Fracture models, systems and related methods

Abstract

The present disclosure relates to surgical systems, devices and methods for planning and performing surgical procedures, including bone fracture repair. The systems and methods disclosed herein can be utilized to establish physical models of anatomical structures.

Description

[Technical Field]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims the benefit of U.S. Patent Application No. 63 / 480,361, filed January 18, 2023, which is incorporated herein by reference in its entirety. [Background technology]

[0002] The present disclosure relates to surgical systems, devices, and methods for planning and performing surgical procedures utilizing physical models of anatomical structures.

[0003] Patients may experience fractures of one or more bones due to trauma, and surgeons may reduce the fractures and fixate the bone fragments with implants, restoring function to the patient.

[0004] A surgeon may prepare for an orthopaedic surgery by performing the procedure on a cadaver or femoral simulant. Summary of the Invention [Means for solving the problem]

[0005] The present disclosure relates to systems, devices, and methods for performing surgical procedures. The system may be utilized to perform one or more surgical procedures on a physical anatomical model representing an anatomical structure. The physical anatomical model may be separable along a fracture path to establish one or more fragments. The physical anatomical model and associated fracture path may be established based on a virtual anatomical model of the anatomical structure.

[0006] The physical anatomical model, according to the implementation, may include a body including an outer surface that can be associated with an anatomical profile of a bone. The body may include a fracture path that can establish one or more localized regions. The body may be separable along the fracture path to establish one or more fragments that can be associated with a respective one of the one or more localized regions.

[0007] According to an implementation, the orthopaedic system may include a physical anatomical model including a body having a fracture path, and a fracture tool may be adapted to separate the body along the fracture path to establish one or more fragments.

[0008] A system for practicing a surgical procedure according to the implementation may include a computing device including 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.

[0009] A method for establishing a physical anatomical model for a surgical procedure by implementing the present invention 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 according to the assigned fracture pattern.

[0010] The present disclosure may include any one or more of the individual features disclosed above and / or below, alone or in any combination thereof.

[0011] The various features and advantages of the present disclosure will become apparent to those skilled in the art from the following detailed description. The drawings that accompany the detailed description can be briefly described as follows. [Brief explanation of the drawings]

