Dave's PCF WIP: Paragraphs

Paragraphs

Actions	Matter	Content	Para #	Notes	Modified
View Edit Delete	PER-32	Advantageously, the system 900 can help a surgeon overcome one or more of the challenges in performing an osteotomy procedure, particularly on bones of a hand or of a foot of a patient, such as on the forefoot, midfoot, or hindfoot. One challenge during an osteotomy procedure can be maintaining control of, and/or position, and/or orientation of a bone, one or more bones, and/or bone pieces/fragments, particularly once a resection or dissection is performed. Advantageously, the fasteners 910, resection guide(s) 920, and/or complementary components 930 can be configured to assist in overcoming this challenge.	151	Added by DJM Jan 2024	1/6/24, 9:48 PM
View Edit Delete	PER-32	Advantageously, the system 900 can help a surgeon in positioning, placing, and/or orienting a resection guide accurately. Modern techniques may include preoperative planning, simulation, or even practice using computer models, 3D printed models, virtual reality systems, augmented reality systems or the like. However, simulations and models are still different from actually positioning a resection guide on a patient’s bone, joint, or body part during the procedure. The system 900 can include a number of features, including patient-specific features, to assist the surgeon with the positioning. In one embodiment, the resection guide 920 can include one or more landmark registration features 928.	152	Added by DJM Jan 2024	1/6/24, 9:48 PM
View Edit Delete	PER-32	Advantageously, the system 900 can help a surgeon in securing guides of the osteotomy system 900, such as a resection guide, as well as how to readily remove the guide (e.g., resection guide) without disturbing a reduction, shifting, reorienting, or repositioning one or more bones or parts of bones while removing the guide. In certain embodiments, the system 900 is configured to permit removal of a guide while keeping temporary fasteners in place for use in subsequent steps of an osteotomy procedure. Alternatively, or in addition, the system 900 facilitates positioning of temporary fasteners during one step of the wedge osteotomy procedure for use in a subsequent step of the wedge osteotomy procedure. Removal of a guide during an osteotomy procedure can be particularly challenging where translation and/or rotation of the bones involved in the wedge osteotomy procedure is required for the success of the wedge osteotomy procedure. Advantageously, the system 900 accommodates translation and/or rotation of the bones during the wedge osteotomy procedure while facilitating a successful outcome for the wedge osteotomy procedure.	153	Added by DJM Jan 2024	1/6/24, 9:48 PM
View Edit Delete	PER-32	Advantageously, the components of the system 900 can be specifically designed for a particular patient. Alternatively, or in addition, the components of the system 900 can be specifically designed for a class of patients. Each of the components of the system 900 can be designed, adapted, engineered and/or manufactured such that each feature, attribute, or aspect of the component is specifically designed to address one or more specific indications present in a patient. Advantageously, the cuts made for the osteotomy procedure can be of a size, position, orientation, and/or angle that provides from an optimal osteotomy with minimal risk of undesirable resection. In one embodiment, the components of the system 900 can be configured such that an osteotomy is performed that enables a correction in more than one plane in relation to the parts of the body of the patient. For example, cut channels in a resection guide 920 can be oriented and configured such that when the bones are fused/fixated the correction results from translation, rotation, and/or movement of bones or bone parts in two or more planes (e.g., sagittal and transverse).	154	Added by DJM Jan 2024	1/6/24, 9:48 PM
View Edit Delete	PER-32	In certain embodiments, the exemplary system 900 may include a plurality of fasteners 910, resection guides 920, and/or complementary components 930. For example, a surgeon may plan to resect a plurality of wedge segments from the bone(s) in order to accomplish a desired correction. One or more wedge segments may be resected from a medial side of a patient's foot and another one or more wedge segments may be resected from a lateral side of the patient's foot. These wedge segments may extend part way into the foot, or through from one side of the foot to the other. Of course, multiple wedge segments may be formed on one side of the foot as well.	155	Added by DJM Jan 2024	1/6/24, 9:48 PM
