Fracture models, systems, and associated methods

Abstract

The present disclosure relates to surgical systems, devices, and methods for planning and performing surgical procedures, including fracture repair. Systems and methods disclosed herein may be used to establish a physical model of an anatomical structure.

Description

[0001] Cross-reference to related applications

[0002] This application claims the benefit of U.S. Application No. 63 / 480,361, filed January 18, 2023, which is incorporated herein by reference in its entirety. Background Art

[0003] The present disclosure relates to surgical systems, devices, and methods for planning and performing surgical procedures using physical models of anatomy.

[0004] A patient may experience a fracture of one or more bones due to trauma. Surgeons can reduce the fracture and fix the bone fragments with implants to restore function to the patient.

[0005] Surgeons may prepare for orthopedic surgery by operating on cadaveric or sawn bone specimens. Summary of the Invention

[0006] The present disclosure relates to systems, devices, and methods for performing surgical procedures. The system can be used to perform one or more surgical procedures on a physical anatomical model representing an anatomical structure. The physical anatomical model can be cut along a fracture path to create one or more fragments. The physical anatomical model and associated fracture path can be created based on a virtual anatomical model of the anatomical structure.

[0007] A physical anatomical model according to an embodiment may include a body including an outer surface that can be associated with an anatomical feature of a bone, the body including a fracture path that can establish one or more localized regions, wherein the body can be cut along the fracture path to establish one or more fragments that can be associated with a corresponding one of the one or more localized regions.

[0008] An orthopedic system according to an embodiment may include a physical anatomical model comprising a body having a fracture path. A fracture tool may be adapted to sever the body along the fracture path to create one or more fragments.

[0009] A system for practicing surgical procedures according to one embodiment may include a computing device comprising a processor coupled to a memory. The processor may be configured to access a virtual anatomical model from the memory. The virtual anatomical model may be associated with an anatomical structure. The processor may be configured to display the virtual anatomical model in a graphical user interface. The processor may be configured to assign a fracture pattern to the virtual anatomical model based on one or more parameters. The processor may be configured to generate a configuration associated with a physical anatomical model that may represent the virtual anatomical model. The configuration may specify a fracture path established according to the assigned fracture pattern.

[0010] According to one embodiment, a method for establishing a physical anatomical model for use in a surgical procedure may include selecting a virtual anatomical model associated with an anatomical structure. The method may include assigning a fracture pattern to the virtual anatomical model based on one or more parameters. The method may include generating a configuration associated with the physical anatomical model that may represent the virtual anatomical model. The configuration may specify a fracture path established based on the assigned fracture pattern.

[0011] The present disclosure may include any one or more of the individual features disclosed above and / or below, alone or in any combination thereof.

[0012] Those skilled in the art will appreciate the various features and advantages of the present disclosure from the following detailed description. The drawings accompanying the detailed description can be briefly described as follows. BRIEF DESCRIPTION OF THE DRAWINGS

[0013] Figure 1 An exemplary planning system is disclosed.

[0014] Figure 2 Another exemplary planning system including a user interface is disclosed.

[0015] Figure 3 Public Figure 2 The user interface includes a display window including various parameters.

[0016] Figure 4 Public Figure 2 A display window of a user interface including a help screen presenting fracture classification information.

[0017] Figure 5 Public Figure 2 A user interface comprising a display window depicting a virtual anatomical model.

[0018] Figure 6-8 Public Figure 2 The user interface includes a Figure 5 A display window of various aspects of the virtual anatomical model.

[0019] Figure 9 Public Figure 2 A user interface that includes a diagram depicting the Figure 8 Display window of the fracture pattern of the virtual anatomical model.

[0020] Figures 10A-10D Public Figure 9 Various aspects of the fracture pattern.

[0021] Figure 11 Public Figure 2 A user interface that includes a diagram depicting the Figure 9Display window of the fracture pattern of the virtual anatomical model.

[0022] Figure 12 Public Figure 2 A user interface that includes a diagram depicting the Figure 9 Display window of the fracture body of the virtual anatomical model.

[0023] Figure 13A Public Figure 12 Cross-sectional views of various aspects of the fracture body.

[0024] Figure 13B Public Figure 12 Isolated view of the fracture body.

[0025] Figure 14 A cross-sectional view of a physical anatomical model according to another embodiment is disclosed.

[0026] Figures 15A-15C A cross-sectional view of the fractured body relative to the virtual anatomical model is disclosed.

[0027] Figures 16A-16C Disclosed relative to Figures 15A-15C A cross-sectional view of a fractured body of a soft tissue body associated with the virtual anatomical model.

[0028] Figure 17 Public Figure 2 A user interface comprising a display window depicting a virtual indicator relative to a virtual anatomical model.

[0029] Figure 18-20 Various states of a physical anatomical model are disclosed that incorporates information relative to the fracture path and Figure 17 Physical indicators associated with the virtual anatomical model.

[0030] Figures 21A-21C Various states of a physical anatomical model incorporating physical indicators relative to a fracture path are disclosed.

[0031] Figure 22 Another embodiment of an anatomical model relative to an indicator is disclosed.

[0032] Figure 23-24 Another embodiment of an anatomical model incorporating one or more voids is disclosed.

[0033] Figure 25 A perspective view of a fracture tool according to one embodiment is disclosed.

[0034] Figure 26 Disclosed are positioning relative to a physical anatomical model Figure 25 Fracture tools.

[0035] Figures 27A-27E Disclosed relative to Figure 26 Various states of the physical anatomical model of the fracture tool.

[0036] Figure 28 A perspective view of a fracture tool according to another embodiment is disclosed.

[0037] Figures 29A-29C Disclosed are positioning relative to a physical anatomical model Figure 28 Perspective views of the fracture tool in various states.

[0038] Figure 30 A fracture tool according to another embodiment is disclosed.

[0039] Figure 31 A perspective view of a fracture tool according to yet another embodiment is disclosed.

[0040] Figure 32 Public Figure 31 Side view of the fracture tool.

[0041] Figure 33 Public Figure 31 Cross-sectional view of the fracture tool.

[0042] Figure 34 Disclosed relative to Figure 32 A view of the fracture tool taken along line 34-34.

[0043] Figure 35 Disclosed are positioning relative to a physical anatomical model Figure 31 Perspective view of the fracture tool.

[0044] Figure 36 Disclosed relative to Figure 35 Another view of the fracture tool positioned on the physical anatomy model.

[0045] Figure 37 Disclosed is a physical anatomical model positioned relative to another Figure 31 Perspective view of the fracture tool.

[0046] Figure 38 Disclosed relative to Figure 37 Another view of the fracture tool positioned on the physical anatomy model.

[0047] Figure 39 Exemplary methods for planning and performing surgical procedures using physical anatomical models are disclosed.

[0048] Figure 40 A technique for forming a physical anatomical model is disclosed.

[0049] Figures 41A-41CA virtual anatomical model, a fragmented state of the virtual anatomical model, and a fragmented state of a physical anatomical model associated with the virtual anatomical model are disclosed.

[0050] Figures 42A-42B The fragmentation state of the physical anatomical model is disclosed.

[0051] Figures 42C-42D Disclosed positioning and fixing to Figure 42B Physical anatomical model of the implant.

[0052] Figure 43 Another embodiment of a virtual anatomical model in a display window is disclosed.

[0053] Figures 44A-44B Publicly disclosed with Figure 43 The virtual anatomical model is associated with the physical anatomical model.

[0054] Figure 45 The virtual anatomical model was released Figure 2 Implementation in the user interface of .

[0055] Figure 46 Another embodiment of a virtual anatomical model in a display window is disclosed.

[0056] Figures 47A-47B Publicly disclosed with Figure 46 The virtual anatomical model is associated with the physical anatomical model.

[0057] Figure 48 A virtual anatomical model including corresponding bone fracture volumes according to an embodiment is disclosed.

[0058] Figure 49 Public Figure 48 The fracture body of FIG, where the virtual anatomical model is represented by a dotted line.

[0059] Figures 50-51 Disclosed in different directions Figure 48 Isolated view of the fracture body.

[0060] Figure 52 Public Figure 48 A cross-sectional view of one of the virtual anatomical models and the associated fracture bodies.

[0061] Figures 53-55 Various states of a physical anatomical model including a fracture path are disclosed.

[0062] Figure 56 A physical anatomical model according to another embodiment is disclosed.

[0063] Figure 57 A physical anatomical model according to yet another embodiment is disclosed.

[0064] Figure 58 A physical anatomical model including a bone fracture body according to another embodiment is disclosed.

[0065] Figure 59 A virtual anatomical model including a virtual fracture pattern is disclosed.

[0066] Figure 60 Disclosed are virtual fracture bodies Figure 59 Virtual anatomical model.

[0067] Figure 61 Public Figure 60 Separated view of the virtual fracture body.

[0068] Figure 62 Public Figure 60 Cross-sectional view of the virtual fracture body.

[0069] Figure 63 Public Figure 60 The virtual anatomical model and the associated cross-sectional view of the virtual fracture body.

[0070] Like reference numbers and designations in the various drawings indicate like elements. DETAILED DESCRIPTION

[0071] The present disclosure relates to surgical systems, devices, and methods for planning and performing surgical procedures using physical models of anatomical structures. Physical anatomical models can be used to practice and train for various surgical procedures, including fracture repair.

[0072] The disclosed technology can be used to provide a training experience for surgeons that can be targeted or customized to the surgeon based on the surgery, skill set, experience, etc. The surgeon can select a specific configuration of a virtual anatomical model, which can be manufactured or otherwise formed to build a physical anatomical model based on the anatomical structure or pathology that the surgeon may intend to treat. In a scenario, the surgeon may be unfamiliar with a specific fracture type or other deformation and can choose to train using the configuration of the physical anatomical model. The surgeon can use the physical anatomical model to train with specific instruments, implants, and other devices that may be intended to be used to treat the patient's planned surgery. Once training on the physical anatomical model is completed, the surgeon can select more challenging cases in subsequent training cycles.

[0073] The surgeon, assistant, or other user can interact with a graphical user interface (GUI) to select various parameters or characteristics of the physical anatomical model. Parameters may include anatomical structure, patient, fracture classification, case, etc., to establish the desired configuration of the physical anatomical model. The surgeon can customize or select one or more variables or parameters specific to the fracture classification scheme based on the content the surgeon wishes to train. The specified parameters can be represented in the physical anatomical model.

[0074] The surgeon can interact with the user interface to select a desired case associated with a corresponding virtual anatomical model. The surgeon can interact with the user interface to select a previous case. The surgeon can select a case corresponding to the intended patient, or can select a previous or hypothetical case that can approximately correspond to a particular fracture classification.

[0075] Various techniques can be used to set up a physical anatomical model, including any technique in the technology disclosed herein. A virtual fracture pattern (e.g., a virtual fracture path) and / or a virtual fracture body can be set up relative to a virtual anatomical model. A fracture pattern can be set up based on one or more parameters of a fracture classification scheme. A virtual fracture body can be set up along or otherwise adjacent to a fracture pattern. A physical fracture path and / or a physical fracture body can be set up based on a virtual fracture pattern and / or a virtual fracture body, which can be incorporated into the physical anatomical model. The fracture body can set up a relatively weak local area of ​​the physical anatomical model, which can promote the fragmentation of the physical anatomical model. The surgeon can reassemble (e.g., restore) the fragments of the physical anatomical model. The surgeon can fix the fragments to each other and / or the rest of the physical anatomical model, such as with a bone plate or another implant. The anatomical model can be incorporated into one or more indicators to promote the assessment of repair.

[0076] The fracture tool can be used to join and establish the fragmented state of the physical anatomical model. The surgeon or clinical user can manipulate the fracture tool to establish one or more fragments. The fracture tool can apply a compressive force on the physical anatomical model to cause the physical anatomical model to fracture along a fracture path and / or fracture body to establish fragments.

[0077] The restored physical anatomical model can serve as an artifact for surgeons. Once training is complete, surgeons can leave the training facility with the modified animal anatomy model. The surgeon can refer to the modified animal anatomy model before and during surgery on the corresponding patient.

[0078] A physical anatomical model according to an embodiment may include a body including an outer surface that can be associated with an anatomical feature of a bone, the body including a fracture path that can establish one or more localized regions, wherein the body can be cut along the fracture path to establish one or more fragments that can be associated with a corresponding one of the one or more localized regions.

[0079] In any embodiment, the fracture path may include one or more segments. Each of the one or more segments may establish a ring around a corresponding local area.

[0080] In any embodiment, a fracture path can be established according to a predetermined fracture pattern.

[0081] In any embodiment, the body can include a first body and a second body. The first body can establish the outer surface of the body and can represent cortical bone. The second body can represent cancellous bone.

[0082] In any embodiment, the outer surface along at least one of the localized regions can be associated with an articular surface of a joint.

[0083] In any embodiment, the fracture path can extend along a boundary region between the first body and the second body. The body can include a fracture body established along the fracture path such that the fracture body can be at least partially embedded in the first body. The body can be cut along the fracture body to establish one or more fragments.

[0084] In any embodiment, the first body can have a first characteristic. The fracture body can have a second characteristic that can be different from the first characteristic.

[0085] In any embodiment, the first characteristic may include a first material strength. The second characteristic may include a second material strength that may be less than the first material strength.

[0086] In any embodiment, one or more extensions may extend from an outer surface of the body adjacent the fracture path.The one or more extensions may represent soft tissue.

[0087] In any embodiment, the body can include one or more indicators that can be associated with the fracture path.

[0088] In any embodiment, the one or more indicators may include a plurality of graduations that may be distributed along the length of the fracture path.

[0089] In any embodiment, the one or more indicators can include an indicator path along the outer surface of the body.The indicator path can be sized to follow the length of the fracture path.

[0090] In any embodiment, the body can include a fracture body that can be established along the fracture path. The body can be cut along the fracture body to establish one or more fragments. The one or more indicators can include a visual contrast between the body and the fracture body.

[0091] In any embodiment, the fracture body can be spaced apart from the outer surface of the body.

[0092] In any embodiment, the one or more indicators may comprise an established shape along an outer surface of the body.The shape may span between at least two regions in the localized area.

[0093] In any embodiment, the shape can be a contour associated with a perimeter of an orthopedic implant capable of being secured to adjacent bone fragments.

[0094] In any embodiment, the fracture body can be associated with the fracture path.The fracture body can extend substantially through the body such that the body can be severed along the fracture body to create one or more fragments.

[0095] In any embodiment, the body can have a first characteristic. The fracture body can have a second characteristic that can be different from the first characteristic.

[0096] In any embodiment, the fracture body can include at least one indicator adapted to selectively communicate a state of the physical anatomical model in response to an external force.

[0097] In any embodiment, the fracture body can include a compressible material.

[0098] In any embodiment, the fracture body can be adapted to release an amount of fluid in response to an external force exceeding a preselected limit.

[0099] In any embodiment, the fracture body can be adapted to release one or more objects in response to an external force exceeding a preselected limit.

[0100] In any embodiment, the body may comprise a polymeric material.

[0101] In any embodiment, the bony anatomical feature can be associated with a long bone.

[0102] An orthopedic system according to an embodiment may include a physical anatomical model comprising a body having a fracture path. A fracture tool may be adapted to sever the body along the fracture path to create one or more fragments.

[0103] In any embodiment, the body can include a first body and a second body. The first body can establish the outer surface of the body and can represent cortical bone. The second body can represent cancellous bone.

[0104] In any embodiment, the fracture tool can include a clamp having a first clamp element and a second clamp element. The first clamp element can include a plurality of configurable engagement elements that can be sized to engage selectable contact points along the body. Each of the engagement elements can be adapted to cooperate with the second clamp element to apply a compressive force at a corresponding contact point to sever the body along the fracture path to create the one or more fragments.

[0105] In any embodiment, a plurality of contact indicators may be established along an outer surface of the body adjacent the respective contact points.Each of the contact indicators may be associated with a respective one of the engagement elements.