[0012] [Figure 1]An exemplary planning system is disclosed. [Figure 2] Another exemplary planning system is disclosed that includes a user interface. [Figure 3] The user interface of FIG. 2 is disclosed, which includes a display window containing various parameters. [Figure 4] 3 discloses a display window of the user interface of FIG. 2 that includes a help screen that presents fracture classification information. [Figure 5] The user interface of FIG. 2 is disclosed, including a display window showing a virtual anatomical model. [Figure 6] 2 including a display window showing an embodiment of the virtual anatomical model of FIG. 5. [Figure 7] 2 including a display window showing an embodiment of the virtual anatomical model of FIG. 5. [Figure 8] 2 including a display window showing an embodiment of the virtual anatomical model of FIG. 5. [Figure 9] 2 including a display window showing a fracture pattern for the virtual anatomical model of FIG. 8. [Figure 10A] The embodiment of the fracture pattern of FIG. 9 is disclosed. [Figure 10B] The embodiment of the fracture pattern of FIG. 9 is disclosed. [Figure 10C] The embodiment of the fracture pattern of FIG. 9 is disclosed. [Figure 10D] The embodiment of the fracture pattern of FIG. 9 is disclosed. [Figure 11] 2 including a display window showing a fracture pattern for the virtual anatomical model of FIG. 9. [Figure 12] 2 including a display window showing fracture volume for the virtual anatomical model of FIG. 9. [Figure 13A] 13 discloses a cross-sectional view of the embodiment of the fracture volume of FIG. 12. [Figure 13B] FIG. 12 discloses an isolated view of the fracture volume. [Figure 14] A cross-sectional view of a physical anatomical model according to another implementation is disclosed. [Figure 15A] A cross-sectional view of a fracture volume relative to a virtual anatomical model is disclosed. [Figure 15B] A cross-sectional view of a fracture volume relative to a virtual anatomical model is disclosed. [Figure 15C] A cross-sectional view of a fracture volume relative to a virtual anatomical model is disclosed. [Figure 16A] 15A-15C disclose cross-sectional views of fracture volume relative to soft tissue volume associated with the virtual anatomical model. [Figure 16B] 15A-15C disclose cross-sectional views of fracture volume relative to soft tissue volume associated with the virtual anatomical model. [Figure 16C] 15A-15C disclose cross-sectional views of fracture volume relative to soft tissue volume associated with the virtual anatomical model. [Figure 17] The user interface of FIG. 2 is disclosed, which includes a display window showing a virtual indicator for a virtual anatomical model. [Figure 18] Various states of a physical anatomical model incorporating physical indicators for fracture path and associated with the virtual anatomical model of FIG. 17 are disclosed. [Figure 19] Various states of a physical anatomical model incorporating physical indicators for fracture path and associated with the virtual anatomical model of FIG. 17 are disclosed. [Figure 20] Various states of a physical anatomical model incorporating physical indicators for fracture path and associated with the virtual anatomical model of FIG. 17 are disclosed. [Figure 21A] Various states of the physical anatomical model are disclosed that incorporate physical indicators for fracture paths. [Figure 21B] Various states of the physical anatomical model are disclosed that incorporate physical indicators for fracture paths. [Figure 21C] Various states of the physical anatomical model are disclosed that incorporate physical indicators for fracture paths. [Figure 22]Another implementation of an anatomical model for an indicator is disclosed. [Figure 23] Another implementation of an anatomical model incorporating one or more voids is disclosed. [Figure 24] Another implementation of an anatomical model incorporating one or more voids is disclosed. [Figure 25] 1 discloses a perspective view of an implementation of a fracture tool. [Figure 26] 26 discloses the fracture tool of FIG. 25 positioned relative to a physical anatomical model. [Figure 27A] 27 discloses various states of the physical anatomical model for the fracture tool of FIG. 26. [Figure 27B] 27 discloses various states of the physical anatomical model for the fracture tool of FIG. 26. [Figure 27C] 27 discloses various states of the physical anatomical model for the fracture tool of FIG. 26. [Figure 27D] 27 discloses various states of the physical anatomical model for the fracture tool of FIG. 26. [Figure 27E] 27 discloses various states of the physical anatomical model for the fracture tool of FIG. 26. [Figure 28] 10A and 10B disclose a perspective view of a fracture tool according to another implementation. [Figure 29A] 29A-29C disclose perspective views of various positions of the fracture tool of FIG. 28 positioned relative to a physical anatomical model. [Figure 29B] 29A-29C disclose perspective views of various positions of the fracture tool of FIG. 28 positioned relative to a physical anatomical model. [Figure 29C] 29A-29C disclose perspective views of various positions of the fracture tool of FIG. 28 positioned relative to a physical anatomical model. [Figure 30] Another implementation of a fracture tool is disclosed. [Figure 31] 10A and 10B show perspective views of a fracture tool according to yet another implementation; [Figure 32] 32 discloses a side view of the fracture tool of FIG. 31. [Figure 33] 32 discloses a cross-sectional view of the fracture tool of FIG. 31. [Figure 34] 34 discloses a view of the fracture tool taken along line 34-34 of FIG. [Figure 35] 32 discloses a perspective view of the fracture tool of FIG. 31 positioned relative to a physical anatomical model. [Figure 36] 36 discloses another view of the fracture tool positioned relative to the physical anatomical model of FIG. 35. [Figure 37] 32 discloses a perspective view of the fracture tool of FIG. 31 positioned relative to another physical anatomical model. [Figure 38] 38 discloses another view of the fracture tool positioned relative to the physical anatomical model of FIG. 37. [Figure 39] An exemplary method for planning and performing a surgical procedure utilizing physical anatomical model(s) is disclosed. [Figure 40] Techniques for creating physical anatomical models are disclosed. [Figure 41A] A virtual anatomical model, a fragmentation state of the virtual anatomical model, and a fragmentation state of a physical anatomical model associated with the virtual anatomical model are disclosed. [Figure 41B] A virtual anatomical model, a fragmentation state of the virtual anatomical model, and a fragmentation state of a physical anatomical model associated with the virtual anatomical model are disclosed. [Figure 41C] A virtual anatomical model, a fragmentation state of the virtual anatomical model, and a fragmentation state of a physical anatomical model associated with the virtual anatomical model are disclosed. [Figure 42A] The fragmentation state of the physical anatomical model is disclosed. [Figure 42B] The fragmentation state of the physical anatomical model is disclosed. [Figure 42C] FIG. 42B discloses the implant positioned and secured in the physical anatomical model. [Figure 42D] FIG. 42B discloses the implant positioned and secured in the physical anatomical model. [Figure 43] Another implementation of a virtual anatomical model in a viewing window is disclosed. [Figure 44A]A physical anatomical model associated with the virtual anatomical model of FIG. 43 is disclosed. [Figure 44B] A physical anatomical model associated with the virtual anatomical model of FIG. 43 is disclosed. [Figure 45] The implementation of a virtual anatomical model in the user interface of FIG. 2 is disclosed. [Figure 46] Another implementation of a virtual anatomical model in a viewing window is disclosed. [Figure 47A] A physical anatomical model associated with the virtual anatomical model of FIG. 46 is disclosed. [Figure 47B] A physical anatomical model associated with the virtual anatomical model of FIG. 46 is disclosed. [Figure 48] A virtual anatomical model including respective fracture volumes according to the implementation is disclosed. [Figure 49] The fracture volume is disclosed in FIG. 48, with the virtual anatomical model shown in dashed lines. [Figure 50] 48A and 48B disclose isolated views of the fracture volume in different orientations. [Figure 51] 48A and 48B disclose isolated views of the fracture volume in different orientations. [Figure 52] 49 discloses a cross-sectional view of one of the virtual anatomical models and the associated fracture volume of FIG. 48. [Figure 53] Various aspects of the physical anatomical model, including fracture paths, are disclosed. [Figure 54] Various aspects of the physical anatomical model, including fracture paths, are disclosed. [Figure 55] Various aspects of the physical anatomical model, including fracture paths, are disclosed. [Figure 56] Another implementation of a physical anatomical model is disclosed. [Figure 57] Another implementation of a physical anatomical model is disclosed. [Figure 58] Another implementation of a physical anatomical model including fracture volumes is disclosed. [Figure 59] A virtual anatomical model including a virtual fracture pattern is disclosed. [Figure 60]The virtual anatomical model of FIG. 59 is disclosed, including a virtual fracture volume. [Figure 61] FIG. 60 discloses an isolated view of the hypothetical fracture volume. [Figure 62] FIG. 61 discloses a cross-sectional view of a hypothetical fracture volume. [Figure 63] FIG. 60 discloses a cross-sectional view of a virtual anatomical model and associated virtual fracture volume. DETAILED DESCRIPTION OF THE INVENTION

