Dave's PCF WIP: Paragraphs

Paragraphs

Actions	Matter	Content	Para #	Notes	Modified
View Edit Delete	PER-12	In certain embodiments, the osteotomy system 4400 may include a guide for managing how deep a surgeon cuts into the calcaneus 1806 using the cutting tool. In one embodiment, the depth may be recommended in a preoperative plan and a surgeon may configure the cutting tool to indicate when that depth is reached. Alternatively, or in addition, the resection guide 4420 may include a stop that prevents cutting below the recommended depth. For example, the resection guide 4420 may have a height that is such that a lateral side of the resection guide 4420 may serve as a stop to prevent cutting beyond a particular depth. Alternatively, or in addition, a separate structure may be provided with the osteotomy system 4400 and/or the resection guide 4420 to serve as a stop to control cutting depth into a bone.	540	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Figure 45A illustrates the resection guide 4420 secured to the calcaneus 1806 by way of fasteners 4410a,b,c. In this embodiment, the resection guide 4420 includes a different set of bone attachment features 4424 than other embodiments described. The resection guide 4420 includes a first bone attachment feature 4424a and a second bone attachment feature 4424b on an anterior side of the resection guide 4420 and a third bone attachment feature 4424c on a posterior side of the resection guide 4420. In certain embodiments, the first bone attachment feature 4424a and second bone attachment feature 4424b may be configured such that a first fastener 4410a and second fastener 4410b deployed in the first bone attachment feature 4424a and the second bone attachment feature 4424b can be used in subsequent steps of the surgical procedure. In this embodiment, a wedge bone fragment formed by the osteotomy may not be connected to a fastener 4410. However, a surgeon may remove the wedge bone fragment using forceps.	541	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Figure 45B illustrates a stage in the procedure in which the surgeon has created the osteotomy. In one embodiment, the anterior bone fragment 1806a is separated from the posterior bone fragment 1806b. The resection guide 4420 is not shown in this view. In another embodiment, the anterior bone fragment 1806a may be connected to the posterior bone fragment 1806b by way of a living hinge (e.g., a portion of a medial cortex opposite the osteotomy). Advantageously, fastener 4410a and fastener 4410b engage with the anterior bone fragment 1806a and fastener 2010c engages with the posterior bone fragment 1806b. Thus, a surgeon can manipulate these bone fragments as needed.	542	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Referring now to Figure 45C, a surgeon may couple a pin guide 4440 to one of the resection features 4422 of the resection guide 4420. In this manner, a surgeon can position a reduction fastener 4442. In one embodiment, a reduction fastener 4442 can be used to assist in reducing the osteotomy. Advantageously, the angle and position of the reduction fastener 4442 can be predetermined and/or can be patient-specific for this patient and the needs of the patient and/or surgeon for the surgical procedure.	543	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	In certain embodiments, the pin guide 4440 can be used before forming one or more osteotomies. Alternatively, or in addition, a surgeon may form the osteotomies and then use the pin guide 4440 to deploy the reduction fastener 4442.	544	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Next, a surgeon can remove the pin guide 4440, the resection guide 4420, and the third fastener 4410c. The first fastener 4410a, second fastener 4410b, and reduction fastener 4442 remain in the bone fragments.	545	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Figure 45D illustrates a stage in the surgical osteotomy procedure. The pin guide 4440, the resection guide 4420, and the third fastener 4410c have been removed. The fasteners 4410a,b and reduction fastener 4442 remain engaged with the bone fragments of the calcaneus 1806. The anterior bone fragment 1806a and posterior bone fragment 1806b are shown reduced. The surgeon may reduce the bone fragments manually or the surgeon may use a complementary component 1930 such as one embodiment of a positioning guide 2300. In the illustrated embodiment, the action of sliding a positioning guide 2300 on the first fastener 4410a, second fastener 4410b, and reduction fastener 4442 can cause the posterior bone fragment 1806b to translate relative to the anterior bone fragment 1806a.	546	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Figures 46A-46G illustrate views of a resection guide of an osteotomy system, according to one embodiment. The resection guide 4420 can include some, or all, of the same, or substantially the same, features, aspects, and/or components as the other resection guides included in the present disclosure. Accordingly, the resection guide 4420 can, or may, include one or more resection features 4422 (e.g., resection features 4422a-b), one or more bone attachment features 4424 (e.g., bone attachment features 4424a-c), one or more handles, one or more landmark registration features, one or more bone engagement surfaces 4430, or the like.	547	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	In the illustrated embodiment, the resection guide 4420 includes a first resection feature 4422a and a second resection feature 4422b. The first resection feature 4422a may be configured to guide a cutting tool to form a first osteotomy. The second resection feature 4422b may be configured to guide a cutting tool (which may be the same cutting tool) to form a second osteotomy.	