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Delete 		PER-32 In certain embodiments, the proximal bone attachment feature 1058 and/or distal bone attachment feature 1060 may be aligned with a corresponding resection feature 1022. In one embodiment, the holes 1056 of the proximal bone attachment feature 1058 may be parallel to at least part of the resection feature 1022. 181 Added by DJM Jan 2024 1/6/24, 9:49 PM
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Delete 		PER-32 The landmark registration feature 1028 serves to facilitate registration of a guide 1020 to a surface of a bone and/or to one or more landmarks of one or more bones. In one embodiment, the landmark registration features 1028 can be configured to engage a cortical surface of a bone. The resection guide 1020 can include one, two, or more landmark registration features 1028. In the illustrated embodiment, the resection guide 1020 may include two landmark registration features 1028. The landmark registration features 1028 can extend from one or more sides of the resection guide 1020. In the illustrated embodiment, the landmark registration features 1028 extend from the anterior side 1034 and/or the posterior side 1036. Those of skill in the art will appreciate that the landmark registration features 1028 can have various lengths, widths, and thicknesses. Advantageously, the landmark registration features 1028 can also include a bone engagement surface 1026 that may extend a bone engagement surface 1026 on bone engagement surface 1026 of the resection guide 1020. 182 Added by DJM Jan 2024 1/6/24, 9:49 PM
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Delete 		PER-32 Advantageously, the landmark registration feature 1028 can provide a surgeon with confidence and assurance in the placement and positioning of the resection guide 1020 on a bone because the landmark registration feature 1028 can be configured to engage with a particular landmark on the bone or other patient anatomy (e.g., a projection or a depression or cavity). Alternatively, or in addition, the landmark registration feature 1028 can include a contoured bone engagement surface that can further facilitate registration of the landmark registration feature 1028 and/or guide 1020 with the bone. In this manner, a surgeon can be assured intraoperatively that the resection guide 1020 is positioned in accordance with a preoperative plan. 183 Added by DJM Jan 2024 1/6/24, 9:49 PM
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Delete 		PER-32 In certain embodiments, the landmark registration feature 1028 can be shaped like a hook to engage a surface of bone. Alternatively, or in addition, the resection guide 1020 may include a landmark registration feature 1028 on different sides, together the landmark registration features 1028 can engage one or more landmarks of a surface of the bone such that the surgeon can accurately position and register the resection guide 1020 to the bone. 184 Added by DJM Jan 2024 1/6/24, 9:49 PM
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Delete 		PER-32 FIG. 11E illustrates a resection guide 1020d that, like resection guide 1020a, includes a single resection feature 1022. In the illustrated embodiment, the resection guide 1020d may include one or more stops 1047. The stop 1047 serves to prevent resection beyond a certain, point, line, or plane. 185 Added by DJM Jan 2024 1/6/24, 9:49 PM
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Delete 		PER-32 In the illustrated embodiment, the stop 1047 may take the form of an opening at a particular position within the resection feature 1022. For example, the stop 1047 may be positioned at a vertex of the single slot 1052. The stop 1047 may be embodied as a hole 1048 that extends from one side of the resection guide 1020 to the other and a fastener 1050 configured to fit within that hole 1048. 186 Added by DJM Jan 2024 1/6/24, 9:49 PM
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Delete 		PER-32 In one example, a k-wire can be placed in a hole in the vertex to implement the stop 1047. In this manner, the stop 1047 prevents resection beyond that vertex of the resection feature 1022. The stop 1047 may be so positioned to assist a surgeon in maintaining a cortical section of bone on one side of the bone. In the illustrated embodiment, the stop 1047 prevents a resection by a cutting tool in the posterior direction in the bone, such as a distal tibia, which can preserve a section of cortical bone on the posterior side of the bone. This preserved bone (e.g., preserved posterior cortex) can serve as a living hinge once a wedge section is resected. The stop 1047 can serve as a cutting guide to prevent resection of areas during a procedure. 187 Added by DJM Jan 2024 1/6/24, 9:49 PM