[0013] Like reference numbers and designations in the various drawings indicate like elements.

[0014] The present disclosure relates to surgical systems, devices, and methods for planning and performing surgical procedures utilizing physical models of anatomical structures. Physical anatomical models may be utilized to practice and train on various surgical procedures, including fracture repair.

[0015] The disclosed technology can be utilized to provide surgeons with a training experience that can be targeted or tailored to them based on procedure, skill set, experience, etc. A surgeon can select a particular configuration of a virtual anatomical model that can be fabricated or otherwise formed to establish a physical anatomical model based on an anatomical structure or pathology that the surgeon may intend to treat. In a scenario, a surgeon may be unfamiliar with a particular fracture type or other deformity and may choose to train using that configuration of the physical anatomical model. A surgeon can utilize the physical anatomical model to train with specific instruments, implants, and other devices that may be intended for a planned surgery to treat a patient. Once training on the physical anatomical model is complete, the surgeon can select more challenging cases in subsequent training cycles.

[0016] A surgeon, assistant, or other user may interact with a graphical user interface (GUI) to select various parameters or characteristics of the physical anatomical model. Parameters may include anatomy, patient, fracture classification, case, etc., to establish a desired configuration of the physical anatomical model. A surgeon may adjust or select one or more variables or parameters specific to a fracture classification scheme depending on what the surgeon wants to train. The specified parameters may be represented in the physical anatomical model.

[0017] The surgeon may interact with the user interface to select a desired case associated with each virtual anatomical model. The surgeon may interact with the user interface to select a previous case. The surgeon may select a case that corresponds to the intended patient, or may select a previous or hypothetical case that may closely correspond to a particular fracture classification.

[0018] Various techniques may be utilized to establish a physical anatomical model, including any of the techniques disclosed herein. A virtual fracture pattern (e.g., a virtual fracture path) and / or a virtual fracture volume may be established for the virtual anatomical model. The fracture pattern may be established based on one or more parameters of a fracture classification scheme. The virtual fracture volume may be established along or otherwise adjacent to the fracture pattern. The physical fracture path and / or physical fracture volume may be established based on a virtual fracture pattern and / or a virtual fracture volume, which may be incorporated into the physical anatomical model. The fracture volume may establish localized areas of relative weakness in the physical anatomical model, which may promote fragmentation of the physical anatomical model. The surgeon may reassemble (e.g., reduce) the fragment(s) of the physical anatomical model. The surgeon may fix the fragment(s) to each other and / or to the remainder of the physical anatomical model, such as with a bone plate or another implant. The anatomical model may incorporate one or more indicators to facilitate assessment of the repair.

[0019] A fracture tool may be utilized to engage and establish a fragmentation state of the physical anatomical model. A surgeon or clinical user may manipulate the fracture tool to establish one or more fragments. The fracture tool may apply a compressive force to the physical anatomical model to fracture the physical anatomical model along a fracture path and / or fracture volume to establish the fragment(s).

[0020] The restored physical anatomical model may serve as the surgeon's artifact. Upon completion of training, the surgeon may leave the training facility with the modified physical anatomical model. The surgeon may refer to the modified physical anatomical model before and during each patient's surgical procedure.

[0021] The physical anatomical model, according to the implementation, may include a body including an outer surface that can be associated with an anatomical profile of a bone. The body may include a fracture path that can establish one or more localized regions. The body may be separable along the fracture path to establish one or more fragments that can be associated with a respective one of the one or more localized regions.

[0022] In either implementation, the fracture path may include one or more segments, each of which may establish a loop around a respective local region.

[0023] In either implementation, the fracture path may be established according to a predetermined fracture pattern.

[0024] In either implementation, the body may include a first volume and a second volume. The first volume may establish an outer surface of the body and may represent cortical bone. The second volume may represent cancellous bone.