[0106] A system for practicing surgical procedures according to one embodiment may include a computing device comprising a processor coupled to a memory. The processor may be configured to access a virtual anatomical model from the memory. The virtual anatomical model may be associated with an anatomical structure. The processor may be configured to display the virtual anatomical model in a graphical user interface. The processor may be configured to assign a fracture pattern to the virtual anatomical model based on one or more parameters. The processor may be configured to generate a configuration associated with a physical anatomical model that may represent the virtual anatomical model. The configuration may specify a fracture path established according to the assigned fracture pattern.

[0107] In any embodiment, the processor can be configured to generate the configuration such that the physical anatomical model can be severed along the fracture path to create one or more fragments.

[0108] In any embodiment, the processor can be configured to generate a fracture volume of a length that can follow the fracture pattern. A configuration can be established based on the fracture volume.

[0109] In any embodiment, the fracture pattern can include a first fracture path and a second virtual fracture path that can be spaced apart from each other.A fracture volume can be defined between the first fracture path and the second fracture path.

[0110] In any embodiment, the fracture volume can be associated with a weaker material than adjacent portions of the virtual anatomical model.

[0111] In any embodiment, the configuration may specify one or more indicators associated with the fracture path.

[0112] In any embodiment, the one or more parameters may be associated with a predefined fracture classification scheme.The processor may be configured to assign the fracture pattern to the virtual anatomical model in response to setting the one or more parameters associated with the predefined fracture classification scheme.

[0113] In any embodiment, the virtual anatomical model may include a first body and a second body. The first body may represent cortical bone and the second body may represent cancellous bone.

[0114] In any embodiment, the processor can be configured to generate a fracture pattern.The fracture pattern can extend along a boundary region between the first body and the second body.

[0115] In any embodiment, the processor can be configured to generate a fracture volume of a length that can follow the fracture pattern. A configuration can be established based on the fracture volume.

[0116] In any embodiment, the configuration may specify one or more indicators associated with the fracture path.

[0117] In any embodiment, the one or more indicators may include at least one or more of an indicator path that may follow the length of the fracture path, a plurality of scales that may be distributed along the length of the fracture path, a shape that may span the fracture path, and a visual contrast between the fracture path and adjacent portions of the physical anatomical model.

[0118] In any embodiment, at least one indicator can include a contour.The contour can be associated with a perimeter of an orthopedic implant that is securable to adjacent bone fragments.

[0119] In any embodiment, the processor can be configured to generate a fracture body based on the fracture pattern such that the fracture body can extend substantially through the body of the physical anatomical model such that the body can be severed along the fracture body to create one or more fragments.

[0120] In any embodiment, the body can have a first characteristic. The fracture body can have a second characteristic that can be different from the first characteristic.

[0121] In any embodiment, the fracture body can include at least one indicator associated with a status of the physical anatomical model.

[0122] In any embodiment, the fracture body can include a compressible material.

[0123] According to one embodiment, a method for establishing a physical anatomical model for use in a surgical procedure may include selecting a virtual anatomical model associated with an anatomical structure. The method may include assigning a fracture pattern to the virtual anatomical model based on one or more parameters. The method may include generating a configuration associated with the physical anatomical model that may represent the virtual anatomical model. The configuration may specify a fracture path established based on the assigned fracture pattern.

[0124] In any embodiment, the one or more parameters may be associated with a predefined fracture classification scheme.The step of assigning the fracture pattern may occur in response to setting the one or more parameters associated with the predefined fracture classification scheme.

[0125] In any embodiment, the method can include causing the virtual anatomical model and the assigned fracture pattern to be displayed in a graphical user interface.

[0126] In any embodiment, the method may include setting the one or more parameters in response to user interaction with the graphical user interface.

[0127] In any embodiment, the method may include forming the physical anatomical model based on the configuration. The fracture path may establish one or more localized regions of the physical anatomical model. The physical anatomical model may be cut along the fracture path to establish one or more fragments associated with the corresponding localized regions.

[0128] In any embodiment, the forming step may include printing layers of material upon each other to create the physical anatomical model.

[0129] In any embodiment, the physical anatomical model can include a first body and a second body. The first body can represent cortical bone. The second body can represent cancellous bone.

[0130] In any embodiment, the configuration may specify a fracture volume that may follow the length of the fracture path.The physical anatomical model may be cut along the fracture volume to create the one or more fragments.

[0131] In any embodiment, the configuration may specify one or more indicators associated with the fracture path.

[0132] In any embodiment, the one or more indicators can include a plurality of contact indicators that can be distributed along the physical anatomical model. Each of the contact indicators can be associated with a corresponding contact element of the fracture tool. The body of the physical anatomical model can be severed along the fracture path to create one or more fragments in response to the fracture tool applying a certain amount of force at a contact point along the physical anatomical model adjacent to a corresponding contact indicator.

[0133] In any embodiment, the configuration can specify a fracture body that can span between opposite sides of the fracture path such that the fracture body can extend substantially through the body of the physical anatomical model. The physical anatomical model can be cut along the fracture body to create one or more fragments.

[0134] Figure 1 A planning system 20 is shown that can be used to plan surgical procedures according to one embodiment. The system 20 can be used to plan orthopedic surgery, including preoperatively, intraoperatively, and / or postoperatively to create, edit, execute, and / or review surgical plans. The system 20 can be used for training and rehearsing various surgical procedures, including prior patient cases and surgical plans, as well as hypothetical cases.

[0135] System 20 may include a host computer 21 and one or more client computers 22. Host computer 21 may be configured to execute one or more software programs. In an embodiment, host computer 21 may include more than one computer that is collectively configured to process software instructions serially or in parallel.

[0136] Host computer 21 can communicate with one or more networks, such as network 23, which includes one or more computing devices. Network 23 can be a private local area network (LAN), a private wide area network (WAN), the Internet, or a mesh network.

[0137] The host computer 21 and each client computer 22 may include one or more of a computer processor, memory, storage components, network devices, and input and / or output devices and / or interfaces. Input devices may include a keyboard, a mouse, etc. Output devices may include a monitor, a speaker, a printer, etc. Memory may include UVPROM, EEPROM, FLASH, RAM, ROM, DVD, CD, hard drive, or other computer-readable media that may store data and / or other information related to the features and techniques disclosed herein. The host computer 21 and each client computer 22 may be a desktop computer, a laptop computer, a smartphone, a tablet computer, or any other computing device. Interfaces may facilitate communication with other systems and / or components of the network 23.

[0138] Each client computer 22 can be configured to communicate with the host computer 21 directly through a direct client interface 24 or through a network 23. The client computers 22 can be configured to execute one or more software programs, such as various surgical tools. Each client computer 22 can be operated to access and execute a planning environment 26 locally and / or remotely. The planning environment 26 can be a stand-alone software package or can be incorporated into another surgical tool. The planning environment 26 can be configured to communicate with the host computer 21 through the network 23 or directly through a direct client interface 24. In an embodiment, the client computers 22 can be configured to communicate directly with each other through a peer interface 25.

[0139] The planning environment 26 can provide, through one or more graphical user interfaces (GUIs), a display or visualization of one or more virtual anatomical models 29 and associated images and / or one or more implant models 30. Each anatomical model 29, implant model 30, and associated images and other information can be stored in one or more files or records according to a specified data structure.

[0140] System 20 may include at least one storage system 27 that is operable to store data or otherwise provide data to other computing devices. Storage system 27 may be a storage area network device (SAN) configured to communicate with host computer 21 and / or client computer 22 via network 23. In an embodiment, storage system 27 may be incorporated into or directly coupled to host computer 21 and / or client computer 22. Storage system 27 may be configured to store one or more of computer software instructions, data, database files, configuration information, and the like.

[0141] In an embodiment, system 20 may be a client-server architecture configured to execute computer software on a host computer 21, which may be accessed by a client computer 22 using a thin client application or a web browser executing on the client computer 22. The host computer 21 may load the computer software instructions into memory from a local storage device or from a storage system 27 and may execute the computer software using one or more computer processors.

[0142] The system 20 may include one or more databases 28. The database 28 may be stored in a central location, such as a storage system 27. In an embodiment, the one or more databases 28 may be stored in the host computer 21 and / or may be a distributed database provided by one or more of the client computers 22. Each database 28 may be a relational database configured to associate one or more anatomical models 29 and / or one or more implant models 30 with each other and / or with an operation plan 31. Each operation plan 31 may be associated with a corresponding patient. A unique identifier or database entry may be assigned to each anatomical model 29, implant model 30, and operation plan 31. The database 28 may be configured to store data corresponding to the anatomical model 29, implant model 30, and operation plan 31 in one or more database records or entries, and / or may be configured to link or otherwise associate one or more files corresponding to each corresponding anatomical model 29, implant model 30, and operation plan 31. The anatomical models 29 stored in the database 28 can correspond to corresponding patient anatomies from previous and / or planned surgical cases and can be arranged by one or more predefined categories, such as gender, age, race, size, defect category, surgery type, etc. The anatomical models 29 and / or implant models 30 can be associated with corresponding instruments and devices for implementing the associated surgical plan 31.

[0143] Each anatomical model 29 can include the information obtained from one or more medical devices or tools, and the one or more medical devices or tools are such as computed tomography (CT), magnetic resonance imaging (MRI) machines and / or X-ray machines, which can obtain one or more images of the patient. The anatomical model 29 can include one or more digital images and / or coordinate information relevant to the patient's anatomical structure, and the digital image and / or coordinate information are obtained or derived from the medical device. In an embodiment, one or more of the anatomical models 29 can be created by a designer and can represent a hypothetical anatomical structure. Each implant model 30 can include the coordinate information associated with a predefined design. The planning environment 26 can be incorporated with one or more modeling packages (such as computer-aided design (CAD) packages) and / or be connected with one or more modeling packages to reproduce models 29, 30 as two-dimensional (2D) and / or three-dimensional (3D) bodies or structures. Each anatomical model 29 and implant model 30 can correspond to 2D and / or 3D geometric shapes and can be used to generate wireframe, grid and / or solid structures in a display.

[0144] Implant model 30 can correspond to implant and the assembly of various configurations, shapes, sizes, operations, instruments etc.Each implant can comprise one or more assemblies that can be positioned at the surgical site, and described one or more assemblies comprise plate, anchor, screw, nail, suture, graft etc.Each implant model 30 can correspond to single assembly, or can comprise two or more assemblies that can be configured to set up assembly.Implant model 30 can comprise the base plate that is connected to hinge member, be configured to bone plate, intramedullary nail, suture anchor etc. that adjacent bone or bone fragment are interconnected.Hinged member can have the articular surface that size is set to cooperate with the articular surface of relative bone or implant.

[0145] Each surgical plan 31 can be associated with one or more of the anatomical model 29 and / or the implant model 30. The surgical plan 31 can include one or more modifications to the anatomical model 29 and information related to the positioning of the implant model 30 relative to the original and / or modified anatomical model 29. The surgical plan 31 can include coordinate information related to the modified anatomical model 29 and the relative positioning of the implant model 30 in a predefined data structure. Modifications to each anatomical model 29, implant model 30, and surgical plan 31 can be stored in the database 28 automatically and / or in response to user interaction with the system 20.

[0146] One or more surgeons, assistants, and other clinical users can be provided with a planning environment 26 via a client computer 22 and can simultaneously access each anatomical model 29, implant model 30, and surgical plan 31 stored in a database 28. Each user can interact with the planning environment 26 to create, view, and / or modify various aspects of the surgical plan 31. Each client computer 22 can be configured to store a local instance of the anatomical model 29, implant model 30, and / or surgical plan 31, which can be synchronized with the database 28 in real time or periodically. The planning environment 26 can be a stand-alone software package executed on the client computer 22, or can be provided as one or more services executed on the host computer 21.

[0147] Figure 2A surgical system 120 according to one embodiment is shown. The system 120 is used to facilitate the planning, rehearsal and / or training of surgical procedures. The system 120 can be used to plan, rehearse, train and perform various orthopedic and other surgical procedures, such as arthroplasty to repair a joint. The system 120 can be used to plan the resection or modification of one or more bones. The system 120 can be used to plan the placement of implants to restore function of bones and / or joints, such as the shoulder joint, during dissection or reverse shoulder rotation surgery. The system 120 can be used to plan the repair of fractures of one or more bones, including one or more long bones, such as the humerus. Although the planning systems and methods disclosed herein are primarily directed to repairing the shoulder, it should be understood that the planning system 120 can be used to repair other locations on a patient and other surgical procedures, including repairing other joints, such as the ankle, wrist, hand, hip or knee, and including repairing other tissues, such as cartilage, muscles, tendons and ligaments.

[0148] The system 120 can be configured to generate one or more physical anatomical models, including any of the physical anatomical models disclosed herein. A surgeon can perform one or more modifications to the physical anatomical models to practice or train for a surgical procedure. The system 120 can be configured to generate a configuration associated with the corresponding physical anatomical model. The configuration can be used to form the physical anatomical model. Each physical anatomical model can represent a virtual anatomical model 129, including a geometry, texture density, porosity, color, etc. that substantially or approximately corresponds to the virtual anatomical model 129. The virtual anatomical model 129 can be associated with an anatomical structure, such as a patient's anatomical structure and / or a hypothetical anatomical structure. The anatomical model 129 can include one or more anatomical features. The anatomical features can represent anatomical structures, including one or more bones, including cartilage, cortical and / or cancellous bone tissue; soft tissue, including muscle, ligaments and / or tendons; and / or other tissues.

[0149] The system 120 may include a computing device 132. The computing device 132 may include at least one processor 133 coupled to a memory 134. The computing device 132 may include any of the computing devices disclosed herein, such as Figure 1 The host computer 21 and / or the client computer 22 may be configured to execute the planning environment 126 for creating, editing, executing, and / or reviewing one or more surgical (e.g., preoperative) plans 131 during the preoperative, intraoperative, and / or postoperative phases of a surgical procedure. The processor 133 may be configured to access one or more virtual anatomical models 129 from a storage location such as a memory 134. The anatomical models 129 and surgical plans 131 may be associated with actual cases of patients or may be hypothetical cases created for rehearsing and / or training surgeons, assistants, medical staff, and other clinical users.

[0150] The planning environment 126 may include at least a data module 135, a display module 136, a space module 137, and a comparison module 138. The processor 133 may be configured to execute the data module 135, the display module 136, the space module 137, and the comparison module 138. Figure 2 While four modules are disclosed in the embodiment of the present invention, it should be understood that fewer or more than four modules may be utilized and / or one or more of the modules may be combined to provide the disclosed functionality.

[0151] The data module 135 can be configured to access, retrieve, and / or store data and other information corresponding to one or more virtual anatomical models 129, implant models 130, and / or surgical plans 131 in the database 128. The data and other information can be stored in the database 128 as one or more records or entries 139. In an embodiment, the data and other information can be stored in one or more files that can be accessed by reference to one or more objects or memory locations referenced by the record 139.

[0152] The memory 134 can be configured to access, load, edit, and / or store one or more instances of the anatomical model 129, the implant model 130, and / or the surgical plan 131 in response to one or more commands from the data module 135. The data module 135 can be configured to cause the memory 134 to store local instances of the anatomical model 129, the implant model 130, and / or the surgical plan 131, which can be synchronized with the records 139 in the database 128.

[0153] The display module 136 can be configured to display data and other information related to the one or more surgical plans 131 in at least one graphical user interface (GUI) 142. The computing device 132 can be coupled to a display device 140. The display module 136 can be configured to cause the display device 140 to display the virtual anatomical model 129 in the user interface 142. A surgeon or other clinical user can interact with the user interface 142 through the planning environment 126 to create, edit, execute, and / or review aspects of the one or more anatomical models 129. A surgeon or other user can interact with the user interface 142 through the planning environment 126 to create, edit, execute, and / or review one or more surgical plans 131.