548	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	In certain embodiments, one or more of the handles 4426 can serve as both a handle used by a user to position the resection guide 4420 and/or as a landmark registration feature 4428. The landmark registration feature 4428 can provide the same features, advantages, and/or benefits as the landmark registration feature 2042 described above.	549	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	As also shown in Figure 24A, method 2400 may include removing the wedge bone fragment by way of the first fastener and the second fastener (block 2416). For example, a surgeon may remove the wedge bone fragment by way of the first fastener and the second fastener, as described herein.	407	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	As further shown in Figure 24A, method 2400 may include sliding a positioning guide over the posterior pin and the anterior pin by passing the posterior pin through a posterior alignment feature and passing the anterior pin through an anterior alignment feature (block 2418). For example, a surgeon may slide a positioning guide over the posterior pin and the anterior pin by passing the posterior pin through a posterior alignment feature and passing the anterior pin through an anterior alignment feature, as described herein.	408	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	As also shown in Figure 24A, method 2400 may include sliding the positioning guide along the posterior pin and anterior pin until the positioning guide contacts the posterior bone fragment and the anterior bone fragment (block 2420). For example, a surgeon may slide the positioning guide along the posterior pin and anterior pin until the positioning guide contacts the posterior bone fragment and the anterior bone fragment, as described herein.	409	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	As further shown in Figure 24A, method 2400 may include deploying fixation across an osteotomy between the posterior bone fragment and the anterior bone fragment (block 2422). For example, a surgeon may deploy fixation across an osteotomy between the posterior bone fragment and the anterior bone fragment, as described herein.	410	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Figures 24B-24G illustrates different stages of performing a surgical osteotomy procedure (e.g., a Dwyer osteotomy) using certain embodiments of the osteotomy system 2000 and/or the method 2400, according to one embodiment. Typically, a preferred approach for a Dwyer osteotomy is on the lateral side of the calcaneus 1806. In the illustrated embodiment, the surgical procedure creates a wedge osteotomy. According to one embodiment, a surgeon may access a lateral surface of the calcaneus 1806 (block 2402, Figure 24A).	411	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Next a surgeon may position a resection guide 2020 such as resection guide 2020a on the lateral surface in a position predetermined using a calcaneus model of the patient’s calcaneus 1806. In certain embodiments, the step of positioning can include seating or registration of the resection guide 2020 to a surface of the calcaneus 1806 (a bone). The resection guide 2020 may be configured, for example, as one of the embodiments described herein.	412	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Once positioned, a surgeon may deploy a first fastener 2010 into a first bone attachment feature 2024a and a second fastener into second bone attachment feature 2024b such that the first fastener and second fastener are parallel relative to each other and enter a portion of the calcaneus that will form a wedge bone fragment. (block 2406)	413	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Figure 24B illustrates the resection guide 2020a secured to the calcaneus 1806 by way of fasteners 2010. Figure 24C illustrates the resection guide 2020b (an alternative embodiment, fasteners 2010 omitted) positioned on a calcaneus 1806 of a foot.	414	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Next, a surgeon may insert a cutting tool into a posterior resection feature 2022a and an anterior resection feature 2022b and form a wedge bone fragment 2050. (blocks 2408 and 2410). In certain embodiments, the osteotomy system 2000 may include a guide for managing how deep a surgeon cuts into the calcaneus 1806 using the cutting tool. In one embodiment, the depth may be recommended in a preoperative plan and a surgeon may configure the cutting tool to indicate when that depth is reached. Alternatively, or in addition, the resection guide 2020 may include a stop that prevents cutting below the recommended depth. For example, the resection guide 2020 may have a height 2106 that is such that the lateral side 2030 of the resection guide 2020 may serve as a stop to prevent cutting beyond a particular depth. Alternatively, or in addition, a separate structure may be provided with the osteotomy system 2000 and/or the resection guide 2020 to serve as a stop to control cutting depth into a bone.	415	Added by DJM Jan 2024	1/6/24, 10:03 PM
View Edit Delete	PER-12	Next, a surgeon may engage a posterior pin guide 2202 with the posterior resection feature 2022a and an anterior pin guide 2204 with the anterior resection feature 2022b. in addition, the surgeon may deploy a posterior pin 2220 into the posterior pin guide 2202 and an anterior pin 2222 into the anterior pin guide 2204. (block 2412)	416	Added by DJM Jan 2024	1/6/24, 10:03 PM

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