[0025] In either implementation, the outer surface along at least one of the localized regions may be associated with an articular surface of the joint.

[0026] In either implementation, the fracture path can extend along a boundary region between the first volume and the second volume. The body can include a fracture volume established along the fracture path such that the fracture volume can be at least partially embedded in the first volume. The body can be separable along the fracture volume to establish one or more fragments.

[0027] In either implementation, the first volume may have a first characteristic, and the fracture volume may have a second characteristic that may be different from the first characteristic.

[0028] In either implementation, the first characteristic may include a first material strength, and the second characteristic may include a second material strength, which may be less than the first material strength.

[0029] In either implementation, one or more extensions may extend from the outer surface of the body adjacent the fracture path. The one or more extensions may represent soft tissue.

[0030] In either implementation, the body may include one or more indicators that may be associated with the fracture path.

[0031] In either implementation, the one or more indicators may include multiple graduations that may be distributed along the length of the fracture path.

[0032] In either implementation, the one or more indicators may include an indication path along the outer surface of the body, which may be sized to follow the length of the fracture path.

[0033] In either implementation, the body may include a fracture volume that can be established along the fracture path. The body may be separable along the fracture volume to establish one or more fragments. The one or more indicators may include a visual contrast between the body and the fracture volume.

[0034] In either implementation, the fracture volume may be spaced from the outer surface of the body.

[0035] In either implementation, the one or more indicators may include a shape established along the outer surface of the body, and the shape may span between at least two of the localized regions.

[0036] In either implementation, the shape may be a silhouette associated with the periphery of an orthopedic implant that is fixable to adjacent bone fragments.

[0037] In either implementation, a fracture volume may be associated with the fracture path. The fracture volume may extend substantially through the body such that the body may be separable along the fracture volume to establish one or more fragments.

[0038] In either implementation, the body may have a first characteristic, and the fracture volume may have a second characteristic that may be different from the first characteristic.

[0039] In either implementation, the fracture volume may include at least one indicator adapted to selectively communicate a state of the physical anatomical model in response to an external force.

[0040] In either implementation, the fracture volume may include a compressible material.

[0041] In either implementation, the fracture volume may be adapted to release a quantity of fluid in response to an external force exceeding a preselected limit.

[0042] In either implementation, the fracture volume may be adapted to release one or more objects in response to an external force exceeding a preselected limit.

[0043] In either implementation, the body may comprise a polymeric material.

[0044] In either implementation, a bony anatomical profile may be associated with the long bone.

[0045] According to an implementation, the orthopaedic system may include a physical anatomical model including a body having a fracture path, and a fracture tool may be adapted to separate the body along the fracture path to establish one or more fragments.

[0046] In either implementation, the body may include a first volume and a second volume. The first volume may establish an outer surface of the body and may represent cortical bone. The second volume may represent cancellous bone.

[0047] In either implementation, the fracture tool may include a clamp having a first clamping element and a second clamping element. The first clamping element may include a plurality of configurable engagement elements that may be dimensioned to engage selectable contact points along the body. Each of the engagement elements may be adapted to cooperate with the second clamping element to apply a compressive force at the respective contact point to separate the body along the fracture path to establish one or more fragments.

[0048] In either implementation, a plurality of contact indicators may be established along the outer surface of the body adjacent to each contact point, each of the contact indicators being associated with a respective one of the engagement elements.

[0049] A system for practicing a surgical procedure according to the implementation may include a computing device including 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.

[0050] In either implementation, the processor may be configured to generate a configuration such that the physical anatomical model is separable along the fracture path to establish one or more fragments.

[0051] In either implementation, the processor may be configured to generate a fracture volume that may follow the length of the fracture pattern. The configuration may be established according to the fracture volume.

[0052] In either implementation, the fracture pattern may include a first and a second virtual fracture path that may be spaced apart from one another, and a fracture volume may be bounded between the first and second fracture paths.

[0053] In either implementation, the fracture volume may be associated with weaker material than adjacent portions of the virtual anatomical model.

[0054] In either implementation, the configuration may specify one or more indicators associated with the fracture path.

[0055] In either implementation, the one or more parameters may be associated with a predetermined fracture classification scheme, and the processor may be configured to assign a fracture pattern to the virtual anatomical model in response to setting the one or more parameters associated with the predetermined fracture classification scheme.

[0056] In either implementation, the virtual anatomical model may include a first volume and a second volume. The first volume may represent cortical bone. The second volume may represent cancellous bone.

[0057] In either implementation, the processor may be configured to generate a fracture pattern, which may extend along a boundary region between the first volume and the second volume.

[0058] In either implementation, the processor may be configured to generate a fracture volume that may follow the length of the fracture pattern. The configuration may be established according to the fracture volume.

[0059] In either implementation, the configuration may specify one or more indicators associated with the fracture path.

