such as screws or strategic placement of fixation, plates, staples, etc.	191	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	FIG. 11E illustrates a medial side view of patient-specific guide 1020d according to one embodiment. FIG. 11E also illustrates a three-dimensional axis 1100. The three-dimensional axis 1100 includes a cephalad-caudal axis 1102, a medial-lateral axis 1104, and an anterior-posterior axis 1106.	192	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	FIGs. 11E illustrate the position and/or angle (e.g., orientation) of one a resection feature 1022 (e.g., single slot 1052) based on patient imaging data. In the illustrated embodiment, the single slot 1052 is positioned with a first side 1108 perpendicular to a longitudinal axis of the bone (e.g., a tibia) and a second side 1110 offset from the first side by an angle B. Advantageously, the angle B is determined by a surgeon in a prescription and/or preoperative plan that were used to fabricate the resection guide 1020. The angle B is defined to overcome a condition of the patient and can range between about 1 degree and about 80 degrees. Advantageously, the patient imaging data can be used to recommend a correction angle for angle B, that a surgeon can confirm or adjust as needed.	193	Added by DJM Jan 2024	1/6/24, 9:49 PM
View Edit Delete	PER-32	In the illustrated embodiment, the single slot 1052 is angled relative to the anterior-posterior axis 1106. In the illustrated embodiment, the second side 1110 extends caudally from the anterior-posterior axis 1106 at a desired angle, labeled angle B. This orientation and configuration for the single slot 1052 can be used to form an anterior closing wedge in a distal end of a tibia by resecting from a medial side.	194	Added by DJM Jan 2024	1/6/24, 9:49 PM

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