[0154] Each surgical plan 131 can be associated with one or more (e.g., original) virtual anatomical models 129 prior to any modifications, which can substantially or generally approximate the anatomical structure. Each surgical plan 131 can be associated with one or more (e.g., modified) virtual anatomical models 129 that can incorporate one or more modifications to the anatomical structure and / or an associated physical anatomical model. The original and modified anatomical models 129 can be associated with each other in the surgical plan 131. In an embodiment, the modifications can be stored as one or more parameters of the original anatomical model 129.

[0155] The planning system 120 may be configured to generate a link to the surgical plan 131. A surgeon, assistant, or other clinical user may interact with the link to review and edit the surgical plan 131. Interacting with the link may cause the planning system 120 to display or otherwise present aspects of the surgical plan 131 in the graphical user interface 142.

[0156] The planning system 120 can be used to generate a physical instance of a virtual anatomical model 129 that a surgeon can use to practice or train to repair a fracture. The surgeon can interact with the fracture state of the physical anatomical model, which can be associated with the virtual anatomical model 129. Each fracture can be classified according to one or more fracture classification schemes 141. Various fracture classification schemes can be utilized according to the teachings disclosed herein, including predefined industry classification schemes and / or user-defined classification schemes. Industry-defined classification schemes can include the Müller AO fracture classification, the Neer classification, and the AO Foundation and Orthopaedic Trauma Association (AO / OTA) fracture classification scheme. The AO / OTA fracture classification scheme can include the 2018 revision of the AO / OTA Fracture and Dislocation Classification Compendium published by the AO Foundation. The Neer classification can be used to classify proximal humeral fractures. Other fracture classification schemes can be utilized according to the teachings disclosed herein, including any known classification scheme recognized in the medical community.

[0157] The planning system 120 may be adapted to access one or more fracture classification schemes 141. The comparison module 138 may be adapted to access one or more fracture patterns (e.g., virtual fracture paths) 143. Various techniques may be used to establish the fracture patterns 143, including any of the techniques disclosed herein. The planning system 120 may be adapted to associate each fracture pattern 143 with one or more fracture classification schemes 141. The data module 135 may be configured to access, retrieve, and / or store data and other information corresponding to one or more fracture classification schemes 141 and / or fracture patterns 143 in the database 128. The fracture classification schemes 141 and / or fracture patterns 143 may be predefined and / or may be established by the comparison module 138. In an embodiment, the planning system 120 may generate one or more fracture classification schemes 141 and / or fracture patterns 143 automatically and / or in response to user input. Various techniques, such as finite element analysis (FEA) and other parametric modeling, may be utilized to generate the fracture patterns 143.

[0158] The comparison module 138 can be adapted to associate each anatomical model 129 with one or more fracture classification schemes 141 and / or fracture patterns 143. The comparison module 138 can be adapted to assign one or more fracture classification schemes 141 to each fracture pattern 143 automatically and / or in response to a user interaction with a user interface 142 and / or another portion of the planning system 120. The data module 135 can be adapted to store and / or access instances of each anatomical model 129 and associated fracture classification schemes 141 and / or fracture patterns 143 in the database 128 or another memory location. The comparison module 138 can be adapted to generate, modify, or otherwise associate the surgical plan 131 with the anatomical model 129, the fracture classification scheme 141, and / or the fracture pattern 143.

[0159] Each fracture classification scheme 141 and / or fracture pattern 143 can be stored in a corresponding predefined data structure in the database 128 or another portion of the system 120. Data and other information associated with the corresponding fracture classification scheme 141 and / or fracture pattern 143 can be stored in the database 128 as one or more corresponding records or entries 139. In an embodiment, the data and other information can be stored in one or more files that can be accessed by referencing one or more objects or memory locations referenced by the record 139. The memory 134 can be configured to access, load, edit, and / or store one or more instances of the fracture classification scheme 141 and / or fracture pattern 143 in response to one or more commands from the data module 135. The data module 135 can be configured to cause the memory 134 to store a local instance of the fracture classification scheme 141 and / or fracture pattern 143, which can be synchronized with the record 139 in the database 128.

[0160] The planning system 120 can be used to create one or more physical anatomy models 148 , including any of the physical anatomy models disclosed herein. The physical anatomy model 148 can represent an associated virtual anatomy model 129 .

[0161] refer to Figure 3 , continue to refer to Figure 2 The user interface 142 may include one or more display windows 144 and one or more objects 146, such as the first display window 144-1. The objects 146 may include graphics such as menus, tabs, lists, input fields, and buttons that are accessible to user interactions, such as tabs 146T, buttons 146B, drop-down lists 146L, menus 146M, direction indicators 146D, 146R (e.g., Figure 5 ) and graphics associated with corresponding display windows 144. In an embodiment, one or more entries may be specified in corresponding input fields, including any parameters associated with list 146L. Geometric objects, including the selected virtual anatomical model 129, implant model 130, fracture pattern 143, and / or other information related to surgical plan 131, may be displayed in one or more of display windows 144.

[0162] The comparison module 138 can be configured to assign a fracture pattern 143 to the virtual anatomical model 129 based on one or more parameters, including any of the parameters disclosed herein. The parameters can be associated with a predefined fracture classification scheme 141. The comparison module 138 can be configured to assign the fracture pattern 143 to the virtual anatomical model 129 in response to setting one or more parameters associated with the fracture classification scheme 141.

[0163] The surgeon or clinical user can interact with the display window 144 and / or another portion of the user interface 142 to select one or more anatomical models 129. Various parameters can be used to select the anatomical models 129. The anatomical models 129 can be categorized by anatomy, patient, defect (e.g., fracture classification), case, etc. The parameters can be associated with corresponding objects 146 of the user interface 142. The parameters of the display window 144 can be interconnected to provide a filtering feature so that each selection of a parameter can cause the remaining parameters to be filtered out to depict the available options. Each parameter can be associated with a set of anatomical models 129 accessible to the planning environment 126.

[0164] The display module 136 can be adapted to present one or more parameters associated with the anatomical structure, patient, fracture classification scheme, and / or case to the surgeon or clinical user in a display window 144. The surgeon or clinical user can interact with the user interface 142 to select or otherwise specify one or more of the parameters. The anatomical parameters can be arranged in one or more lists 146L by category (e.g., joint, etc.), subcategory (e.g., shoulder, ankle, hip, hand, foot, etc.), model (e.g., glenoid, humerus, femur, pelvis, tibia, etc.), and anatomical size (e.g., small, medium, large). The categories can be subdivided into gross anatomical categories including surface anatomy (e.g., external body), regional anatomy (e.g., specific regions of the body), and system anatomy (e.g., specific organ systems). The data module 135 can be adapted to populate the display module 136 with entries associated with the virtual anatomical model 129 and other parameters including categories, subcategories, models, and / or sizes in the corresponding lists 146L. The spatial module 137 can be configured to scale the geometry of the selected anatomical model 129 in response to the selection of the anatomical size. The surgeon or clinical user can select or otherwise specify anatomical parameters, including the category, subcategory, model, and / or size of the anatomical structure, in response to interaction with the display window 144 and / or another portion of the user interface 142. Each list 146L can be associated with one or more virtual anatomical models 129. The anatomical models 129 can be associated with the patient's anatomical structure (e.g., a previous case or a planned case) and / or a hypothetical anatomical structure. The surgeon or clinical user can select or otherwise specify parameters associated with the corresponding virtual anatomical model 129.

[0165] The anatomical models 129 can be categorized by patient parameters. Various patient parameters can be utilized, such as gender, age, and race. The patient parameters can be presented in a corresponding list 146L. The data module 135 can be adapted to cause the display module 136 to populate the corresponding list 146L with one or more associated patient parameters. The data module 135 can be adapted to cause the display module 136 to populate entries associated with the anatomical structures and other parameters including category, subcategory, model, and / or size in response to specifying parameters associated with a patient population.

[0166] Case parameters may include case type (e.g., previous, planned, and hypothetical), case number, etc. The surgeon may interact with list 146L and / or another portion of user interface 142 to select and / or review a particular case, such as a previous, planned, or hypothetical case associated with surgical plan 131, which may be filtered by data module 135 based on a previous selection of parameters. The surgeon may interact with user interface 142 to review previous cases, including previous cases for a particular surgical procedure, anatomical structure, and / or patient group. The planning system 120 may be configured to provide analysis of previous cases, such as biometric testing of a repaired joint, finite element analysis (FEA), etc. The surgeon or clinical user may select a virtual anatomical model 129 corresponding to the intended patient. The selected virtual anatomical model 129 may correspond to an acquired CT scan of the patient. The surgeon may select a virtual anatomical model 129 that may be associated with a particular classification.

[0167] The data module 135 can be adapted to cause the display module 136 to populate entries associated with the case, such as type (e.g., prior, planned, or hypothetical) and / or case number in the corresponding list 146L. The data module 135 can be adapted to cause the display module 136 to populate entries associated with the case and other parameters including type and / or case number in the corresponding list 146L in response to specifying parameters associated with the patient population.

[0168] The surgical plan 131 can be associated with the anatomical model 129 before any modification, and can be associated with another (e.g., modified) anatomical model 129 incorporating one or more modifications based on the performance of the associated surgical procedure. The modification can include removing material using one or more drilling, milling, resectioning, reaming, and cutting operations. The modification can include one or more fragmented states of the anatomical model 129, including before and / or after registration of any associated fragments.

[0169] The display module 136 can be adapted to present one or more parameters of the fracture classification scheme 141 associated with the virtual anatomical model 129 in the user interface 142. The display module 136 can be adapted to display the parameters associated with the classification scheme 141 in a first display window 144-1. The display module 136 can be configured to present one or more parameters of the corresponding classification scheme 141 in response to a selection of a bone type and / or a fracture location. The display module 136 can be adapted to present one or more parameters associated with the classification scheme 141 in response to selecting a bone type (e.g., humerus, femur, tibia, etc.) and / or a fracture location (e.g., a proximal humeral fracture location) from one or more menus 146L and / or another portion of the user interface 142. The data module 135 can be adapted to cause the display module 136 to populate entries associated with the parameters of the fracture classification scheme 141 in the corresponding list 146L and / or other portions of the user interface 142. The fracture classification scheme 141 can be selected automatically and / or manually in response to one or more selections associated with an anatomical structure, a patient, and / or a case. Entries can include bone type (e.g., humerus), location (e.g., proximal segment), type (e.g., two-part, three-part, or four-part), group (e.g., surgical neck fracture), and subgroup (e.g., with larger trochanteric fractures) as well as other parameters of the associated fracture classification scheme 141, such as qualifiers and / or modifiers in the corresponding list 146L.

[0170] The data module 135 may be adapted to access a virtual anatomical model 129 from a memory, such as the memory 134 and / or the database 128, in response to selecting one or more parameters in a display window 144 of the graphical user interface 142. The data module 135 may be configured to select an anatomical model 129 from a memory, such as the database 128 or the memory 134, in response to a user interaction with the display window 144 or another portion of the user interface 142. The data module 135 may select a fracture pattern 143 in response to selecting or otherwise specifying one or more of the parameters of the fracture classification scheme 141 for the selected virtual anatomical model 129.

[0171] The surgeon or clinical user can select the virtual anatomical model 129 based on the severity of various defects, such as mild, severe, non-pathological, fracture, etc. Defect parameters can be established for various defects and can be arranged by category, sub-category, etc. The surgeon, assistant or other user can interact with buttons 146B (see, for example, question mark button 146Q) to interpret the defect parameters (see, for example, Figure 4146L). In an embodiment, selecting the virtual anatomical model 129 from the list 146L can cause a help screen with one or more fracture classification options to be generated and displayed in response to selection of the button 146Q. The fracture classification options can be associated with corresponding fracture classification schemes 141, including any of the fracture classification schemes disclosed herein. A surgeon or clinical user can select from a variety of classification parameters to practice and / or train for surgical procedures, including treating fractures.

[0172] refer to Figure 5 , continue to refer to Figure 2 , the selected virtual anatomical model 129 may be displayed in one or more display windows 144 of the user interface 142. Figure 5 In an embodiment, various views of the virtual anatomical model 129 can be displayed in the display windows 144-2, such as the second group of display windows 144-2A to 144-2D. Each virtual anatomical model 129 can include one or more components 129C. The components 129C can include various representations of tissues, such as bones and soft tissues. Bones can be represented by corresponding bone bodies 129B. Soft tissues can be represented by corresponding soft tissue bodies 129S. Various representations of soft tissues can be utilized, such as tendons, ligaments, muscle tissue, and other soft tissues. The anatomical model 129 can establish a portion of a joint 129J. The bone body 129B can include at least an articular surface 129A, which can be sized to cooperate with adjacent articular surfaces to establish the joint 129J. Although Figure 5 144 - 2A through 144 - 2D are shown, but it should be understood that fewer or more than four display windows 144 may be utilized in accordance with the teachings disclosed herein. A surgeon or clinical user may interact with one or more of the objects 146 to view various aspects of the anatomical model 129. In an embodiment, a surgeon or clinical user may interact with the list 146L to select a corresponding anatomical object (e.g., a humerus).

[0173] refer to Figure 6 , continue to refer to Figure 2 and 5, a surgeon or clinical user can interact with the user interface 142 to observe one or more aspects of the anatomical model 129. The user interface 142 may include one or more display windows 144-3, such as the third group of display windows 144-3A to 144-3D. The user can interact with the list 146L to select a particular portion of the soft tissue 129S, such as the rotator cuff. The display module 136 can be adapted to display one or more components 129C of the anatomical model 129, such as the attachment area 129R. The attachment area 129R can be established along the interface between the bone body 129B and the corresponding soft tissue body 129S. The surgeon or clinical user can interact with one of the objects 146 to specify the transparency of one or more of these selected components 129C, such as one or more of the soft tissue bodies 129S. Reference Figure 7 , continue to refer to Figure 2-3 and 6. The surgeon or clinical user may interact with the user interface 142, such as by interacting with one of the buttons 146B or another object 146 to select an attachment view within the list 146L, such that the display module 136 may display a view omitting the attachment region 129R of the soft tissue (see, e.g., Figure 6 ). The attachment area 129R may be displayed in one or more display windows 144-4, such as the fourth group of display windows 144-4A to 144-4D.

[0174] refer to Figure 8 , continue to refer to Figure 2 and 7 , a surgeon or clinical user can interact with the user interface 142 to observe an isolated view of the bone body 129B. The virtual anatomical model 129 can be displayed in one or more display windows 144-5, such as the fifth group of display windows 144-5A to 144-5D. The display module 136 can be adapted to display one or more aspects of the bone body 129B, such as the cortical bone body 129CO and / or the cancellous bone body 129CA. In an embodiment, the cortical bone body 129CO can be displayed in dotted lines, and the cancellous bone body 129CA can be displayed as a two-dimensional or three-dimensional solid.

[0175] The virtual anatomical model 129 may include one or more bodies 129V. One or more characteristics of the body 129V may be the same or different. The characteristics may include any of the characteristics disclosed herein, such as material composition and / or structure. In an embodiment, the body 129V may include a first body 129V1 and a second body 129V2. The first (e.g., cortical bone) body 129V1 may represent cortical bone. The second (e.g., cancellous bone) body 129V2 may represent cancellous bone. The cortical bone body 129CO may establish the first body 129V1. The cancellous bone body 129CA may establish the second body 129V2. The first body 129V1 and the second body 129V2 may include one or more characteristics that may be the same or different, such as material composition and / or structure. In an embodiment, the density of the first and second bodies 129V1, 129V2 may be different. Different densities may be associated with different bone densities of the associated anatomical structures.

[0176] refer to Figure 9 , continue to refer to Figure 2 and 8 , one or more fracture patterns 143 may be selected or assigned to each virtual anatomical model 129. In an embodiment, the data module 135 may be configured to access the one or more fracture patterns 143 from the database 128 and / or another data location internal and / or external to the planning system 120. The spatial module 137 may be configured to generate the fracture patterns 143.