[0060] In any implementation, the one or more indicators may include at least one or more of a display 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.

[0061] In either implementation, the at least one indicator may include a silhouette that may be associated with the periphery of an orthopaedic implant that is fixable to adjacent bone fragments.

[0062] In either implementation, the processor may be configured to generate a fracture volume based on the fracture pattern such that the fracture volume can extend substantially through the body of the physical anatomical model, such that the body can be separated along the fracture volume to establish one or more fragments.

[0063] In either implementation, the body may have a first characteristic, and the fracture volume may have a second characteristic that may be different from the first characteristic.

[0064] In either implementation, the fracture volume may include at least one indicator associated with the state of the physical anatomical model.

[0065] In either implementation, the fracture volume may include a compressible material.

[0066] A method for establishing a physical anatomical model for a surgical procedure by implementing the present invention 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 according to the assigned fracture pattern.

[0067] In either implementation, the one or more parameters may be associated with a predetermined fracture classification scheme, and the step of assigning a fracture pattern may occur in response to setting the one or more parameters associated with the predetermined fracture classification scheme.

[0068] In either implementation, the method may include displaying the virtual anatomical model and the assigned fracture pattern in a graphical user interface.

[0069] In either implementation, the method may include setting one or more parameters in response to user interaction with the graphical user interface.

[0070] In either implementation, the method may include forming a 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 establish one or more fragments separable along the fracture path and associated with each localized region.

[0071] In either implementation, the creation process may involve printing layers of material on top of each other to establish a physical anatomical model.

[0072] In either implementation, the physical anatomical model may include a first volume and a second volume. The first volume may represent cortical bone. The second volume may represent cancellous bone.

[0073] In either implementation, the configuration may specify a fracture volume that can follow the length of the fracture path. The physical anatomical model may be separable along the fracture volume to establish one or more fragments.

[0074] In either implementation, the configuration may specify one or more indicators associated with the fracture path.

[0075] In either implementation, the one or more indicators may include a plurality of contact indicators that may be distributed along the physical anatomical model. Each of the contact indicators may be associated with a respective contact element of the fracture tool. The body of the physical anatomical model may be separable along the fracture path to establish one or more fragments in response to the fracture tool applying an amount of force to a contact point along the physical anatomical model adjacent a respective contact indicator.

[0076] In either implementation, the configuration may specify a fracture volume that can span between either side of the fracture path, such that the fracture volume can extend substantially through the body of the physical anatomical model. The physical anatomical model may be separable along the fracture volume to establish one or more fragments.

[0077] 1 illustrates a planning system 20 that may be utilized to plan a surgical procedure, according to an implementation. The system 20 may be used to plan orthopedic surgical procedures, including pre-operative, intra-operative, and / or post-operative, to create, edit, execute, and / or review surgical plans. The system 20 may be used to train and practice for various surgical procedures, including patient prior cases and surgical plans, as well as hypothetical cases.

[0078] 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 implementations, host computer 21 may include two or more computers jointly configured to process software instructions serially or in parallel.

[0079] Host computer 21 may communicate with one or more networks, such as network 23, which may be a private local area network (LAN), a private wide area network (WAN), the Internet, or a mesh network, of one or more computing devices.

[0080] The host computer 21 and each client computer 22 may include one or more of a computer processor, memory, storage means, network devices, and input and / or output devices and / or interfaces. Input devices may include a keyboard, mouse, etc. Output devices may include a monitor, speakers, printer, etc. Memory may include UVPROM, EEPROM, FLASH, RAM, ROM, DVD, CD, hard drive, or other computer-readable medium capable of storing 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, laptop computer, smartphone, tablet, or any other computing device. Interfaces may facilitate communication with other systems and / or components of the network 23.

[0081] Each client computer 22 may be configured to communicate with the host computer 21 directly via a direct client interface 24 or via a network 23. The client computers 22 may be configured to execute one or more software programs, such as various surgical instruments. Each client computer 22 may be operable to access and execute a planning environment 26 locally and / or remotely. The planning environment 26 may be a standalone software package or may be embedded in another surgical instrument. The planning environment 26 may be configured to communicate with the host computer 21 either via the network 23 or directly via a direct client interface 24. In implementations, the client computers 22 may be configured to communicate directly with each other via a peer-to-peer interface 25.

[0082] The planning environment 26 may provide, via one or more graphical user interfaces (GUIs), the 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 may be stored in one or more files or records according to a specified data structure.

[0083] System 20 may include at least one storage system 27, which may be operable to store 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 implementations, storage system 27 may be incorporated within host computer 21 and / or client computer 22 or may be 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, etc.

[0084] In implementation, system 20 may be a client-server architecture configured to execute computer software on host computer 21, which may be accessible by client computer 22 using either a thin client application or a web browser running on client computer 22. Host computer 21 may load computer software instructions into memory from local storage or from storage system 27 and execute the computer software using one or more computer processors.