View Edit Delete	PER-32	A plurality of wedge segments may be formed using the same resection guide 920 or a plurality of resection guides 920. By using two or more wedge segments, a surgeon may combine the effect of the two or more wedge segments to create a single correction angle that is 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. Alternatively, or in addition, the apparatuses, systems, and/or methods of the present disclosure can be used to provide an osteotomy guide that is a biplanar osteotomy guide. A biplanar osteotomy guide can include a guide in which one or more or each of the resection cuts made are in one, two, or three planes.	156	Added by DJM Jan 2024	1/6/24, 9:48 PM
View Edit Delete	PER-32	Additionally, a surgeon may use one or more components in an exemplary system 900 to make multiple cuts 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.	157	Added by DJM Jan 2024	1/6/24, 9:48 PM
View Edit Delete	PER-32	In certain embodiments, the components of the system 900 may be made as small as possible to minimize the amount of soft tissue that is opened in the patient for the osteotomy procedure. Alternatively, or in addition, walls and/or sides of the components may be beveled and/or angled to avoid contact with other hard tissue or soft tissues in the operating field for the osteotomy procedure.	158	Added by DJM Jan 2024	1/6/24, 9:48 PM
View Edit Delete	PER-32	Those of skill in the art will appreciate that for certain wedge osteotomy procedure a complementary component 930 may not be needed or a given complementary component 930 may be optional for use in the wedge osteotomy procedure. Similarly, those of skill in the art will appreciate that certain features of the fasteners 910, resection guides 920, and/or complementary components 930 can be combined into one or more of apparatus or devices or may be provided using a plurality of separate devices.	159	Added by DJM Jan 2024	1/6/24, 9:48 PM
View Edit Delete	PER-32	FIG. 10 illustrates an exemplary system 1000, according to one embodiment. The system 1000 may include one or more fasteners 910, such as fasteners 1010, one or more resection guides 920, such as resection guide 1020a or resection guide 1020b or resection guide 1020c, and may include one or more other complementary components 930. In the illustrated embodiments, each of the resection guides 1020a,b,c includes one or more resection features 1022a,b. In other embodiments, the resection guides 1020a,b,c may include one resection feature 1022, three resection features 1022, four resection features 1022, or the like.	160	Added by DJM Jan 2024	1/6/24, 9:48 PM
View Edit Delete	PER-32	The resection features 1022a,b guide a surgeon in performing a resection by facilitating keeping a cutting tool in line with, and/or within the resection features 1022a,b (at a desired trajectory relative to one or more bones of the patient). In the illustrated embodiments, the resection features 1022 are shaped like slots or channels and include a first end 1030 and a second end 1031. In the illustrated embodiment, the first end 1030 and/or second end 1031 may be open ended or closed ended.	161	Added by DJM Jan 2024	1/6/24, 9:48 PM
View Edit Delete	PER-32	One difference between the illustrated embodiments of the resection guides 1020a,b,c may be the number of resection features 1022 for a resection guide 1020, the angle of the resection features 1022 relative to the resection guide 1020 and/or patient bone, the shape and/or size of the resection features 1022, and the like. Each of these are examples of patient-specific features of the resection guides 1020.	162	Added by DJM Jan 2024	1/6/24, 9:48 PM
View Edit Delete	PER-32	Another difference between the illustrated embodiments of the resection guides 1020a,b,c may be the relationship of the first end 1030 and second end 1031 of one resection feature 1022 in relation to another resection feature 1022 of the same resection guide 1020 or may be the relationship of the first end 1030 and second end 1031 of one resection feature 1022 in relation to another resection guide 1020a,b,c.	163	Added by DJM Jan 2024	1/6/24, 9:48 PM
View Edit Delete	PER-32	In the illustrated embodiment, each of the resection guides 1020a,b,c may be configured for use on a medial side of an ankle of a patient, with the side visible in FIG. 10 facing away from the bone(s). The resection features 1022a,b may be positioned and oriented relative to each other to facilitate forming cuts for a wedge that can be resected to form a closing wedge. Of course, the resection features 1022 can be configured to enable osteotomies for an opening wedge and/or for a bone shorten osteotomy and/or for a bone lengthening osteotomy.	164	Added by DJM Jan 2024	1/6/24, 9:48 PM