[0177] The fracture pattern 143 may extend along the boundary region 129BR between the first body 129V1 and the second body 129V2 (see, e.g., Figure 8 ). A boundary region 129BR may be established along the interface between the cortical bone body 129CO and the cancellous bone body 129CA (see, e.g., Figure 8 ). The boundary region 129BR can be along the outer surface of the cancellous bone body 129CA and / or the inner surface of the cortical bone body 129CO.

[0178] A surgeon or clinical user may interact with the user interface 142 to view one or more aspects of the selected or assigned fracture pattern 143. The spatial module 137 may be adapted to arrange the assigned or selected fracture pattern 143 relative to the corresponding bone body 129B. Figure 9 In an embodiment, the display module 136 can be adapted to display one or more views of the bone body 129B and associated fracture patterns 143 in one or more display windows 144, such as the sixth set of display windows 144-6A to 144-D. The surgeon or clinical user can interact with one or more objects, such as the list 146L, to select a fracture view.

[0179] refer to Figures 10A-10B , continue to refer to Figure 2and 9 , showing Figure 9 Each fracture pattern 143 may be generated automatically and / or in response to a user's interaction with the user interface 142. In an embodiment, a user may interact with the user interface 142 to manually specify the geometry of the fracture pattern 143.

[0180] Each fracture pattern 143 may include one or more segments 143S. The fracture pattern 143 may include two or more segments 143S, which may be continuous or may be spaced apart from each other. Two or more of the segments 143S may meet at one or more joints 143J. Each segment 143S may be a continuous loop and / or may be established between a pair of joints 143J. In an embodiment, each of the segments 143S may extend along the surface of a portion of the bone body 129B, such as the outer surface of the cancellous bone body 129CA. In other embodiments, one or more of the segments 143S may extend along the surface of the cortical bone body 129CO (see, e.g., Figure 8 ). Each of the segments 143S is a linear or nonlinear path extending between two joints 143J. In an embodiment, each of the segments 143S may include one or more undulations. The undulations may represent fracture lines observed in previous cases and / or hypothetical cases based on empirical data, parametric modeling, etc.

[0181] refer to Figures 10C-10D , continue to refer to Figure 2 、 9 and 10A-10B, various techniques can be utilized to establish the fracture pattern 143. The spatial module 137 can be adapted to establish or identify one or more landmarks L relative to the bone body 129B and / or another portion of the virtual anatomical model 129. In an embodiment, the comparison module 138 can be adapted to determine the one or more landmarks L based on a comparison of the anatomical model 129 with one or more prior cases. In an embodiment, a surgeon or clinical user can interact with a display window 144, such as display window 144-6A or 144-6B, to adjust the positioning of one or more landmarks L (see, e.g., landmark L'). The spatial module 137 can be adapted to adjust the positioning of one or more segments 143S (see, e.g., segment 143S' and associated joint 143J') in response to adjusting one or more associated landmarks L.

[0182] The display model 136 may be adapted to display an isolated view of the fracture pattern 143 relative to the bone body 129B and / or the attachment region 129R. Figure 11In an embodiment, a surgeon or clinical user may interact with one or more display windows 144-7, such as the seventh group of display windows 144-7A through 144-7D, or another portion of the user interface 142, such as one of the lists 146L, to hide the representation of the cortical bone body 129CO (see Figure 8 Selectively concealing the cortical bone body 129CO can help a surgeon or clinical user observe the relative positioning between the fracture pattern 143 and the attachment area 129R.

[0183] refer to Figure 12 , continue to refer to Figure 2 Various techniques may be utilized to establish the fracture pattern 143 relative to the virtual anatomical model 129. The display module 136 may be configured to display the virtual anatomical model 129 in one or more display windows 144-8, such as an eighth set of display windows 144-8A through 144-8D.

[0184] The spatial module 137 can be configured to generate a virtual fracture volume 147, which can be associated with a fracture pattern 143. The virtual fracture volume 147 can substantially or generally follow the length of the corresponding fracture pattern 143 (see, e.g., Figures 10A-10D For the purposes of this disclosure, unless otherwise indicated, the term "substantially" means ±10% of the stated relationship or value. A configuration (e.g., definition) 145 ( Figure 2 ).

[0185] refer to Figure 13A , continue to refer to Figure 2 and Figure 12 Various techniques can be used to create the virtual fracture body 147. The display module 136 can be adapted to display the virtual fracture body 147 in one or more display windows 144, such as display windows 144-8E, 144-8F. Figure 13B ). Virtual fracture body 147 can be established by extruding shape along the length of fracture pattern 143. Display module 136 can be suitable for displaying virtual fracture body 147 in display window 144-8E, 144-8F. Various shapes can be utilized, such as straight line or curve section, ellipse (e.g., circle), polygon (e.g., rectangle) and / or complex shape. The geometric shape of virtual fracture body 147 can be selected to promote the cutting of physical anatomical model. In an embodiment, the size of virtual fracture body 147 can be set to span between the outer surface of cancellous bone body 129CA and the outer surface of cortical bone body 129CO. Figure 13B Public Figure 13A 144-8F in the display window 144-8F. In other embodiments, the fracture body 152' can be spaced apart from the outer surface of the cortical bone body 129CO (body 152' is spaced apart from the outer surface of the cortical bone body 129CO). Figure 13A shown by dotted lines).

[0186] The fracture body 147 can have various configurations. The fracture body 147 can be uniform or can have two or more heterogeneous regions. In an embodiment, the fracture body 147 can be substantially hollow or can include one or more voids that can be used to weaken a localized region of an associated physical anatomical model.

[0187] refer to Figure 14 , continue to refer to Figure 2 and 13A -13B, the virtual anatomical model 129 can be used to build the physical anatomical model 148. The comparison module 138 can be configured to generate one or more configurations 145 associated with the virtual anatomical model 129 ( Figure 2 The comparison module 138 can be adapted to generate the configuration 145 in response to specifying one or more parameters associated with the respective virtual anatomical model 129 , including any of the parameters disclosed herein, such as parameters of the fracture classification scheme 141 .

[0188] The configuration 145 can specify various information for forming an instance of an associated physical anatomical model 148, which can be based on the corresponding virtual anatomical model 129. The configuration 145 can include one or more files in a predetermined data structure or format. In an embodiment, the configuration 145 can include a coordinate set and / or other information, such as material selection associated with the body of the physical anatomical model 148. Each physical anatomical model 148 can be formed using various techniques, including any of the techniques disclosed herein, such as rapid prototyping (e.g., printing) and other additive manufacturing techniques, casting, machining, etc.

[0189] The configuration 145 can specify fracture paths (e.g., fracture patterns) 150 that can be associated with the physical anatomical model 148. Each fracture path 150 can be established according to the assigned fracture pattern 143 so that the fracture pattern 143 can be reproducible. The configuration 145 can specify coordinate data and / or other information to establish the fracture path 150 according to the assigned fracture pattern 143. The configuration 145 can be generated so that the corresponding physical anatomical model 148 can be cut along the fracture path 150 to establish one or more fragments, thereby establishing a fragmented state of the physical anatomical model 148 (see, e.g., FIG. 1 ). Figure 19-20 Fragment 348F).

[0190] The physical anatomy model 148 may include a body 148M. For purposes of this disclosure, unless otherwise noted, the alphanumeric suffixes associated with each indicator of the virtual anatomy model are used in a similar manner to describe similar aspects of the physical anatomy model. The body 148M may include an outer surface 148E associated with an anatomical feature of a bone, including any of the bones disclosed herein. In an embodiment, the anatomical feature of the bone may be associated with a long bone, such as a humerus, femur, or tibia. The physical anatomy model 148 may be secured to at least one fixture 166 to establish an assembly 168 (in Figure 14 shown by dotted lines).

[0191] The physical anatomical model 148 may include one or more physical components 148C. Each component 148C may represent an associated component 129C of the corresponding virtual anatomical model 129. The components 148C of the physical anatomical model 148 may include any of the components 129C of the corresponding virtual anatomical model 129, such as the bone body 148B. The representation of one or more of the components 129C may be omitted from the physical anatomical model 148 to provide customized training (e.g., different difficulty levels, etc.) to the surgeon or clinical user.

[0192] The physical anatomy model 148 may include one or more extensions 148X (shown in dashed lines). Each extension 148X may extend from an outer surface 148E of the main body 148M. One or more of the extensions 148X may represent a corresponding soft tissue volume 148S, including any of the soft tissues disclosed herein. The soft tissue volume 148S may be attached to the bone body 129B at a corresponding attachment area 148R.

[0193] The main body 148M of the physical anatomical model 148 may include one or more bodies 148V. The main body 148M may include a first body 148V1 and a second body 148V2. The first body 148V1 may establish an outer surface 148E of the main body 148M. The first body 148V1 may represent cortical bone. The second body 148V2 may represent cancellous bone.

[0194] At least one fracture path 150 can be established along the physical anatomical model 148. The fracture path 150 can be established according to the predetermined fracture pattern 143 (see, e.g., Figure 13A ) establishes a fracture path 150. The body 148M may include the fracture path 150. The fracture path 150 may establish one or more localized regions 148L of the physical anatomical model 148. The fracture path 150 may divide the body 148M into one or more localized regions 148L. The fracture path 150 may include one or more segments 150S. Each of the segments 150S may establish a loop around a corresponding localized region 148L (see also Figure 14The outer surface 148E of at least one of the localized regions 148L can be associated with an articular surface of a joint, including any of the joints and bones disclosed herein, such as the articular surface of the humerus. Each extension 148X can extend from the outer surface 148E of one or more segments 150S of the main body 148M adjacent to the fracture path 150.

[0195] The body 148M of the physical anatomical model 148 may include at least one or more physical fracture bodies 152. The physical fracture bodies 152 may be established along the fracture path 150. The body 148M may be cut along the fracture body 152 to establish one or more fragments (see, e.g., Figure 19-20 The physical fracture bodies 152 can establish frangible connections between the local regions 148L of the physical anatomy model 148 and each other and / or the main body 148M.

[0196] The fracture path 150 can extend along a boundary region 148BR between adjacent bodies 148V of the physical anatomical model 148, such as between a first body 148V1 and a second body 148V2. A fracture body 152 can be established along the fracture path 150 such that the fracture body 152 can be at least partially embedded in one or more of the bodies 148V, such as the first body 148V1 of the main body 148M. The main body 148M can be severed along the fracture body 152 to establish one or more fragments. In an embodiment, the physical fracture body 152 can be spaced apart from the outer surface of the main body 148M of the physical anatomical model 148 (see, e.g., Figure 13A fracture body 152').

[0197] The bodies 148V of the physical anatomical model 148 can have various properties. The first body 148V1 can have a first property. The second body 148V2 can have a second property. The fracture body 152 can have a third property. The first, second, and / or third properties can be the same or can be different from each other. The first, second, and third properties can include corresponding first, second, and third material strengths. The second and / or third material strengths of the second body 148V2 and the fracture body 152 can be less than the first material strength of the first body 148V1. The first material strength can represent cortical bone. The second material strength can represent cancellous bone. The smaller material strength can establish relatively weak areas in the physical anatomical model 148 to facilitate fragmentation of the physical anatomical model 148 in a reproducible manner. The fracture body 152 can incorporate any of the materials disclosed herein, such as a silica-based material.

[0198] refer to Figures 15A-15C and 16A-16C, continue to refer to Figure 2In an embodiment, the spatial module 137 can be adapted to extrude a virtual fracture body 247 along one or more sections 243S of the corresponding fracture pattern 243. The display module 136 can be adapted to display a fracture body 252 in one or more display windows 144 (e.g., display windows 144-10A to 144-10F). The virtual fracture body 247 can span between the outer surface of the cortical bone body 229CO and the outer surface of the cancellous bone body 229CA. The fracture body 247 can be extruded so that the fracture body 252 can extend inwardly from the outer surface of the cancellous bone body 229CA. The fracture body 247 can be at least partially surrounded by the cancellous bone body 229CA. The display module 136 can be adapted to display other aspects of the virtual fracture body 247 and / or the virtual anatomical model 229 in one or more display windows 144-10, such as the tenth group of display windows 144-10A to 144-10F. The display module 136 may be adapted to display the fracture volume 252 relative to the soft tissue volume 229S and / or the attachment region 229R (see, e.g., Figures 16A-16C ).

[0199] refer to Figure 17 , continue to refer to Figure 2 , the planning system 120 can establish one or more virtual indicators 354 relative to the fracture pattern 343 and / or the virtual anatomical model 329. Each of the virtual indicators 354 can be associated with the fracture pattern 343. The display module 136 can be adapted to display one or more of the virtual indicators 354 relative to the fracture pattern 343 in the ninth display window 144-9. Each of the virtual indicators 354 can serve as a visual aid and can provide information about the fracture pattern 343 to the surgeon or clinical user.

[0200] Various virtual indicators 354 can be used to transmit clinically useful information to the surgeon or clinical user, including any indicator in the indicator disclosed herein. Various technologies can be utilized to establish virtual indicators 354. Comparison module 138 can be suitable for generating one or more virtual indicators 354 along or otherwise adjacent to one or more sections 343S and / or joints 343J of fracture pattern 343. Virtual indicator 354 can be automatically generated and / or generated in response to the interaction of the user with user interface 142 and / or another part of planning system 120. Indicator 354 can have various geometric shapes, including various shapes and sizes. Indicator 354 can include one or more characteristics that can be different from anatomical structure, including different visual (e.g., shape, pattern, color, chroma, etc.) and / or tactile (e.g., texture) characteristics. Indicator 354 can be established according to one or more visual or color schemes. In an embodiment, the indicator 354 can be assigned one or more artificial colors to establish a visual contrast with adjacent portions of the virtual anatomical model 329, which can be assigned corresponding colors that can correspond to the natural colors of the corresponding portions of the anatomical structure. The visual contrast can help the surgeon identify the indicator 354. For the purposes of this disclosure, the term "natural" color means a color that substantially corresponds to the expected or actual color of the corresponding tissue, while the term "artificial" color means a color that does not occur naturally for the corresponding tissue. Artificial colors can include yellow, orange, red, green, blue, etc. The visual contrast can help the surgeon identify the physical instance of the indicator and any deviations in the arrangement of any fragments relative to each other and / or the rest of the body of the associated physical anatomical model.

[0201] One or more of the virtual indicators 354 may include a shape (e.g., a star) that may be sized to span a segment of the fracture pattern 343. The one or more virtual indicators 354 may include an indicator path 354P. The indicator path 354P may substantially or generally follow the length of one or more segments 343S of the fracture pattern 343. The one or more virtual indicators 354 may include a visual contrast (e.g., color, chroma, etc.) between the fracture pattern 343 and adjacent portions of the virtual anatomical model 329. The virtual indicators 354 may include one or more scales (e.g., markings) that may be distributed along the length of the fracture pattern 143 (see, e.g., FIG. Figures 21A-21C 456G). Figure 22 In an embodiment, the virtual indicator 554 may include a profile 554S. The profile 554S may be associated with an orthopedic implant that may be fixed to adjacent bone fragments (see, e.g., Figures 42C-42DThe outline 554S may include one or more shapes representing pores sized to receive corresponding fasteners that secure the implant to the bone (see, e.g., Figure 42C ).

[0202] In an embodiment, the physical anatomy model 448 can incorporate one or more circuits to provide feedback to a surgeon or clinical user associated with the registration fragment 448F. The indication path 456P can include adjacent portions 456P1, 456P2. The adjacent portions 456P1, 456P2 can be incorporated with a conductive material, such as copper or another metallic material. The adjacent portions 456P1, 456P2 can be coupled to an evaluation device 457 and can cooperate to establish a circuit 455. The evaluation device 457 can be configured to provide feedback to the surgeon or clinical user, such as an audible signal, a visual indicator (e.g., a readout or graphic), or other indicator, in response to establishing contact between the adjacent portions 456P1, 456P2.