[0085] The system 20 may include one or more databases 28. The databases 28 may be stored in a central location, such as the storage system 27. In implementations, the one or more databases 28 may be stored on the host computer 21 and / or may be distributed databases 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 surgical plans 31. Each surgical plan 31 may be associated with a respective patient. Each anatomical model 29, implant model 30, and surgical plan 31 may be assigned a unique identifier or database entry. The database 28 may be configured to store data corresponding to the anatomical models 29, implant models 30, and surgical plans 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 respective anatomical model 29, implant model 30, and surgical plan 31. The anatomical models 29 stored in the database 28 may correspond to respective patient anatomies from previous and / or planned surgical cases and may be classified into one or more predetermined categories such as gender, age, ethnicity, size, defect category, procedure type, etc. The anatomical models 29 and / or implant models 30 may be associated with respective instruments and devices for performing the associated surgical plan 31.

[0086] Each anatomical model 29 may include information acquired from one or more medical devices or tools, such as a computed tomography (CT), magnetic resonance imaging (MRI) machine, and / or an X-ray machine that may acquire one or more images of the patient. The anatomical model 29 may include one or more digital images and / or coordinate information associated with the patient's anatomy, acquired or derived from a medical device. In implementations, one or more of the anatomical models 29 may be created by a designer and may represent hypothetical anatomical structures. Each implant model 30 may include coordinate information associated with a given design. The planning environment 26 may incorporate and / or interface with one or more modeling packages, such as a computer-aided design (CAD) package, to render the models 29, 30 as two-dimensional (2D) and / or three-dimensional (3D) volumes or constructs. Each anatomical model 29 and implant model 30 may correspond to 2D and / or 3D geometric shapes and may be utilized to generate wireframes, meshes, and / or solid constructs within a display.

[0087] The implant models 30 may correspond to implants and components of various configurations, shapes, sizes, procedures, instruments, etc. Each implant may include one or more components that can be placed at a surgical site, including plates, anchors, screws, nails, sutures, grafts, etc. Each implant model 30 may correspond to a single component or may include two or more components that can be configured to establish an assembly. The implant models 30 may include a base plate coupled to an articulating member, a bone plate configured to interconnect adjacent bones or bone fragments, an intermedullary nail, a suture anchor, etc. The articulating member may have an articular surface sized to mate with the articular surface of an opposing bone or implant.

[0088] Each surgical plan 31 may be associated with one or more of the anatomical model 29 and / or the implant model 30. The surgical plan 31 may include information related to one or more modifications of the anatomical model 29 and the position of the implant model 30 relative to the original and / or modified anatomical model 29. The surgical plan 31 may include coordinate information related to the modified anatomical model 29 and the relative position of the implant model 30 in a predetermined data structure. Modifications of each anatomical model 29, implant model 30, and surgical plan 31 may be stored in the database 28 automatically and / or in response to user interaction with the system 20.

[0089] One or more surgeons, assistants, and other clinical users may be provided with the planning environment 26 via the client computers 22 and may simultaneously access the anatomical models 29, implant models 30, and surgical plans 31 stored in the database 28. Each user may interact with the planning environment 26 to create, view, and / or modify various aspects of the surgical plan 31. Each client computer 22 may be configured to store a local instance of the anatomical model 29, implant model 30, and / or surgical plan 31, which may be synchronized with the database 28 in real time or periodically. The planning environment 26 may be a standalone software package executing on the client computer 22 or may be provided as one or more services executing on the host computer 21.

[0090] FIG. 2 illustrates an implementation of a surgical system 120. The system 120 is utilized to facilitate planning, practice, and / or training for a surgical procedure. The system 120 may be utilized to plan, practice, train, and perform various orthopedic and other surgical procedures, such as arthroplasty procedures to repair joints. The system 120 may be utilized in planning the resection or modification of one or more bones. The system 120 may be utilized in planning the placement of implants to restore function to a bone and / or joint, such as a shoulder joint, during an anatomical or reverse shoulder procedure. The system 120 may be utilized in planning the repair of a fracture of one or more bones, including one or more long bones, such as the humerus. While the planning systems and methods disclosed herein primarily refer to shoulder repair, it should be understood that the planning system 120 may be utilized in other surgical procedures, including repairs elsewhere in a patient, as well as repairs of other joints, such as the ankle, wrist, hand, hip, or knee, and repairs of other tissues, such as cartilage, muscles, tendons, and ligaments.

[0091] System 120 may be configured to generate one or more physical anatomical models, including any of the physical anatomical models disclosed herein. A surgeon may perform one or more modifications to the physical anatomical model to practice or train for a surgical procedure. System 120 may be configured to generate configuration(s) associated with each physical anatomical model(s). The configuration(s) may be utilized to form the physical anatomical model(s). Each physical anatomical model may represent a virtual anatomical model 129, including substantially or generally corresponding geometric shapes, texture densities, porosities, colors, etc., as virtual anatomical models 129. Virtual anatomical models 129 may be associated with anatomical structures, such as the patient's anatomy and / or a hypothetical anatomy. Anatomical models 129 may include one or more anatomical features. The anatomical features may represent anatomical structures, including one or more bones, including cartilage, cortical and / or cancellous bone tissue, soft tissue, including muscles, ligaments and / or tendons, and / or other tissues.