View Edit Delete	PER-32	One resection guide 1020 (e.g., resection guide 1020a) may be configured to facilitate forming a wedge resection that opens to an anterior side of a distal tibia. Resection guide 1020a includes a single resection features 1022 in the shape of a “V”. Another resection guide 1020 (e.g., resection guide 1020b) may be configured to facilitate forming a wedge resection that opens to a medial side of a distal tibia and/or ankle. The resection guide 1020b may include two resection features 1022, one for forming each side of a resection wedge.	165	Added by DJM Jan 2024	1/6/24, 9:48 PM
View Edit Delete	PER-32	Another resection guide 1020 (e.g., resection guide 1020c) may be configured to facilitate forming a wedge resection that opens to a medial side of a distal tibia and/or ankle. The resection guide 1020b may include two resection features 1022, one for forming each side of a resection wedge.	166	Added by DJM Jan 2024	1/6/24, 9:48 PM
View Edit Delete	PER-32	Those of skill in the art will appreciate that the resection guide(s) 920 may have a variety of shapes, sizes and configurations. In one embodiment, these attributes can each be customized and adapted to meet needs or preferences of patients, a patient’s anatomy, the nature of the deformity, and/or surgeon preferences. In certain embodiments, the resection guide(s) 920 can be sized to be small enough to support minimally invasive surgery techniques and large enough to provide the surgeon the desired view of the operating field for the procedure. In certain embodiments, the resection guide 920 include visualization features (e.g., pattern 1033, windows, open areas around the body 1032, and the like). The visualization features can serve as important markers to assist a surgeon in knowing that the resection guide 920 is properly placed, positioned, oriented, seated, registered relative to other anatomical structures during a surgical procedure. In particular, a surgeon can confirm intraoperatively that steps of the procedure match the information, steps, and/or plan set forth in a preoperative plan. Advantageously, the features of the resection guides 920 can facilitate one or more osteotomies as well as other steps in a surgical procedure.	167	Added by DJM Jan 2024	1/6/24, 9:48 PM
View Edit Delete	PER-32	Advantageously, the angle of each resection feature 1022 relative to each other and/or relative to one or more bones (or bone surfaces or other reference points, reference lines, and/or reference planes) can be determined, selected, or indicated by a surgeon before the resection guide 1020 is fabricated. Similarly, a surgeon can designate whether they want a resection guide 1020 for forming a plantar wedge, a dorsal wedge, an anterior wedge, a posterior wedge, a medial wedge, and/or a lateral wedge and whether the wedge is an opening wedge or a closing wedge.	168	Added by DJM Jan 2024	1/6/24, 9:48 PM
View Edit Delete	PER-32	In addition, a surgeon can designate which sides of the resection features 1022 are open and/or closed. In one embodiment, a surgeon can indicate that they want to make a single cut or resection in order to perform an opening wedge procedure. Alternatively, or in addition, the surgeon may indicate whether the opening wedge will be filled with a graft such as an allograft. Using a model and/or a preoperative plan, the size of an allograft can be determined preoperatively and the allograft and/or an implant, to be placed into an opening wedge, can be determined and/or fabricated prior to the surgical procedure. Alternatively, or in addition, the allograft and/or an implant can be sized to precise dimensions provided in a preoperative plan during the operation, for example on a back table. The size and shape of the allograft and/or an implant can be predefined to achieve a desired erectus disposition for the anatomy of the patient.	169	Added by DJM Jan 2024	1/6/24, 9:48 PM
View Edit Delete	PER-32	FIGS. 11A-11D illustrate views of an example resection guide 1020a of the system 1000 of FIG. 10, according to one embodiment. The resection guide 1020a includes a single resection feature 1022, one or more bone attachment features 1024, and/or one or more bone engagement surfaces 1026. In certain embodiments, the resection guide 1020a may include one or more landmark registration features 1028. Other embodiments may not include landmark registration features 1028. The resection guide 1020 includes a body 1032 that supports the resection feature 1022, one or more bone attachment features 1024, and/or one or more bone engagement surfaces 1026.	170	Added by DJM Jan 2024	1/6/24, 9:48 PM

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