[0203] refer to Figure 18-20 , continue to refer to Figure 2 and 17 , various states of the physical anatomical model 348 are disclosed. Figure 18 Can be associated with a first (eg, initial, complete, or pre-fragmented) state of the physical anatomical model 348 . Figure 19 Can be used with Figure 18 is associated with a second (e.g., fragmented) state of the physical anatomical model 348. Figure 20 Can be used with Figure 18 is associated with a third (e.g., fragmented) state of the physical anatomical model 348.

[0204] The body 348M and / or other portions of the physical anatomical model 348 may include one or more physical indicators 356. Each of the virtual indicators 354 may be associated with a physical indicator 356 incorporated into the physical anatomical model 348. Each physical indicator 356 may be associated with a corresponding virtual indicator 354. The configuration 145 ( Figure 2 ) can specify coordinate data and other characteristics associated with the virtual indicator 354 to establish one or more of the physical indicators 356. Each physical indicator 356 can be established along an outer surface of the physical anatomical model 348 and / or at the thickness of the physical anatomical model. Each physical indicator 356 can be associated with a fracture path 350 and / or a fracture volume 352.

[0205] exist Figure 18-20In one embodiment, one or more physical indicators 356 may include a shape 356S that can span a segment of the fracture path 350. The shape 356S may be established along the outer surface 348E of the body 348M. The shape 356S may span between at least two regions in the localized area 348L. The physical indicator 356 may include one or more indicator paths 356P. Each indicator path 356P may substantially or generally follow the length of one or more segments 350S of the fracture path 350. The indicator paths 356P may be established along the outer surface 348E of the body 348M.

[0206] One or more physical indicators 356 may include visual contrast between the fracture path 350 and adjacent portions of the physical anatomical model 348. The indicator 356 may include visual contrast between the body 348M and the fracture body 352. In an embodiment, visual contrast may be established by a marking having a different color and / or chromatic shade than adjacent portions of the physical anatomical model 348. In an embodiment, the shape 356S and / or indicator path 356P may establish visual contrast with adjacent portions of the physical anatomical model 348. The physical anatomical model 348 may additionally and / or alternatively incorporate other physical indicators 356. Figures 21A-21C In one embodiment, the one or more physical indicators 456 may include one or more scales (e.g., markings) 456G. The scales 456G may be distributed along the length of one or more segments 450S of the fracture path 450. The scales 456G may facilitate the surgeon's assessment of the repair, including the relative alignment between adjacent fragments 448F. Each scale 456G may extend across the fracture path 450.

[0207] The body 348M of the physical anatomy model 348 can be severed along the fracture path 350 to create one or more fragments 348F associated with the fragmented state of the physical anatomy model 348 (see, e.g., FIG. Figure 19-20 ). Each fragment 348F can be associated with a corresponding one of the local areas 348L of the main body 348M of the physical anatomical model 348 or the rest of the local area. The fragment 348F can include a corresponding portion of the bone body 348B. In an embodiment, the soft tissue body 348S can be attached to the fragment 348F (at Figure 19 The fracture path 350 and / or the physical fracture volume 352 can be sized such that each of the fragments 348F can include a portion of a volume 348V, such as a portion of the first volume 348V1 and / or a portion of the second volume 348V1 (see, e.g., FIG. Figure 41B The body 1429V1', 1429V2' of the virtual anatomical model 1429'.

[0208] The surgeon or clinical user can interact with the physical anatomical model 348 to register the fragments 348F relative to each other and / or another portion (e.g., the remaining portion) of the physical anatomical model 348. The surgeon or clinical user can utilize one or more of the physical indicators 356 to obtain feedback regarding the fit of the arrangement of the fragments 348F relative to the initial state of the physical anatomical model 348, such as relative to the volume of the physical anatomical model 348 prior to creation of the fragments 348F (see, e.g., Figure 18 ).

[0209] The physical indicator 356 may provide an indication of the alignment and / or distance of each fragment 348F relative to an adjacent fragment 348F and / or another portion of the physical anatomical model 348. Figure 19 In an embodiment, one or more indicators 356 may indicate a physical gap G established between adjacent portions of the respective indicators 356. The physical gap G may indicate a deviation of the fragment 348F from perfect registration with respect to the pre-fragmentation state of the physical anatomical model 348 (see, e.g., Figure 18 ).exist Figure 20 In the embodiment of the present invention, the fragments 348F can be aligned in close proximity to each other so that any physical gap G between the portions of the indicator 456 can be relatively close to each other. Figure 19 The layout is reduced.

[0210] exist Figures 21A-21C In an embodiment, scale 456G can be used to facilitate repair by assessing the fragmentation state of physical anatomical model 448. Each scale in scale 456G can include segments 456G1, 456G2 on opposite sides of fracture path 450. Segments 456G1, 456G2 can be associated with local volumes 448L on opposite sides of fracture path 450. Severing physical anatomical model 448 can occur to create fragments 448F associated with corresponding local volumes 448L. Severing physical anatomical model 448 can occur such that segments 456G1, 456G2 can be associated with adjacent fragments 448F. The surgeon can register or otherwise position fragments 448F such that segments 456G1, 456G2 of scale 456G can be misaligned, substantially aligned, or otherwise adjacent to each other to provide the surgeon with visual feedback regarding corresponding local volumes 448L before physical anatomical model 448 is fragmented. A predetermined threshold may be associated with the scale 456G.The registration of the fragment 456G may be evaluated based on the alignment of the segments 456G1 , 456G2 of the scale 456G being below, meeting, or exceeding the predetermined threshold.

[0211] exist Figure 22 In an embodiment, the physical indicator 556 may include a profile 556S. The profile 556S may be associated with an orthopedic implant that may be fixed to adjacent bone fragments (see, e.g., Figure 42C The outline 556S may be associated with the perimeter of the implant 1582. The outline 556S may include one or more shapes representing apertures sized to receive corresponding fasteners that secure the implant to the bone.

[0212] refer to Figure 23 and 24 , continue to refer to Figure 2 Other techniques may be utilized to establish the fracture pattern of the virtual anatomical model and the associated fracture path of the physical anatomical model. Planning system 120 may be adapted to establish a fracture path 643 comprising one or more voids 643V. Voids 643V may establish perforations in adjacent bodies 629V of virtual anatomical model 629. Voids 643V may terminate at boundary regions 629BR between adjacent bodies 629V1 and 629V2. Body 629V1 may be established by cortical bone body 629CO. Body 629V2 may be established by cancellous bone body 629CA.

[0213] One or more physical voids 650V can be established in the physical anatomical model 648 along or otherwise adjacent to the fracture path 650. The voids 650V can be associated with corresponding voids 643V. The voids 650V can be printed or otherwise formed with adjacent portions of the physical anatomical model 648. The voids 650V can facilitate fracture along the fracture path 650 of the physical anatomical model 648 to create one or more fragments.

[0214] Various techniques can be used to create fragmented states of physical anatomical models. Figure 25 , discloses a fracture tool 760 for engaging a physical anatomical model. The fracture tool 760 may include a body 760M and an interface portion 760I. A handle 760H may extend from the body 760M. In an embodiment, the body 760M may include an elongated shaft. The handle 760H may be manipulated by a surgeon or clinical user to position the fracture tool 760 relative to the physical anatomical model.

[0215] refer to Figure 26 , continue to refer to Figure 25 , the interface portion 760I can be adapted to engage the physical anatomical model 748. The physical anatomical model 748 and the fracture tool 760 can establish an orthopedic system 761. The fracture tool 760 and one or more physical anatomical models 748 can be provided in a kit to a surgeon or clinical user. The physical anatomical models 748 can be the same or different. Each physical anatomical model 748 can be established according to any of the techniques disclosed herein.

[0216] The physical anatomical model 748 may include a body 748M having at least one fracture path 750. The physical anatomical model 748 may include a fracture body 752 established along the corresponding fracture path 750. The fracture tool 760 may be adapted to sever the body 748M of the physical anatomical model 748 along the fracture path 750 and / or the fracture body 752 to establish one or more fragments 748F ( Figure 27E ).

[0217] Various techniques can be used to establish engagement between the physical anatomy model 748 and the fracture tool 760. The physical anatomy model 748 may include one or more interfaces 748I. The interface 748I may extend inwardly from the outer surface 748E of the physical anatomy model 748. Each interface 748I may be associated with a local area 748L of the physical anatomy model 748. Each interface 748I may be established along the fracture path 750 and the associated fracture body 752, adjacent to it, or spaced apart therefrom. The interface portion 760I may be inserted into each of the interfaces 748I of the physical anatomy model 748, but the opposite arrangement may be utilized. The size of the interface portion 760I may be set to cooperate with the optional interface in the interface 748I. In an embodiment, the interface portion 760I and the interface 748I may include a plurality of threads that cooperate with each other to establish a connection between the fracture tool 760 and the physical anatomy model 748.

[0218] refer to Figures 27A-27E , continue to refer to Figures 25-26 , the fracture tool 760 can be used to establish the fragmented state of the physical anatomical model 748. Figure 27A , the fracture tool 760 can be moved in direction D1 toward the selected interface of the interface 748I. Figures 27B-27C , the interface portion 760I can engage the interface 748I to establish a connection between the fracture tool 760 and the physical anatomy model 748. Figures 27D-27E , the fracture tool 760 can be moved relative to the physical anatomical model 748 to create one or more fragments 748F. Each fragment 748F can be associated with a corresponding localized area 748L of the physical anatomical model 748. The fracture tool 760 can be moved relative to the longitudinal axis X of the fracture tool 760 in a direction D2 (e.g., translation, etc.) and / or a rotational direction R1 (e.g., twisting, pivoting, etc.) to sever the physical anatomical model 748 along the associated fracture path 750 and / or fracture body 752. The direction D2 can be perpendicular to or otherwise transverse to the axis X. In an embodiment, the direction D2 can be substantially parallel to the axis X.

[0219] Figure 28A fracture tool 860 according to another embodiment is disclosed. The fracture tool 860 may include a body 860M and a clamp 860C. The clamp 860C may be adapted to establish a clamping action with a physical anatomical model that may be accommodated in the clamp 860C. The clamp 860C may include one or more clamp elements 860CE. Each of the clamp elements 860CE may include an interface portion 860I. The interface portion 860I may be adapted to engage the physical anatomical model to establish a fragmented state of the physical anatomical model. The geometric shapes of the clamp elements 860CE and / or the interface portions 860I may be the same or may differ from each other. The clamp element 860CE may include a first clamp element 860CE-1 and a second clamp element 860CE-2. In an embodiment, the clamp element 860CE may be a set of jaws. The dimensions of the clamp elements 860CE-1 and 860CE-2 may be set so that the corresponding interface portions 860I can be relative to each other. Each interface portion 860I can have a generally flat surface sized to engage a physical anatomical model. The fracture tool 860 can have more than two clamp elements 860CE. Figure 30 In an embodiment, the fracture tool 960 can include first, second, and third clamp elements 960CE-1, 960CE-2, 960CE-3 that can cooperate to establish a clamp 960C. The clamp elements 960CE-1, 960CE-2, 960CE-3 can be generally opposite to each other.

[0220] refer to Figure 28 The fracture tool 860 may include a drive element 860D that can actuate the clamp 860C. The drive element 860D may be adapted to adjust the relative positioning of the clamp elements 860CE. The drive element 860D may be at least partially housed within the body 860M. The drive element 860D may extend along the axis X of the fracture tool 860. The drive element 860D may carry one or more of the clamp elements 860CE, such as the second clamp element 860CE-2. The drive element 860D may be movable relative to the body 860M to adjust the distance between the interface portions 860I of the clamp elements 860CE-1 and 860CE-2.

[0221] The fracture tool 860 may include a handle 860H that may extend from the body 860M. The surgeon or clinical user may manipulate the handle 860H to position the fracture tool 860 relative to the physical anatomical model. The fracture tool 860 may include an actuator 860A. Various actuators may be utilized. In an embodiment, the actuator 860A may include an actuating mechanism (see, e.g., Figure 33The actuator 860A can be adapted to move the drive element 860D relative to the body 860M of the fracture tool 860, such as a ratchet, in a third direction D3 relative to the axis X of the fracture tool 860 to adjust the distance between the clamp elements 860CE-1 and 860CE-2. A surgeon or clinical user can manipulate the actuator 860A to cause the clamp elements 860CE-1 and 860CE-2 to apply a certain amount of force to a physical anatomical model positioned between and engaged with the interface portion 860I of the fracture tool 860.

[0222] refer to Figures 29A-29C , continue to refer to Figure 28 , the fracture tool 860 can be used to establish the fragmented state of the physical anatomical model 848. Figure 29A , the physical anatomy model 848 can be at least partially positioned in the fixture 860C. The physical anatomy model 848 can be positioned between the interface portions 848I of the fixture elements 860CE-1, 860CE-2. Figure 29B , the surgeon or clinical user can manipulate the actuator 860A to move the drive element 860D in the direction D3 so that the interface portion 848I of the clamp elements 860CE-1, 860CE-2 can engage the outer surface 848E of the physical anatomical model 848.

[0223] refer to Figure 29C , the drive element 860D can be moved in a direction D3 relative to the axis X of the fracture tool 860 to sever the physical anatomical model 848 along the associated fracture path 850 and / or fracture volume 852. The surgeon or clinical user can manipulate the actuator 860A to cause the interface portion 860I of the clamp elements 860CE-1 and 860CE-2 to apply a certain amount of compressive force to the main body 848M of the physical anatomical model 848, thereby severing the main body 848M along the fracture path 850 and / or associated fracture volume 852 to create one or more fragments 848F. Each fragment 848F can be associated with a corresponding localized region 848L of the physical anatomical model 848.

[0224] Figures 31-33 A fracture tool 1060 according to another embodiment is disclosed. The fracture tool 1060 may include a clamp 1060C. The clamp 1060C may include one or more clamp elements 1060CE. Figures 31-33In an embodiment, the clamp element 1060CE can include a first clamp element 1060CE-1 and a second clamp element 1060CE-2. The first and second clamp elements 1060CE-1 and 1060CE-2 can be opposite each other. The geometric shape of the first clamp element 1060CE-1 can be the same as or different from that of the second clamp element 1060CE-2. The interface portion 1060I of the second clamp element 1060CE-2 can have a substantially flat surface sized to engage a physical anatomical model.

[0225] The first clamp element 1060CE-1 may include a base 1062 and one or more engagement elements 1064. The engagement elements 1064 may be sized to engage a physical anatomical model. The engagement elements 1064 may be integrally formed with the base 1062 or may be releasably secured to the base. The engagement elements 1064 may have various geometric shapes. Figures 31-33 In the embodiment of the present invention, the engagement elements 1064 can be elongated pins. Each engagement element 1064 can establish a corresponding interface portion 1060I of the fracture tool 1060.

[0226] The engagement elements 1064 can be configured to engage optional contact points along the physical anatomical model and / or avoid one or more portions of the physical anatomical model. The base 1062 can include one or more receptacles 1062R. The receptacles 1062R can be established at spaced intervals along the base 1062. Figure 34 In an embodiment, the receptacles 1062R can be arranged in a grid and can be labeled in the grid (e.g., by an alphanumeric convention). Each receptacle 1062R can be assigned a unique location relative to the base 1062. Each receptacle 1062R can be sized to receive the engagement element 1064.

[0227] The surgeon or clinical user can configure the fracture tool 1060 to engage one or more contact points of the physical anatomical model. The surgeon or clinical user can position one or more engagement elements 1064 in selected receptacles 1062R of the base 1062. The positioning of each engagement element 1064 can be determined in the surgical plan 131 ( Figure 2 ) or may be otherwise predetermined. The surgeon or clinical user may arrange the joint elements 1064 into two or more configurations to establish different fragmentation patterns of the physical anatomical model that may be consistent with the fracture classification scheme 141 and / or corresponding fracture patterns ( Figure 2 ) is associated with.