[0092] System 120 may include a computing device 132. Computing device 132 may include at least one processor 133 coupled to memory 134. Computing device 132 may include any of the computing devices disclosed herein, such as host computer 21 and / or client computer 22 of FIG. 1. Processor 133 may be configured to execute planning environment 126 for creating, editing, executing, and / or reviewing one or more surgical (e.g., pre-operative) plans 131 during pre-operative, intra-operative, and / or post-operative phases of a surgical procedure. Processor 133 may be configured to access one or more virtual anatomical models 129 from a storage location, such as memory 134. Anatomical models 129 and surgical plans 131 may be associated with actual patient cases or may be hypothetical cases established for practice and / or training of surgeons, assistant medical staff, and other clinical users.

[0093] Planning environment 126 may include at least data module 135, display module 136, spatial module 137, and comparison module 138. Processor 133 may be configured to execute data module 135, display module 136, spatial module 137, and comparison module 138. Although four modules are disclosed in the implementation of FIG. 2, it should be understood that fewer than three or more than four modules may be utilized and / or one or more of the modules may be combined to provide the disclosed functionality.

[0094] The data module 135 may 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 may be stored in the database 128 as one or more records or entries 139. In implementation, the data and other information may be stored in one or more files that may be accessible by referencing one or more objects or memory locations referenced by the records 139.

[0095] The memory 134 may be configured to access, load, edit, and / or store instances of one or more anatomical models 129, implant models 130, and / or surgical plans 131 in response to one or more commands from the data module 135. The data module 135 may be configured to cause the memory 134 to store local instances of the anatomical models 129, implant models 130, and / or surgical plans 131, which may be synchronized with records 139 in the database 128.

[0096] The display module 136 may 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 may be coupled to the display device 140. The display module 136 may 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 may interact with the user interface 142 via the planning environment 126 to create, edit, and / or review aspects of the one or more anatomical models 129. A surgeon or other user may interact with the user interface 142 via the planning environment 126 to create, edit, execute, and / or review aspects of the one or more surgical plans 131.

[0097] Each surgical plan 131 may be associated with one or more (e.g., original) virtual anatomical models 129 before any modifications, which may substantially or generally approximate the anatomical structures. Each surgical plan 131 may be associated with one or more (e.g., modified) virtual anatomical models 129, which may incorporate one or more modifications to the anatomical structures and / or associated physical anatomical models. The original anatomical models 129 and the modified anatomical models 129 may be associated with each other in the surgical plan 131. In implementation, the modifications may be stored as one or more parameters of the original anatomical model 129.

[0098] 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.

[0099] The planning system 120 may be utilized to generate a physical instance of a virtual anatomical model 129 that a surgeon can use to practice or train on fracture repair. The surgeon may interact with the fracture conditions of the physical anatomical model, which may be associated with the virtual anatomical model 129. Each fracture may be classified according to one or more fracture classification schemes 141. Various fracture classification schemes, including pre-defined industry classification schemes and / or user-defined classification schemes, may be utilized in accordance with the teachings disclosed herein. Industry-defined classification schemes may include the Mueller AO Classification of Fractures, the Neer Classification, and the AO Foundation and Orthopaedic Trauma Association (AO / OTA) Fracture Classification Scheme. AO / OTA fracture classification schemes may include the 2018 Revision of the AO / OTA Fracture and Dislocation Classification Compendium released by the AO Foundation. The Neer Classification may be utilized to classify proximal humerus fractures. Other fracture classification schemes, including any known classification scheme recognized by the medical community, may be utilized in accordance with the teachings disclosed herein.

[0100] 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. The fracture patterns 143 may be established using various techniques, including any of the techniques disclosed herein. The planning system 120 may be adapted to associate each fracture pattern 143 with one or more of the fracture classification schemes 141. The data module 135 may be configured to access, retrieve, and / or store data and other information in the database(s) 128 corresponding to the one or more fracture classification schemes 141 and / or fracture patterns 143. The fracture classification schemes 141 and / or fracture patterns 143 may be predetermined and / or established by the comparison module 138. In implementation, the planning system 120 may generate the one or more fracture classification schemes 141 and / or fracture patterns 143 automatically and / or in response to user input. The fracture pattern 143 may be generated using a variety of techniques, such as finite element analysis (FEA) and other parametric modeling.

[0101] The comparison module 138 may 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 may be adapted to assign one or more fracture classification schemes 141 to each fracture pattern 143 automatically and / or in response to user interaction with the user interface 142 and / or another portion of the planning system 120. The data module 135 may 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(s) 128 or another memory location. The comparison module 138 may be adapted to generate, revise, or otherwise associate a surgical plan 131 with the anatomical model 129, the fracture classification scheme 141, and / or the fracture pattern 143.

