Dave's PCF WIP: Paragraphs

Paragraphs

Actions	Matter	Content	Para #	Notes	Modified
View Edit Delete	PER-16	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.	239	Added by DJM Jan 2024	1/3/24, 4:26 AM
View Edit Delete	PER-16	Those of skill in the art will appreciate that for certain osteotomy procedure a complementary component 930 may not be needed or a given complementary component 930 may be optional for use in the 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.	240	Added by DJM Jan 2024	1/3/24, 4:26 AM
View Edit Delete	PER-16	FIG. 10A is a side perspective view of an osteotomy system 1000 according to one embodiment. The osteotomy system 1000 includes a pivoting resection guide 1002 (which may be also referred to as a swiveling resection guide, rotating resection guide, or pivoting burr guide) according to one embodiment, shown secured to a bone. The pivoting resection guide 1002 may also be referred to as a pivoting cut jig, swiveling resection guide, rotating resection guide, bone dissection guide, arc resection guide, or a pivoting cutting guide based on how the pivoting resection guide 1002 operates. In this example, the pivoting resection guide 1002 is secured to a metatarsal bone. Of course, the pivoting resection guide 1002 can be secured to other bones of a patient to guide a surgeon in making cuts in one or more bones.	241	Added by DJM Jan 2024	1/3/24, 4:26 AM
View Edit Delete	PER-16	In certain embodiments, the pivoting resection guide 1002 is used for dissecting one or more bones. For example, in a bunion surgical procedure a surgeon can use a pivoting resection guide 1002 to resect or dissect a distal end of a cuneiform (e.g., medial cuneiform 202). Alternatively, or in addition, the surgeon may use the same pivoting resection guide 1002, or a different pivoting resection guide 1002, to resect or dissect a proximal end of a metatarsal 208 (e.g., first metatarsal 208). Thus, embodiments of the present disclosure can be used for surgical procedures on a single bone, on multiple bones, and at or across the a joint of a patient.	242	Added by DJM Jan 2024	1/3/24, 4:26 AM
View Edit Delete	PER-16	When secured as illustrated in FIG. 10A, a user may operate the pivoting resection guide 1002 by inserting a cutting tool such as a burr, a burr drill bit, or a drill bit attached to a manual, mechanical, pneumatic, or electric driver into a hole in the guide 1002. A cutting tool may be referred to interchangeably herein as a drill bit. Next, the user may cut into the bone. In the case of a drill bit with longitudinal flutes or burr, the use may initially direct the cutting tool directly into the bone, drilling a hole in the bone. Alternatively, or in addition, the user may initiate an osteotomy of the bone by contacting a rotating cutting section of the cutting tool with a cortex of a bone. Next, a user can pivot the pivoting resection guide 1002 such that the cutting tool (specifically a distal end of the cutting tool) moves laterally in relation to the bone.	243	Added by DJM Jan 2024	1/3/24, 4:26 AM
View Edit Delete	PER-16	For example, in FIG. 10A, a user may pivot the pivoting resection guide 1002 and direct the cutting tool dorsally, as the cutter guide pivots, the cutting tool cuts bone in the dorsal direction. To move the cutting tool in the dorsal direction, the user moves a proximal end of the cutting tool plantarly. Similarly, the user can pivot the cutter guide such that the cutting tool moves plantarly in relation to the bone, as the cutter guide pivots, the cutting tool cuts bone in the plantar direction. To move the cutting tool in the plantar direction, the user moves a proximal end of the cutting tool dorsally. In this manner, a user can resection or dissect a bone.	244	Added by DJM Jan 2024	1/3/24, 4:26 AM
View Edit Delete	PER-16	A cutter guide is a guide of the pivoting resection guide 1002 that guides a cutting tool. Advantageously, such resections can be done using very small incisions, incisions just large enough to insert the cutting tool. Alternatively, or in addition, such resections can be done using incisions just large enough to insert the pivoting resection guide 1002 and engage the pivoting resection guide 1002 to the bone. In certain embodiments, the bone resection can be done subcutaneously. In other embodiments, bone resection can be done percutaneously through an incision (e.g., stab incision) made by, or made for, the cutting tool while the pivoting resection guide 1002 presses against a surface of the skin at the incision location. Accordingly, the pivoting resection guide 1002 provides a minimally invasive surgical (MIS) instrument for use in osteotomies.	245	Added by DJM Jan 2024	1/3/24, 4:26 AM
View Edit Delete	PER-16	FIG. 10B is a perspective view of a cutting guide, such as pivoting resection guide 1002, according to one embodiment, that includes a handle 1004. The handle 1004 is configured to engage a cutter guide and may serve to facilitate pivoting or swiveling the pivoting resection guide 1002 while resecting or dissecting. A surgeon may move the handle 1004 to direct the resection. Rotary cutting tools such as a drill bit, a mill bit, a router bit, a side-cutting burr, burrs, drill bits, and the like provide a high degree of flexibility in how they are oriented and used to resect or dissect bone. Rotary cutting tools rotate about a longitudinal axis of the cutting tool itself. The pivoting resection guide 1002 guides the rotating cutting tool for a dissection and/or resection. Advantageously, the pivoting resection guide 1002 constrains movement of the rotary cutting tool to motion within a single plane. In particular, where the surgeon has planned to form an osteotomy, such as a resection or dissection, having a particular trajectory and/or position on the bone, the pivoting resection guide 1002 assists the surgeon in making a very precision and accurate resection/dissection within a predetermined plane.	246	Added by DJM Jan 2024	1/3/24, 4:26 AM