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Delete 		PER-32 As an example, a surgeon may position the resection guide 1020d, secure the resection guide 1020d to one or more bones using the bone attachment features 1024. Next, a surgeon may deploy a pin or K-wire in a hole of the stop 1047 to engage with the bone. As the surgeon resects, the K-wire prevents resection beyond the vertex of the resection feature 1022.. The K-wire blocks the cutting tool from cutting farther than intended. 188 Added by DJM Jan 2024 1/6/24, 9:49 PM
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Delete 		PER-32 Those of skill in the art will appreciate that a resection guide 920 may include one or more bone attachment features 1024. Certain bone attachment features 1024 may be positioned to engage with a resected segment, wedge, or bone fragment and other bone attachment features 1024 may engage with remaining bones or bone segments after resection. Furthermore, the resection guide 920, such as example resection guide 1020, may include bone attachment features 1024 that are strategically positioned in the resection guide 920 to serve a trajectory guides, attachment points, compression anchors, distraction anchors, reduction guides, stops, cutting guides, or the like. For example, bone attachment features 1024 and the pins that can be deployed within the can be strategically placed in a way that following the wedge resections, the pins can then be manipulated to aid in the reduction /correction using specialized instrumentation and/or customized instrumentation, segmental compression blocks, or other complementary components 930. 189 Added by DJM Jan 2024 1/6/24, 9:49 PM
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Delete 		PER-32 In addition, the bone attachment features 1024 and associated pins can be designed, positioned, oriented, and utilized to target provisional and/or permanent fixation devices such as pins, staples, screws, bolts, beams, nail or strategically placed reduction wires that can be utilized for external devices such as external fixators. 190 Added by DJM Jan 2024 1/6/24, 9:49 PM
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Delete 		PER-32 As mentioned previously, the method 120 is one species of the method 100; the present disclosure encompasses many different procedures, performed with respect to many different bones and/or joints of the body. Exemplary steps and instrumentation for the method 120 will further be shown and described in connection with the present disclosure. Those of skill in the art will recognize that the method 120 may be used in connection with different instruments; likewise, the instruments of the present disclosure may be used in connection with methods different from the method 100 and the method 120. 81 Added by DJM Jan 2024 1/6/24, 9:48 PM
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Delete 		PER-32 FIG. 2A is a perspective dorsal view of a foot 200. The foot 200 may have a medial cuneiform 202, an intermediate cuneiform 204, lateral cuneiform 206, a first metatarsal 208, a second metatarsal 210, third metatarsal 212, fourth metatarsal 214, fifth metatarsal 216, navicular 218, cuboid 220, and calcaneus 222, among others. The medial cuneiform 202 and the intermediate cuneiform 204 may be joined together at a first metatarsocuneiform joint, and the first metatarsal 208 and the second metatarsal 210 may be joined together at a second metatarsocuneiform joint. 82 Added by DJM Jan 2024 1/6/24, 9:48 PM
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Delete 		PER-32 FIG. 2B is a perspective lateral view of a foot 200, with bones of the foot labeled. 83 Added by DJM Jan 2024 1/6/24, 9:48 PM
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Delete 		PER-32 FIG. 2C is a perspective lateral view of a foot illustrating a dorsal side 280 and a plantar side 282. Dorsal refers to the top of the foot. Plantar refers to the bottom of the foot. Proximal 284 is defined as “closer to the primary attachment point”. Distal 286 is defined as “further away from the attachment point”. Plantarflex or plantarflexion 288 means movement toward the plantar side 282 of a foot or hand, toward the sole or palm. Dorsiflex or dorsiflexion 290 means movement toward the dorsal side 280 of a foot or hand, toward the top. FIG. 2D is a perspective dorsal view of the foot 200. A transverse plane is the plane that shows the top of the foot. A lateral side 292 means a side furthest away from the midline of a body, or away from a plane of bilateral symmetry of the body. A medial side 294 means a side closest to the midline of a body, or toward a plane of bilateral symmetry of the body. For a Lapidus procedure, the intermetatarsal (IM) angle 296 is the angle to be corrected to remove the hallux valgus (bunion) deformity. 84 Added by DJM Jan 2024 1/6/24, 9:48 PM