[0228] refer to Figures 35-36 , continue to refer to Figure 34, the engagement element 1064 can engage the optional contact points 1048CP along the body 1048M of the physical anatomical model 1048. The physical anatomical model 1048 can include one or more contact indicators 1066 ( Figure 36 ). Contact indicators 1066 can be established along the outer surface 1048E of the body 1048M adjacent to the corresponding contact points 1048CP. Each of the contact indicators 1066 can be associated with a corresponding one of the engagement elements 1064. The contact indicators 1066 can be arranged in a three-dimensional grid along the outer surface 1048E of the physical anatomical model 1048 and can be labeled in the three-dimensional grid (e.g., by an alphanumeric convention). In an embodiment, the location of each contact indicator 1066 can be identified according to a corresponding one of the receptacles 1062R. The drive element 1060D can be rotatable relative to the axis X of the fracture tool 1060 in a third direction D3 ( Figure 35 ) to set the distance between the second clamp element 1060CE-2 and the engaging element 1064 of the first clamp element 1060CE-1.

[0229] refer to Figures 37-38 , each of the engagement elements 1064 of the first clamp element 1060CE-1 can be adapted to cooperate with the second clamp element 1060CE-2 to apply a compressive force at a corresponding contact point 1048CP, thereby causing the body 1048M to be severed along the fracture path 1050 and / or associated fracture body 1052 to create one or more fragments (see, e.g., Figure 41C Fragment 1448F and Figures 42A-42B Each engagement element 1164 can be sized to engage a bony volume 1148B and / or a soft tissue volume 1148S of the physical anatomical model 1148. One or more contact indicators 1166 can be established along the corresponding soft tissue volume 1148S.

[0230] Figure 39An exemplary method in flowchart 1280 is shown. Method 1280 can be used for preoperative planning, rehearsal and / or training for various surgical procedures, such as arthroplasty for restoring function of the shoulder, ankle, knee, hip and other joints. Method 1280 can be used with any of the planning systems, virtual anatomical models and / or physical anatomical models disclosed herein. Method 1280 can be used to create a physical anatomical model for training and rehearsing surgical procedures. Method 1280 can be used to assess the accuracy with which a surgeon can perform a surgical procedure on a physical anatomical model associated with a patient's anatomy or a hypothetical case. Fewer or more steps than those listed below may be performed within the scope of the present disclosure, and the order of the steps listed is not intended to limit the present disclosure. For illustrative purposes, reference is made to system 120 and user interface 142.

[0231] refer to Figure 2 , continue to refer to Figure 39 At step 1280-1, one or more virtual anatomical models 129 may be generated. Each virtual anatomical model 129 may be associated with a patient's anatomical structure and / or a hypothetical case. The virtual anatomical models 129 may be generated using any of the techniques disclosed herein. The virtual anatomical models 129 may include any of the anatomical structures and tissue types disclosed herein, including bone, ligament, tendon, cartilage, etc. At step 1280-2, one or more fracture patterns 143 may be generated. The fracture patterns 143 may be generated using any of the techniques disclosed herein.

[0232] At step 1280-3, one or more virtual anatomical models 129 may be selected from a set of virtual anatomical models 129. Each virtual anatomical model 129 may be associated with an anatomical structure. Various techniques may be used to select the virtual anatomical model 129. The virtual anatomical model 129 may be stored in a memory of a computing device, such as in the database 128 or the memory 134 of the computing device 132.

[0233] refer to Figure 3 , continue to refer to Figure 2 and 39 Selecting a virtual anatomical model 129 may include selecting or otherwise specifying various parameters associated with the set of virtual anatomical models 129. The parameters may include any of the parameters disclosed herein, including anatomical structure, patient classification, fracture classification, and / or case. The parameters may be selected in response to a user's interaction with the graphical user interface 142.

[0234] refer to Figure 5-8 , continue to refer to Figure 2 and 39At step 1280-4, the selected virtual anatomical model 129 can be viewed in the graphical user interface 142. Step 1280-4 can include setting parameters in response to a user interaction with the graphical user interface 142. The parameters can be specified in response to a surgeon or clinical user interaction with the user interface 142. One or more of the parameters can be associated with a predefined fracture classification scheme 141. The fracture classification scheme 141 can include any of the fracture classification schemes disclosed herein.

[0235] refer to Figure 9 , continue to refer to Figure 2-3 , 9 and 39, at step 1280-5, one or more fracture patterns 143 can be assigned to the virtual anatomical model 129. The fracture pattern 143 can be assigned to the virtual anatomical model 129 using any of the techniques disclosed herein. The fracture pattern 143 can be assigned to the virtual anatomical model 129 based on one or more parameters, including any of the parameters disclosed herein, such as anatomical structure, patient classification, fracture classification and / or case. Assigning the fracture pattern 143 can occur in response to setting one or more parameters associated with the fracture classification scheme 141. Step 1280-5 can include causing the virtual anatomical model 129 and / or the assigned fracture pattern 143 to be displayed in one or more display windows 144 of the graphical user interface 142, such as display windows 144-6A to 144-6D.

[0236] At step 1280-6, aspects of one or more of the virtual anatomical models 129 may be defined. Each virtual anatomical model 129 may be defined before, during, and / or after generating the virtual anatomical model 129 at step 1280-1, generating the fracture pattern 143 at step 1280-2, selecting the virtual anatomical model 129 at step 1280-3, viewing the selected virtual anatomical model 129 at step 1280-4, and / or assigning the fracture pattern 143 to the virtual anatomical model 129 at step 1280-5. Defining the virtual anatomical model 129 may include setting one or more parameters of the virtual anatomical model 129, including any of the parameters disclosed herein. The virtual anatomical model 129 may be configured in response to a user interacting with the graphical user interface 142 (e.g., Figure 3 ) interaction to select parameters. Parameters can be associated with one or more fracture classifications 141 ( Figure 2 ) and / or fracture pattern 143 (e.g., Figure 2 and 9 ) is associated with.

[0237] refer to Figure 12 and 13A -13B, continue to refer Figure 2 and 39Defining the virtual anatomical model 129 may include generating one or more virtual fracture volumes 147 at step 1280-7. Each virtual fracture volume 147 may be created using any of the techniques disclosed herein.

[0238] At step 1280-8, one or more configurations (e.g., definitions) 145 may be generated. Each configuration 145 may be associated with at least one virtual anatomical model 129, fracture pattern 143, physical anatomical model 148, fracture path 150, and / or physical fracture volume 152. Each configuration 145 may be generated using any of the techniques disclosed herein. A configuration 145 may be associated with a physical anatomical model 148 that may represent a selected virtual anatomical model 129. Each configuration 145 may be generated in response to selecting a corresponding virtual anatomical model 129 at step 1280-3, assigning a corresponding fracture pattern 143 at step 1280-5, and / or defining a selected virtual anatomical model 129 at step 1280-6. A configuration may be established based on the selection or setting of any parameters associated with the selected virtual anatomical model 129, including any fracture pattern 143 and / or fracture volume 152. The configuration 145 may include data and other information sufficient to establish a physical anatomical model 148 based on the parameters of the selected virtual anatomical model 129, including coordinate information, color, texture and / or elastic modulus of associated tissue, geometry associated with one or more fracture paths 150 and associated indicators, etc. The configuration 145 may specify one or more fracture paths 150 to be established in the physical anatomical model 148 according to the assigned fracture pattern 143.

[0239] refer to Figure 18 , continue to refer to Figure 2 and 39 In an embodiment, the configuration 145 may specify one or more physical indicators 356. The physical indicators 356 may be associated with the fracture path 350 and / or the fracture volume 352. The physical indicators 356 may be established according to any of the techniques disclosed herein. Each physical indicator 356 may be associated with a corresponding virtual indicator 354 (see, e.g., Figure 17 ).

[0240] refer to Figure 36 , continue to refer to Figure 2 and 39 , the configuration 145 can specify one or more indicators, such as a plurality of contact indicators 1066 distributed along the physical anatomical model 1048. Each of the contact indicators 1066 can be associated with a corresponding contact element 1064 of the fracture tool 1060.

[0241] refer to Figure 14 , continue to refer to Figure 2 、13A -13B and 39, one or more physical anatomical models 148 can be manufactured or otherwise formed at step 1280-9. The physical anatomical model 148 can be formed to closely resemble or approximate the geometry of the associated anatomical structure (including soft tissue and bone). In an embodiment, the surgeon can interact with the physical anatomical model 148 so that the feel of parts of the physical anatomical model 148 can be similar to the feel of soft (e.g., cancellous) bone tissue, muscle, and other soft tissues. The physical anatomical model 148 can be printed or otherwise formed based on various parameters selected in the user interface 142. Various parameters can be used to form the physical anatomical model 148, including any of the parameters disclosed herein, such as the density of bone and soft tissue, the thickness of cortical bone, indicators, patient age, etc.

[0242] At step 1280-8, each physical anatomical model 148 can be manufactured or otherwise formed based on the configuration 145. A variety of materials can be used to form the physical anatomical model. The physical anatomical model 148, including the body 148M, can incorporate metal and / or non-metal materials, including any of the materials disclosed herein, such as polymeric materials. In an embodiment, the body 148M can be formed from a substantially rigid material, such as a polymeric material, including photopolymers, silicones, and thermoplastics. Portions of the physical anatomical model 148 can be formed from relatively flexible materials, including elastomeric materials, such as rubber or silicone, to create a soft tissue body representing any of the soft tissues disclosed herein.

[0243] Various techniques can be used to form the physical anatomical models. Each physical anatomical model can be formed using any of the techniques disclosed herein, such as rapid prototyping (e.g., printing) and other additive manufacturing techniques, casting, machining, etc. The physical anatomical model can have a unitary construction, or can have two or more components fixedly attached or otherwise secured to each other to create a unit.

[0244] exist Figure 40 In an embodiment, one or more material layers 1382 are printed or otherwise formed on a substrate 1383 to create a physical anatomical model 1348. The physical anatomical model 1348 can represent a virtual anatomical model, including any of the virtual anatomical models disclosed herein. A device 1384, such as a 3D printer, can be configured to form the layers 1383 based on data and other information associated with the corresponding configuration 145. The material layers 1383 can include any of the configurations, materials, color schemes, textures, porosities, etc. disclosed herein. The layers 1383 can have a corresponding elastic modulus that substantially corresponds to the elastic modulus of the corresponding biological material of the anatomical structure. The porosity of the material forming the physical anatomical model 1348 can substantially approximate the porosity or density of the corresponding tissue.

[0245] exist Figure 14 In an embodiment, the physical anatomical model 148 may include a first body 148V1 and a second body 148V2. The first body 148V1 may represent cortical bone. The second body 148V2 may represent cancellous bone. The fracture path 150 may establish one or more local regions 148L of the physical anatomical model 148. The configuration 145 established at step 1280-9 may specify a fracture body 152 that may follow the length of the fracture path 150. The physical anatomical model 148 may be cut along the fracture path 150 and / or the fracture body 152 to establish one or more fragments associated with the corresponding local region 148L. The physical fracture body 152 may establish a frangible connection between the local region 148L and an adjacent local region 148L and / or the main body 148M of the physical anatomical model 148.

[0246] At step 1280-10, the surgeon or clinical user may position or otherwise prepare the physical anatomical model 148. The physical anatomical model 148 may be secured to at least one fixture 166 to create the assembly 168 (in Figure 14 (shown in dashed lines in the figure). Fixture 166 can be arranged relative to a static structure and / or one or more reusable components. Fixture 166 can represent a portion of surrounding tissue or a joint. The surgeon can use fixture 166 to simulate rotation or movement of a limb in the operating room. Fixture 166 can represent skin tissue and can be formed from a relatively flexible material such as an elastomeric material. The surgeon can form one or more openings in fixture 166 to simulate performing an incision to expose another portion of a joint, bone, and / or anatomical structure.

[0247] refer to Figure 19-20 , continue to refer to Figure 2 and 39 At step 1280-11, one or more modifications may be performed on the physical anatomical model 348. The physical anatomical model 148 may be provided to the surgeon or clinical user in a pre-fragmented state or a fragmented state. Step 1280-11 may include severing the main body 348M of the physical anatomical model 348 along the fracture path 350 and / or the physical fracture body 352 to establish a fragmented state of the physical anatomical model 348, the fragmented state including one or more fragments 348F (see also Figure 41C Fragment 1448F and Figures 42A-42B Various techniques can be used to establish the fragmented state of the physical anatomy model 348, including any of the techniques and fracture tools disclosed herein (see, e.g., Figure 27E and 29CThe body 348M of the physical anatomy model 348 may be responsive to causing the fracture tool to contact one or more selected contact points along the physical anatomy model 348, such as adjacent corresponding contact indicators (see, e.g., Figure 36 The contact point 1048CP and the contact indicator 1066) apply a certain amount of force to cut along the fracture path 350 and / or fracture body 352 to create fragments 348F. Figure 36 In an embodiment, a fracture can be created in response to causing the fracture tool 1060 to apply a certain amount of force at a contact point 1048CP adjacent a corresponding contact indicator 1066 along the physical anatomical model 1048. The amount of force at the contact point sufficient to fracture the physical anatomical model 348 can be determined using various techniques, such as empirical data analysis, parametric modeling, etc. Severing the physical anatomical model 348 can occur so that one or more physical indicators, such as the fracture body 352, established below the outer surface 348E of the physical anatomical model 348 can be exposed and establish visual contrast with adjacent portions of the physical anatomical model 348 (see, e.g., FIG. 2 ). Figure 14 The external indicator can present less challenges to the surgeon. The surgeon can choose to form the indicator below the outer surface of the physical anatomical model, which may be closer to the surgical operation on the anatomical structure and may be relatively more challenging.

[0248] The surgeon or clinical user may perform various modifications to the fragmented instances of the physical anatomical model 348 to simulate surgical procedures performed on the anatomical structure to restore function to the patient. The simulated surgical procedures may include one or more repairs to the anatomical structure, such as one or more cutting, drilling, reaming, resection, and implantation operations. Each modification may permanently change the geometry of the physical anatomical model 348. Step 1280-11 may include registering one or more fragments 348F relative to each other and / or the remainder of the body 348M of the physical anatomical model 348 (see also Figure 42B Step 1280-11 may include securing the orthopedic implant to the registered fragments 1548F and / or body 1548M of the physical anatomical model 1548 (see, e.g., Figures 42C-42D ).

[0249] refer to Figure 19-20 , continue to refer to Figure 2 and 39At step 1280-13, one or more modifications to the physical anatomical model may be evaluated using any of the techniques disclosed herein. Step 1280-13 may include determining a state of one or more physical indicators 356 after modifying the physical anatomical model 348 at step 1280-11, including registering or otherwise positioning one or more fragments 348F relative to each other and / or the remainder of the body 348M of the physical anatomical model 348 at step 1280-12. Step 1280-13 may include assigning the modified anatomical model 348 (e.g., Figure 19 and 20 ) and the physical anatomical model 348 (e.g., Figure 18 ) is compared to a previous (e.g., initial or pre-fragmentation) state of ).

[0250] Figures 41A-41C Disclosed are a virtual anatomical model 1429, a virtual anatomical model 1429', and a physical anatomical model 1448 according to one embodiment. The virtual anatomical model 1429' can be a fragmented instance of the virtual anatomical model 1429 and can include one or more fragments 1429F'. In an embodiment, the virtual anatomical model 1429' can represent a four-part fracture of an articular portion of a long bone such as the proximal humerus. The physical anatomical model 1448 can be a physical instance of the virtual anatomical model 1429' and can include one or more fragments 1448F that are registered or otherwise positioned relative to each other and / or the rest of the body 1448M of the physical anatomical model 1448. The virtual anatomical models 1429, 1429', and the physical anatomical model 1448 can be established and arranged using any of the techniques disclosed herein, including any of the steps of the method 1280.