View Edit Delete	PER-16	FIG. 11A is a top perspective view of an osteotomy system 1000 that includes a pivoting resection guide 1002, a handle 1004 (See FIG. 10B), a first bone attachment feature 1006, a second bone attachment feature 1008, a cutter guide 1010, and one or more fasteners 1012. In one embodiment, the fasteners 1012 are temporary fasteners and can be K-wires, pins, or the like. In one embodiment, the fasteners 1012 are configured to engage one or more bones of a patient’s foot.	247	Added by DJM Jan 2024	1/3/24, 4:26 AM
View Edit Delete	PER-16	The pivoting resection guide 1002 leverages the first bone attachment feature 1006 and second bone attachment feature 1008 on opposite sides of the cutter guide 1010 to provide a stable platform or base for pivoting the cutter guide 1010 during the osteotomy. The first bone attachment feature 1006 and second bone attachment feature 1008 on opposite sides of the cutter guide 1010 permit the cutter guide 1010 to pivot, swivel, or rotate about a pivot axis in one plane and restrict and prevent movement of the cutter guide 1010 in another plane. In certain embodiments, the pivot axis of rotation for the cutter guide 1010 is an axis that is transverse to a long axis of a cutting tool used with the pivoting resection guide 1002.	248	Added by DJM Jan 2024	1/3/24, 4:26 AM
View Edit Delete	PER-16	In the illustrated embodiment, the first bone attachment feature 1006 and/or second bone attachment features 1008 each include at least one hole configured to receive a pin, such as a fastener 1012. The first bone attachment feature 1006 and/or second bone attachment feature 1008 are configured to secure or anchor the pivoting resection guide 1002 to one or more bones of a patient. The first bone attachment feature 1006 and second bone attachment feature 1008 also serve to hold the cutter guide 1010 in position so accurate cuts can be made using the cutting tool. Consequently, the first bone attachment feature 1006 and second bone attachment feature 1008 are configured to remain in position and hold the cutter guide 1010 despite forces applied to the cutter guide 1010, first bone attachment feature 1006, and second bone attachment feature 1008 by the pivoting action of the cutter guide 1010.	249	Added by DJM Jan 2024	1/3/24, 4:26 AM
View Edit Delete	PER-16	Accordingly, in certain embodiments, the holes of the first bone attachment feature 1006 and second bone attachment feature 1008 and the cross-section diameter of the fasteners 1012 used with the first bone attachment feature 1006 and second bone attachment feature 1008 are sized to withstand these forces. For example, in one embodiment, the holes may be sized to accommodate fasteners 1012 having cross-section diameters of between about 0.8 millimeters to about 2.0 millimeters. Furthermore, the diameter of the holes of the first bone attachment feature 1006 and second bone attachment feature 1008 may be just larger than the diameters of the fasteners 1012 such that the two fit together in a “close fit.” Those of skill in the art will appreciate that the diameters of the holes in the first bone attachment feature 1006 and second bone attachment feature 1008 and the fasteners 1012 can very depending on the diameter of the bone or bones that the fasteners 1012 are deployed into. Smaller diameter bones will use smaller diameter fasteners 1012 and larger diameter bones will use larger diameter fasteners 1012.	250	Added by DJM Jan 2024	1/3/24, 4:26 AM
View Edit Delete	PER-16	The cutter guide 1010 serves to guide a cutting tool as the cutting tool forms the osteotomy. In particular, the cutter guide 1010 is configured to guide a cutting tool in cutting bone along a predefined plane positioned between the first bone attachment feature 1006 and the second bone attachment feature 1008. The cutter guide 1010 guides the cutting tool as the cutter guide 1010 rotates about a pivot axis 1014. In certain embodiments, the pivot axis 1014 is an axis that is transverse to a longitudinal axis of the fasteners 1012 used to secure the first bone attachment feature 1006 and second bone attachment feature 1008. In one embodiment, the pivot axis 1014 is coupled to the first bone attachment feature 1006 and the second bone attachment feature 1008. The pivot axis 1014 is the axis about which the cutter guide 1010 pivots or rotates as the cutter guide 1010 guides the cutting tool to cut within a predetermined plane.	251	Added by DJM Jan 2024	1/3/24, 4:26 AM
View Edit Delete	PER-16	The cutter guide 1010 includes an opening that enables the cutter guide 1010 to accept a cutting tool and guide the cutting tool along a predetermined trajectory as the cutter guide 1010 swivels or pivots about the pivot axis 1014 (e.g., an axis transverse to a long axis of the cutter guide 1010).	252	Added by DJM Jan 2024	1/3/24, 4:26 AM
View Edit Delete	PER-16	FIG. 11B is a bottom perspective view of the pivoting resection guide 1002, according to one embodiment.	253	Added by DJM Jan 2024	1/3/24, 4:26 AM
View Edit Delete	PER-16	FIG. 11C is a top view of the pivoting resection guide 1002, according to one embodiment.	254	Added by DJM Jan 2024	1/3/24, 4:26 AM
View Edit Delete	PER-16	FIG. 11D is a bottom view of the pivoting resection guide 1002, according to one embodiment.	255	Added by DJM Jan 2024	1/3/24, 4:26 AM
View Edit Delete	PER-16	FIG. 11E is a front view of the pivoting resection guide 1002, according to one embodiment, including a handle 1004.	256	Added by DJM Jan 2024	1/3/24, 4:26 AM
View Edit Delete	PER-16	FIG. 11F is a back view of the pivoting resection guide 1002, according to one embodiment, including a handle 1004.	257	Added by DJM Jan 2024	1/3/24, 4:26 AM
View Edit Delete	PER-16	FIG. 11G is a left side view of the pivoting resection guide 1002, according to one embodiment, including a handle 1004.	258	Added by DJM Jan 2024	1/3/24, 4:26 AM

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