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Delete 		PER-32 Every patient and/or condition is different; accordingly, the degree of angular adjustment needed in each direction may be different for every patient. Use of a patient-specific guide may help the surgeon obtain an optimal realignment, target, or position a bone tunnel, position one or more resections and/or fasteners and the like. Thus, providing patient-specific guides, jigs, and/or instrumentation may provide unique benefits. 85 Added by DJM Jan 2024 1/6/24, 9:48 PM
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Delete 		PER-32 The present patient-specific instrumentation may be used to correct a wide variety of bone conditions. Such conditions include, but are not limited to, any angular deformities from within one bone segment in either the lower or upper extremities (for example, tibial deformities, calcaneal deformities, femoral deformities, and radial deformities). The present disclosure may also be used to treat an interface between two bone segments (for example, the ankle joint, metatarsal cuneiform joint, lisfranc's joint, complex Charcot deformity, wrist joint, knee joint, etc.). As one example, an angular deformity or segmental malalignment in the forefoot may be treated, such as is found at the metatarsal cuneiform level, the midfoot level such as the navicular cuneiform junction, hindfoot at the calcaneal cuboid or subtalar joint or at the ankle between the tibia and talar junction. Additionally, patient-specific instruments could be used in the proximal leg between two bone segments or in the upper extremity such as found at the wrist or metacarpal levels. 86 Added by DJM Jan 2024 1/6/24, 9:48 PM
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Delete 		PER-32 FIG. 3 illustrates a flowchart diagram depicting a method 300 for generating one or more patient-specific instruments configured to correct or address a bone or foot condition, according to one embodiment. Prior to steps of the method 300, a bone model (also referred to as CAD model above) is generated. The bone model may be generated using medical imaging of a patient’s foot and may also be referred to as an anatomic model. The medical imaging image(s) may be used by computing devices to generate patient imaging data. The patient imaging data may be used to measure and account for orientation of one or more structures of a patient’s anatomy. In certain embodiments, the patient imaging data may serve, or be a part of, anatomic data for a patient. 87 Added by DJM Jan 2024 1/6/24, 9:48 PM
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Delete 		PER-32 In one embodiment, the method 300 begins after a bone model of a patient’s body or body part(s) is generated. In a first step 302, the method 300 may review the bone model and data associated with the bone model to determine anatomic data of a patient’s foot. 88 Added by DJM Jan 2024 1/6/24, 9:48 PM
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Delete 		PER-32 After step 302, the method 300 may determine 304 a recommended location and/or a trajectory angle and/or patient-specific features for a procedure using the anatomic data. "Recommended location" refers to a location for deployment of guide or instrument on, in, between, or within one or more body parts (e.g., bones) of a patient. "Trajectory angle" refers to a recommended angle for deployment of an instrument, graft, body part, or resection feature angle relative to a bone of a patient for a procedure. In certain embodiments, determining the recommended location may employ advanced computer analysis system, expert systems, machine learning, and/or automated/artificial intelligence. In another embodiment, the method 300 may include determining one or more alternative locations and/or trajectory angles for tendon deployment. 89 Added by DJM Jan 2024 1/6/24, 9:48 PM
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Delete 		PER-32 Next, the method 300 may proceed and a preliminary guide model is provided 306 from a repository of template tendon trajectory models. A preliminary guide model is a model of a preliminary guide. 90 Added by DJM Jan 2024 1/6/24, 9:48 PM

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