[0251] In an embodiment, the virtual anatomical model 1429 may include one or more virtual indicators 1454. The virtual indicators 1454 may be associated with a predetermined order in which to register or otherwise arrange the localized regions 1429L relative to each other and / or the body 1429 of the virtual anatomical model 1429. The physical anatomical model 1448 may include one or more physical indicators 1456. Each physical indicator 1456 may be associated with a corresponding one of the virtual indicators 1454. The surgeon may utilize the physical indicators 1456 to determine the order in which to arrange the fragments 1448F relative to each other and / or the rest of the body 1448M of the physical anatomical model 1448, which may facilitate training the surgeon for associated fractures and treatment options.

[0252] Figures 42A-42D Various states of the physical anatomy model 1548 are disclosed according to one embodiment. Figure 42AA fragmented state of the physical anatomy model 1548 is disclosed, which may include one or more fragments 1548F registered or otherwise positioned relative to each other and / or the main body 1548M of the physical anatomy model 1548. Figures 42A-42D The physical anatomy model 1548 can represent a four-part fracture of the articular portion of a long bone such as the proximal humerus. Figure 42B In the implementation scheme, Figure 42A One or more of the fragments 1548F may be relatively closer to each other and / or aligned or otherwise positioned with respect to the main body 1548M as compared to the arrangement of the fragments 1548F.

[0253] refer to Figures 42C-42D , continue to refer to Figure 42B , the orthopedic system 1571 may include at least one or more than one implant 1582. The implant 1582 may be associated with a corresponding implant model 130 ( Figure 2 ). The surgeon or clinical user can position the implant 1582 relative to the body 1548M and / or the fragments 1548F of the physical anatomical model 1548. The surgeon or clinical user can position one or more fasteners (e.g., compression screws 1584) through the implant 1582 and into the body 1548M and / or the fragments 1548F to secure the fragments 1548F to each other and / or the body 1548M. Figures 42A-42D The physical anatomical model 1548 and implant 1582 can be created and arranged using any of the techniques disclosed herein, including any of the steps of method 1280.

[0254] The technology disclosed herein can be used to create other virtual and physical anatomical models that represent anatomical structures. The technology disclosed herein can be used to create virtual and physical anatomical models that represent any of the anatomical structures disclosed herein, including the shoulder, ankle, knee, hip, and other joints. The physical anatomical models can be used with various fixtures, including reusable fixtures that can represent anatomical structures.

[0255] Figure 43 The virtual anatomical model 1629 is disclosed in the planning system 120 ( Figure 2) in another embodiment of the display window 144-11. The virtual anatomical model 1629 can represent the shoulder joint. The virtual anatomical model 1629 can include one or more components 1629C, such as one or more bone bodies 1629B and / or one or more soft tissue bodies 1629S. The virtual anatomical model 1629 can include a first bone body 1629B-1 and a second bone body 1629B-2. The first bone body 1629B-1 can be associated with the scapula. The second bone body 1629B-2 can be associated with the humerus. The soft tissue body 1629S can be associated with a corresponding portion of the rotator cuff. The bone bodies 1629B-1, 1629B-2, and the soft tissue body 1629S can establish a portion of the joint 1629J. The joint 1629J can be associated with the shoulder joint. One or more bone bodies in the bone bodies 1629B can be associated with a corresponding fracture body 1647. The fracture body 1647 can be established using any of the techniques disclosed herein. The virtual anatomical model 1629 can be positioned relative to a virtual fixture 1686. The virtual fixture 1686 can have various geometries, such as a substantially flat geometry.

[0256] Figures 44A-44B A physical anatomy model 1648 is disclosed. The physical anatomy model 1648 can be used with Figure 43 The physical anatomical model 1648 may represent a shoulder joint. The physical anatomical model 1648 may include one or more physical components 1648C. Each component 1648C may represent an associated component 1629C of the corresponding virtual anatomical model 1629. The component 1648C may include one or more bone bodies 1648B, such as bone bodies 1648B-1, 1648B-2. The bone bodies 1648B-1, 1648B-2 may represent the bone bodies 1629B-1, 1629B-2 of the virtual anatomical model 1629. The physical anatomical model 1648 may include one or more soft tissue bodies 1648S, which may be associated with the soft tissue bodies 1629S of the virtual anatomical model 1629. The physical anatomical model 1648 may be cut along an associated fracture path 1650 and / or fracture body 1652. The fracture path 1650 and / or fracture body 1652 may be associated with the corresponding fracture pattern 1647 ( Figure 43 The physical anatomical model 1648 may include one or more physical indicators 1656, including any of the indicators disclosed herein.

[0257] The physical anatomical model 1648 can be fixedly attached or otherwise secured to at least one physical fixture 1666 to create an assembly 1668. The physical fixture 1666 can be associated with a virtual fixture 1686. In an embodiment, the virtual fixture 1686 can serve as a substrate for forming the physical anatomical model 1648 (see, e.g., Figure 40substrate 1383).

[0258] The physical anatomy model 1648 can be cut along the fracture path 1650 and / or the fracture body 1652 to create one or more fragments 1648F. The surgeon or clinical user can use implants 1682 to secure the fragments 1648F. The surgeon or clinical user can use one or more fasteners (e.g., compression screws) 1686 to secure the fragments 1648F to each other and / or the body 1648M of the physical anatomy model 1648.

[0259] Figure 45 Another embodiment of a virtual anatomical model 1729 is disclosed. The virtual anatomical model 1729 may represent an ankle joint. The virtual anatomical model 1729 may be displayed on the user interface 142 ( Figure 2 ) in display window 144-12. The virtual anatomical model 1729 may include one or more bone bodies 1729B that may cooperate to create a joint 1629J. The joint 1629J may be associated with an ankle joint. The bone bodies 1729B may be associated with corresponding bones of the ankle joint (e.g., tibia, fibula, talus, calcaneus, etc.). One or more of the bone bodies 1729B may be associated with corresponding fracture bodies 1747.

[0260] Figure 46 Another embodiment of a virtual anatomical model 1829 in the display window 144-14 of the planning system 120 is disclosed. The virtual anatomical model 1829 can represent a limb of a patient, such as a lower limb including an ankle joint. The virtual anatomical model 1829 can be positioned relative to a virtual component 1888. The virtual component 1888 can represent an anatomical structure and can be positioned relative to a physical component 1890 ( Figure 47A ) The virtual component 1888 may be generic or may be associated with a different patient than the virtual anatomical model 1829.

[0261] Figure 47A A physical anatomical model 1848 is disclosed. Figure 47B Public Figure 47B Aspects of the physical anatomy model 1848. The physical anatomy model 1848 can be used with Figure 46 The physical anatomical model 1848 may represent a patient's limbs, such as a lower limb including an ankle joint. Figure 47A) can be associated with virtual component 1888. Physical component 1890 can be a reusable component and can have various configurations. In an embodiment, physical component 1890 can represent an anatomical structure, such as a foot. One or more components of physical anatomical model 1848 can be at least partially housed in physical component 1890. A surgeon or clinical user can utilize implant 1882 to secure one or more fragments 1848F of physical anatomical model 1848.

[0262] Figures 48-49 Disclosed is a virtual anatomical model 1929 according to an embodiment. The anatomical model 1929 may include a first anatomical model 1929-1 and a second anatomical model 1929-2 which may be adjacent to the first anatomical model 1929-1. Figure 49 The anatomical model 1929 is depicted in dashed lines. The anatomical model 1929 may incorporate any of the features disclosed herein, including anatomical features representing anatomical structures, such as one or more bones including cartilage, cortical and / or cancellous bone tissue; soft tissue including muscle, ligaments and / or tendons; and / or other tissues. Each anatomical model 1929 may be associated with a surgical plan (e.g., Figure 2 In one embodiment, anatomical model 1929 can be associated with a corresponding bone of a patient's limb. The bones can be adjacent to each other. Anatomical model 1929-1 can include portions associated with a patient's joints, including any of the joints disclosed herein, such as the ankle joint. Anatomical model 1929-1 can be associated with the patient's tibia. Anatomical model 1929-2 can be associated with the patient's fibula.

[0263] The anatomical models 1929-1, 1929-2 can be associated with corresponding virtual fracture bodies 1947 (indicated by 1947-1, 1947-2). Each fracture body 1947-1, 1947-2 can be established by a corresponding fracture pattern 1943 (indicated by 1943-1, 1943-2). The fracture pattern 1943 can be established using any of the techniques disclosed herein. The fracture classification scheme 141 ( Figure 2 ) establishes a fracture pattern 1943 and an associated fracture volume 1947. In an embodiment, the fracture pattern 1943 can be sized to substantially follow the perimeter of the corresponding anatomical model 1929. The perimeter can be associated with the inner cortical wall or the outer cortical wall of the bone. The fracture volume 1947 can be sized to span between opposite sides of the perimeter of the fracture pattern 1943 such that the fracture volume 1947 can extend substantially through the body of the virtual anatomical model 1929.

[0264] A portion of a virtual fracture volume 1947 can be created by extruding a shape along the length of the perimeter of the fracture pattern 1943. The fracture volume 1947 can include a portion (e.g., a region) within the perimeter of the fracture pattern 1943 such that the fracture volume 1947 can have a continuous (e.g., closed) three-dimensional feature. The fracture volume 1947 can have a variety of geometries, such as being substantially flat or having a complex geometry. Figure 49 In an embodiment, each of the fracture bodies 1947 has a contour geometry associated with a feature of the fracture pattern 1943. Figure 50 Published in Figures 48-49 The fracture bodies 1947-1 and 1947-2 are facing downward. Figure 51 Disclosed are fracture bodies 1947-1 and 1947-2 in different orientations.

[0265] Various techniques can be used to create the geometry of a portion of the fracture body 1947 within the perimeter of the fracture pattern 1943, such as manual carving or automated techniques. Automated techniques can include a "closed-cell" operation, where the interior of the object is filled with a two-dimensional or three-dimensional mesh. The spatial module 137 ( Figure 2 ) can be configured to generate a fracture pattern 1943 and associated fracture bodies 1947 using any of the techniques disclosed herein.

[0266] Figure 52 A cross-sectional view of a virtual anatomical model 1929-1 and a corresponding fracture body 1947-1 is disclosed. Figure 52 In an embodiment, the fracture body 1947-1 can extend completely or at least substantially through the body of the anatomical model 1929-1. The fracture body 1947-1 can be established in the anatomical model 1929-1 to facilitate at least partial or complete separation of adjacent portions of the associated physical anatomical model. The virtual anatomical model 1929 can be used to establish a physical anatomical model using any of the techniques disclosed herein. The anatomical model 1929 and the fracture body 1947 can be associated with the same and / or different structures, materials, porosities, etc., including any of those disclosed herein, for use in establishing a physical anatomical model. Configuration 145( for making a physical anatomical model) Figure 2 ) can specify geometric shapes associated with the fracture bodies 1947-1, 1947-2 for use in establishing physical fracture paths (e.g., patterns) and associated fracture bodies in the physical anatomical model.

[0267] Figures 53-55 Disclosed are various states of a physical anatomy model 2048 including a fracture path (eg, pattern) 2050. The physical anatomy model 2048 may be formed using any of the techniques disclosed herein.

[0268] The physical anatomical model 2048 may include a body 2048M. The body 2048M may include an outer surface 2048E associated with anatomical features of a bone (including any of the bones disclosed herein). The physical anatomical model 2048 may include one or more physical components 2048C. Each component 2048C may represent a corresponding virtual anatomical model 129 ( Figure 2 Component 2048C of the physical anatomy model 2048 may include any of the components disclosed herein, such as corresponding bone body 2048B.

[0269] The fracture path 2050 can be based on the assigned virtual fracture pattern and / or virtual fracture volume, such as Figures 48-49 The virtual fracture pattern 1943 and / or virtual fracture volume 1947 of the physical anatomical model 2048 can be established. The main body 2048M of the physical anatomical model 2048 can include at least one or more physical fracture volumes 2052. The physical fracture volumes 2052 can be established along the fracture path 2050. The physical fracture volumes 2052 can extend completely or at least substantially through the body of the main body 2048M to facilitate partial and / or complete separation. The fracture volumes 2052 can span between opposite sides of the perimeter of the fracture path 2050 to extend completely or at least substantially through the main body 2048M of the physical anatomical model 2048.

[0270] The physical fracture body 2052 can establish one or more localized regions 2048L of the physical anatomical model 2048. The fracture body 2052 can be adapted to separate the main body 2048M into two or more localized regions 2048L associated with corresponding components 2048C. The physical fracture body 2052 can establish a frangible connection between the localized regions 2048L of the physical anatomical model 2048 and each other and / or the main body 2048M. The main body 2048M can be severed along the fracture body 2052 to establish one or more fragments.

[0271] The physical anatomy model 2048, including the main body 2048M and the physical fracture body 2052, can have various properties, which can include any of the properties disclosed herein. The properties of the main body 2048M and the physical fracture body 2052 can be the same or different from each other. The properties can include respective material strengths. The physical fracture body 2052 can have a lower material strength to facilitate reproducible fragmentation of the physical anatomy model 2048. The fracture body 2052 can incorporate any of the materials disclosed herein.

[0272] The physical fracture body 2052 may include one or more indicators adapted to selectively transmit the state of the physical anatomical model 2048 in response to an external force, such as compression, tension, shearing, bending, and / or torsional forces. Various indicators may be utilized. The physical fracture body 2052 may be compressible or otherwise movable to provide an indication, such as tactile feedback in response to the surgeon's compression. The fracture body 2052 may incorporate a compressible material such as an elastomer. The fracture body 2052 may be generated in response to relative movement between adjacent components 2048C. Material properties may be selected so that after a force is applied to the fracture body 2052, the fracture body 2052 may hold adjacent components 2048C together. Material properties may be selected to facilitate simulation of semi-mobile, partial, and / or complete fractures. Semi-mobile fractures may facilitate articulation between the resulting fragments.

[0273] Figure 53 It can be associated with a first state of the physical anatomical model 2048 before an external (eg, compressive) force is applied to the fracture body 2052 . Figure 54 A second state of the physical anatomical model 2048 may be associated with an amount of compressive force applied to the fracture body 2052, thereby partially deforming the fracture body 2052. The amount of compressive force may exceed a first (e.g., lower) preselected limit, which may cause the fracture body 2052 to partially deform. The deformation may be non-permanent. Exceeding the first preselected limit may cause a portion of the fracture body 2052 to bulge (e.g., Figure 54 ). Figure 55 The third state of the physical anatomical model 2048 can be associated with a different (e.g., larger) amount of compressive force applied to the fracture body 2052 in the state. The amount of compressive force can exceed a second (e.g., upper) preselected limit, which may cause the fracture body 2052 to permanently deform (e.g., separate). The preselected limit can be established by various physical material properties of the fracture body 2052. The external force can be generated by the surgical device 2053. In an embodiment, the surgical device 2053 can be a fastener, such as a compression screw, which can be used to attach the components 2048C to each other. The permanent deformation can provide an indication that the amount of compression exceeds the preselected limit.

[0274] Other techniques may be used to provide an indication of the amount of external force applied to the physical fracture. Figure 56 In an embodiment, the physical anatomical model 2148 can include a fracture body 2152 having at least one or more cavities (e.g., fluid reservoirs) 2152C. The cavities 2152C can enclose or otherwise retain a fluid F. Applying a (e.g., compressive) force on the fracture body 2152 that exceeds a (e.g., upper) preselected limit can cause the fracture body 2152 to rupture, releasing a portion of the fluid F from the cavities 2151C. The rupture can provide an indication that the preselected limit has been exceeded.

[0275] exist Figure 57 In an embodiment, the physical anatomical model 2248 can include a physical fracture body 2252. One or more objects 2259 can be at least partially and / or completely embedded in the fracture body 2252. The objects 2259 can have one or more physical properties that can be different from the material of the physical fracture body 2252. In an embodiment, the objects 2259 can be particles having a generally spherical geometry. The particles can be relatively harder than the material of the fracture body 2252. Applying a (e.g., compressive) force on the fracture body 2252 that exceeds (e.g., an upper limit) a preselected limit can cause the objects 2259 to be released (e.g., ejected) from the fracture body 2252 to provide an indication that the preselected limit has been exceeded.

[0276] Figure 58 A physical anatomical model 2348 including a fracture path (e.g., pattern) 2350 is disclosed. The physical anatomical model 2348 can be formed using any of the techniques disclosed herein. The physical anatomical model 2348 can include a body 2348M. An outer surface 2348E of the body 2348M can be associated with an anatomical feature of a bone, including any of the bones disclosed herein, such as the humerus. The fracture path 2350 can be established using any of the techniques disclosed herein based on an assigned virtual fracture pattern and / or virtual fracture volume.

[0277] refer to Figures 59-60 , continue to refer to Figure 58 , discloses a virtual anatomical model 2329 according to an embodiment. The virtual anatomical model 2329 can be created using any of the techniques disclosed herein. The virtual anatomical model 2329 can be associated with a virtual fracture pattern 2343 and / or a virtual fracture body 2347 ( Figure 60 In an embodiment, a fracture path 2350 may be established based on the virtual fracture pattern 2343 and / or the virtual fracture body 2347 ( Figure 58 ).

[0278] The virtual fracture pattern 2343 may include a first (eg, outer) virtual fracture path 2343-1 and a second (eg, inner) virtual fracture path 2343-2 ( Figure 60 ). The fracture paths 2343-1 and 2343-2 may be spaced apart from each other. A virtual fracture body 2347 may be defined between the virtual fracture paths 2343-1 and 2343-1.

[0279] The fracture paths 2343-1 and 2343-2 can have various two-dimensional and / or three-dimensional geometries. Each of the fracture paths 2343-1 and 2343-2 can include one or more undulating portions. Each of the fracture paths 2343-1 and 2343-2 can include one or more segments 2343S. Each of the segments 2343S is a linear or nonlinear path extending between two joints 2343J. The outer and inner virtual fracture paths 2343-1 and 2343-2 can be spaced apart from each other for all or at least a majority of their respective lengths. The outer fracture path 2343-1 can be sized to substantially surround the inner fracture path 2343-2.

[0280] Various techniques can be used to establish virtual fracture paths 2343-1, 2343-2. ​​In an embodiment, fracture paths 2343-1, 2343-2 can be established independently of each other. In other embodiments, the internal fracture path 2343-2 can be formed by a distance from the external fracture path 2343-1 ( Figure 60 ) or vice versa. The internal fracture path 2343-2 can be established by following the length of the external fracture path 2343-1 at the preselected offset distance 2343D, or vice versa. The internal fracture path 2343-2 can have one or more segments 2343S offset from the external fracture path 2343-1 by a distance 2343D′, which can be different from the preselected offset distance 2343D (e.g., Figure 63 ). The portion of the virtual fracture volume 2347 established by the distance 2343D′ can be associated with a relatively weaker region than the portion associated with the preselected offset distance 2343D, which can promote reproducible rupture (e.g., fracture) in the target region of the physical anatomical model 2348.

[0281] External and internal virtual fracture paths 2343-1, 2343-2 can be established based on the features of the virtual anatomical model 2329. The virtual fracture paths 2343-1, 2343-2 can be established relative to bone bodies 2343B, such as cortical bone body 2329CO and / or cancellous bone body 2329CA (see, e.g., Figure 60 and 63 ). In an embodiment, the external fracture path 2343-1 can be sized to substantially follow features of an outer wall of the bone body 2343B, which features can be associated with the cortical bone body 2329CO. The internal fracture path 2343-2 can be sized to substantially follow features of another portion of the virtual anatomical model 2329, such as the inner wall of the cortical bone body 2329CO. Segments 2343S of the internal fracture path 2343-2 can be established along the inner wall of the cortical bone body 2329CO and / or at least partially in the cancellous bone body 2329CA. Figure 63 In an embodiment, segment 2343S of the internal fracture path 2343-2 can be spaced apart from the inner wall (e.g., inward) of the cortical bone body 2329CO.

[0282] refer to Figures 61-62 , continue to refer to Figures 59-60 Each fracture path 2343-1, 2343-2 of the virtual fracture pattern 2343 may have a generally ribbon-like geometry. Each fracture path 2343-1, 2343-2 may have a width 2343W ( Figure 60 ). The width 2343W of each fracture path 2343-1, 2343-2 can be substantially constant or can vary along the respective lengths. Sidewalls 2343SW can be established between adjacent sides of the fracture paths 2343-1, 2343-2 to define a virtual fracture volume 2347. In an embodiment, the sidewalls 2343SW can be established by one or more facets between adjacent sides of the fracture paths 2343-1, 2343-2.

[0283] The virtual fracture volume 2347 can be assigned one or more properties, including any of the properties disclosed herein, such as various material properties, that can be the same as or different from adjacent portions of the virtual anatomical model 2329. In an embodiment, the virtual fracture volume 2347 can be associated with a relatively weaker material than the material associated with adjacent portions of the virtual anatomical model 2329, such as a cortical bone volume 2329CO associated with cortical bone and / or a cancellous bone volume 2329CA associated with cancellous bone.

[0284] The novel apparatus and methods disclosed herein provide flexibility in planning, rehearsing, and training surgical procedures using physical anatomical models. The physical anatomical models can represent various anatomical structures, including anatomical structures associated with various fracture classifications. Surgeons can interact with the disclosed system to become familiar with selected anatomical structures and various surgical procedures that can be used to implement surgical plans, including the repair of fractures that may be associated with different fracture classifications. The physical anatomical models can represent various tissue types and can incorporate one or more indicators to facilitate training. The indicators can assist the surgeon in determining the accuracy of performing surgical procedures on the physical anatomical models.

[0285] Although different non-limiting embodiments are shown as having specific components or steps, the embodiments of the present disclosure are not limited to those specific combinations. It is possible to use some components or features from any non-limiting embodiment in combination with features or components from any other non-limiting embodiment.

[0286] It should be understood that throughout the several drawings, like reference numerals identify corresponding or similar elements.It should also be understood that although particular component arrangements are disclosed and illustrated in these exemplary embodiments, other arrangements may also benefit from the teachings of this disclosure.

[0287] The foregoing description should be interpreted as illustrative rather than in any restrictive sense. It will be appreciated by those skilled in the art that certain modifications may fall within the scope of this disclosure. For these reasons, the following claims should be studied to determine the true scope and content of this disclosure.

Claims

1. A physical anatomical model comprising: a body comprising an outer surface associated with an anatomical feature of a bone and comprising a fracture path establishing one or more localized regions; and wherein the body is capable of being severed along the fracture path to create one or more fragments associated with a respective one of the one or more localized regions. 2 . The physical anatomical model of claim 1 , wherein the fracture path comprises one or more segments, and each of the one or more segments establishes a loop around the corresponding local area.

3. A physical anatomical model according to claim 1 or 2, wherein the fracture path is established according to a predetermined fracture pattern.

4. A physical anatomical model according to any one of the preceding claims, wherein: The main body includes a first body and a second body; The first body establishes the outer surface of the body and represents cortical bone; and The second body represents cancellous bone.

5. The physical anatomical model of claim 4, wherein the outer surface along at least one of the local regions is associated with an articular surface of a joint.

6. A physical anatomical model according to claim 4 or 5, wherein: The fracture path extends along a boundary region between the first body and the second body; and The body includes a fracture body established along the fracture path such that the fracture body is at least partially embedded in the first body, and the body is capable of being severed along the fracture body to establish the one or more fragments.

7. The physical anatomical model according to any one of claims 4 to 6, wherein the first body has a first property and the fracture body has a second property different from the first property.

8. The physical anatomical model of claim 7, wherein the first characteristic comprises a first material strength and the second characteristic comprises a second material strength that is less than the first material strength.

9. The physical anatomical model according to any one of the preceding claims, further comprising: One or more extensions extend from the outer surface of the body adjacent the fracture path, wherein the one or more extensions represent soft tissue.

10. The physical anatomical model of claim 1 , wherein: The body includes one or more indicators associated with the fracture path.

11. The physical anatomical model of claim 10, wherein: The one or more indicators include a plurality of graduations distributed along the length of the fracture path.

12. The physical anatomical model of claim 10, wherein: The one or more indicators include an indicator path along the outer surface of the body, and the indicator path is sized to follow a length of the fracture path.

13. The physical anatomical model according to any one of claims 10 to 12, wherein: The body includes a fracture volume established along the fracture path, and the body is capable of being severed along the fracture volume to establish the one or more fragments; and The one or more indicators include a visual contrast between the main body and the fracture body.

14. The physical anatomical model of claim 13, wherein: The fracture body is spaced apart from the outer surface of the main body.

15. The physical anatomical model according to any one of claims 10 to 14, wherein: The one or more indicators include a shape established along the outer surface of the body, and the shape spans between at least two of the localized regions.

16. The physical anatomical model of claim 15, wherein: The shape is a contour associated with the perimeter of an orthopedic implant that is securable to adjacent bone fragments.

17. The physical anatomical model of claim 1, further comprising: A fracture body is associated with the fracture path, wherein the fracture body extends substantially through the body such that the body can be severed along the fracture body to create the one or more fragments.

18. The physical anatomical model of claim 17, wherein the main body has a first property and the fracture body has a second property different from the first property.

19. The physical anatomy model of claim 17 or 18, wherein the fracture body comprises at least one indicator adapted to selectively communicate a state of the physical anatomy model in response to an external force.

20. The physical anatomical model of any one of claims 17 to 19, wherein the fracture volume comprises a compressible material.

21. A physical anatomical model according to any one of claims 17 to 20, wherein the fracture body is adapted to release a quantity of fluid in response to the external force exceeding a preselected limit.

22. A physical anatomical model according to any one of claims 17 to 21, wherein the fracture body is adapted to release one or more objects in response to the external force exceeding a preselected limit.

23. A physical anatomical model according to any one of the preceding claims, wherein the body comprises a polymer material.

24. The physical anatomical model of any preceding claim, wherein the anatomical features of the bone are associated with long bones.

25. An orthopedic system comprising: a physical anatomical model comprising a body having a fracture path; and A fracture tool is provided, the fracture tool being adapted to sever the body along the fracture path to create one or more fragments.

26. The orthopedic system of claim 25, wherein: The main body includes a first body and a second body; The first body establishes an outer surface of the body and represents cortical bone; and The second body represents cancellous bone.

27. The orthopedic system according to claim 25 or 26, wherein: The fracture tool includes a clamp having a first clamp element and a second clamp element; the first clamp element comprising a plurality of configurable engagement elements sized to engage selectable contact points along the body; and Each of the engagement elements is adapted to cooperate with the second jaw element to apply a compressive force at a corresponding contact point to sever the body along the fracture path to create the one or more fragments.

28. The orthopedic system of claim 27, further comprising: a plurality of contact indicators established along an outer surface of the body adjacent the respective contact points; and Wherein each of the contact indicators is associated with a respective one of the engagement elements.

29. A system for practicing a surgical procedure, the system comprising: A computing device comprising a processor coupled to a memory, wherein the processor is configured to: accessing a virtual anatomical model from the memory, the virtual anatomical model being associated with the anatomical structure; causing the virtual anatomical model to be displayed in a graphical user interface; assigning a fracture pattern to the virtual anatomical model based on one or more parameters; and A configuration associated with a physical anatomical model representing the virtual anatomical model is generated, the configuration specifying a fracture path established according to the assigned fracture pattern.

30. The system of claim 29, wherein: The processor is configured to generate the configuration such that the physical anatomical model can be severed along the fracture path to create one or more fragments.

31. The system of claim 29 or 30, wherein: The processor is configured to generate a fracture volume having a length that follows the fracture pattern, and the configuration is established based on the fracture volume.

32. The system of claim 31 , wherein: The fracture pattern includes a first fracture path and a second virtual fracture path spaced apart from each other, and the fracture volume is defined between the first fracture path and the second fracture path.

33. A system according to claim 31 or 32, wherein: The fracture volume can be associated with a weaker material than adjacent portions of the virtual anatomical model.

34. A system according to any one of the preceding claims, wherein: The configuration specifies one or more indicators associated with the fracture path.

35. A system according to any one of the preceding claims, wherein: The one or more parameters are associated with a predefined fracture classification scheme; and The processor is configured to assign the fracture pattern to the virtual anatomical model in response to setting the one or more parameters associated with the predefined fracture classification scheme.

36. The system of claim 29 or 30, wherein: The virtual anatomical model includes a first body and a second body; The first volume represents cortical bone; and The second body represents cancellous bone.

37. The system of claim 36, wherein: The processor is configured to generate the fracture pattern, and the fracture pattern extends along a boundary region between the first body and the second body.

38. The system of claim 36 or 37, wherein: The processor is configured to generate a fracture volume having a length that follows the fracture pattern, and the configuration is established based on the fracture volume.

39. A system according to any one of claims 36 to 38, wherein: The configuration specifies one or more indicators associated with the fracture path.

40. The system of claim 39, wherein the one or more indicators include at least one or more of the following: an indicated path following the length of said fracture path; a plurality of scales distributed along the length of the fracture path; a shape spanning the fracture path; and A visual contrast between the fracture path and adjacent portions of the physical anatomical model.

41. The system of claim 39 or 40, wherein: At least one indicator includes a contour, and the contour is associated with a perimeter of an orthopedic implant securable to adjacent bone fragments.

42. The system of claim 29, wherein: The processor is configured to generate a fracture body based on the fracture pattern such that the fracture body extends substantially through a body of the physical anatomical model such that the body can be severed along the fracture body to create one or more fragments.

43. The system of claim 42, wherein the body has a first characteristic and the fracture body has a second characteristic different from the first characteristic.

44. The system of claim 42 or 43, wherein the fracture volume comprises at least one indicator associated with a status of the physical anatomical model.

45. The system of any one of claims 42 to 44, wherein the bone fracture body comprises a compressible material.

46. ​​A method of creating a physical anatomical model for use in a surgical procedure, the method comprising: selecting a virtual anatomical model associated with the anatomical structure; assigning a fracture pattern to the virtual anatomical model based on one or more parameters; and A configuration associated with a physical anatomical model representing the virtual anatomical model is generated, the configuration specifying a fracture path established according to the assigned fracture pattern.

47. The method of claim 46, wherein: The one or more parameters are associated with a predefined fracture classification scheme; and The step of assigning the fracture pattern occurs in response to setting the one or more parameters associated with the predefined fracture classification scheme.

48. The method of claim 46 or 47, further comprising: The virtual anatomical model and the assigned fracture pattern are caused to be displayed in a graphical user interface.

49. The method of claim 48, further comprising: The one or more parameters are set in response to user interaction with the graphical user interface.

50. The method of any preceding claim, further comprising: forming the physical anatomical model based on the configuration; wherein the fracture path establishes one or more localized regions of the physical anatomical model; and The physical anatomical model can be cut along the fracture path to create one or more fragments associated with corresponding local areas.

51. The method of claim 50, wherein: The forming step includes printing layers of material upon each other to create the physical anatomical model.

52. The method of claim 50 or 51, wherein: The physical anatomical model includes a first body and a second body; The first volume represents cortical bone; and The second body represents cancellous bone.

53. The method of claim 50 or 51, wherein: The configuration specifies a fracture volume that follows the length of the fracture path; and The physical anatomical model can be cut along the fracture body to create the one or more fragments.

54. A method according to any one of the preceding claims, wherein: The configuration specifies one or more indicators associated with the fracture path.

55. The method of claim 54, wherein: The one or more indicators include a plurality of contact indicators distributed along the physical anatomical model; and Each of the contact indicators is associated with a corresponding contact element of the fracture tool, and the body of the physical anatomical model is capable of severing along the fracture path to create one or more fragments in response to the fracture tool applying a certain amount of force at a contact point adjacent to the corresponding contact indicator along the physical anatomical model.

56. The method of claim 46, 54 or 55, wherein: The configuration specifies a fracture body spanning between opposing sides of the fracture path such that the fracture body extends substantially through a body of the physical anatomical model; and The physical anatomical model can be cut along the fracture body to create one or more fragments.

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