[0102] Each fracture classification scheme 141 and / or fracture pattern 143 may be stored in a respective predetermined data structure(s) within the database 128 or another portion of the system 120. Data and other information associated with each fracture classification scheme 141 and / or fracture pattern 143 may be stored in the database 128 as one or more respective records or entries 139. In implementations, the data and other information may be stored in one or more files that may be accessible by referencing one or more objects or memory locations referenced by the records 139. The memory 134 may be configured to access, load, edit, and / or save instances of one or more fracture classification schemes 141 and / or fracture patterns 143 in response to one or more commands from the data module 135. The data module 135 may be configured to cause the memory 134 to store local instances of the fracture classification scheme(s) 141 and / or fracture pattern(s) 143, which may be synchronized with the records 139 in the database(s) 128.

[0103] The planning system 120 may be utilized to establish one or more physical anatomical models 148, including any of the physical anatomical models disclosed herein. The physical anatomical models 148 may represent an associated virtual anatomical model 129.

[0104] 3 with continuing reference to FIG. 2 , the user interface 142 may include one or more display windows 144, such as a first display window 144-1, and one or more objects 146. The objects 146 may include graphics such as menus, tabs, lists, input fields, and buttons accessible through user interaction, such as tabs 146T, buttons 146B, drop-down lists 146L, menus 146M, directional indicators 146D, 146R (e.g., FIG. 5 ), and graphics associated with each display window(s) 144. In implementations, one or more inputs, including any parameters associated with list 146L, may be specified in each input field. Geometric objects including selected virtual anatomical model(s) 129, implant model(s) 130, fracture pattern(s) 143, and / or other information related to the surgical plan 131 may be displayed in one or more of the display windows 144.

[0105] The comparison module 138 may 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 may be associated with a predetermined fracture classification scheme 141. The comparison module 138 may be configured to assign a fracture pattern 143 to the virtual anatomical model 129 in response to setting one or more parameters associated with the fracture classification scheme 141.

[0106] The surgeon or clinical user may interact with the display window 144 and / or other portions of the user interface 142 to select one or more anatomical models 129. Various parameters may be utilized to select the anatomical model(s) 129. The anatomical models 129 may be categorized by anatomy, patient, defect (e.g., fracture classification), case, etc. Parameters may be associated with each object 146 in the user interface 142. The parameters in the display window 144 may be interconnected to provide filtering features, such that each selection of a parameter may filter the remaining parameters to depict available options. Each parameter may be associated with a set of anatomical models 129 accessible by the planning environment 126.

[0107] The display module 136 may be adapted to present one or more parameters associated with the anatomy, the patient, the fracture classification scheme, and / or the case to a surgeon or clinical user in a display window 144. The surgeon or clinical user may interact with the user interface 142 to select or otherwise specify one or more of the parameters. The anatomical parameters may 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 may be subdivided by gross anatomy, including surface anatomy (e.g., extracorporeal), local anatomy (e.g., specific regions of the body), and systemic anatomy (e.g., specific organ systems). The data module 135 may be adapted to cause the display module 136 to input associated virtual anatomical model(s) 129 and other parameters, including the category, subcategory, model, and / or size of each list 146L. The spatial module 137 may be configured to scale the geometry of the selected anatomical model 129 in response to a selection of an anatomical size. The surgeon or clinical user may 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 may be associated with one or more virtual anatomical model(s) 129. The anatomical models 129 may be associated with a patient's anatomical structure, such as a previous case or a planned case, and / or a hypothetical anatomical structure. The surgeon or clinical user may select or otherwise specify parameter(s) associated with each virtual anatomical model(s) 129.

[0108] The anatomical models 129 may be categorized by patient parameters. Various patient parameters, such as gender, age, ethnicity, etc., may be utilized. The patient parameters may be presented in respective lists 146L. The data module 135 may be adapted to cause the display module 136 to input one or more patient parameters associated with each list 146L. In response to specifying a parameter associated with a patient population, the data module 135 may be adapted to cause the display module 136 to input other parameters, including an anatomical structure, as well as a category, subcategory, model, and / or size, for each list 146L.

[0109] Case parameters may include case type (e.g., previous, planned, and hypothetical), case number, etc. The surgeon may interact with list(s) 146L and / or another portion of user interface 142 to select and / or review specific cases, such as previous, planned, or hypothetical cases associated with surgical plan 131, which may be filtered by data module 135 based on previous selection(s) 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. Planning system 120 may be configured to provide analysis of previous cases, such as biometric testing of the 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.

[0110] The data module 135 may be adapted to cause the display module 136 to enter inputs associated with the case, such as the type (e.g., prior, planned, or hypothetical) and / or case number of each list 146L. In response to specifying parameters associated with the patient population, the data module 135 may be adapted to cause the display module 136 to enter inputs associated with the case and other parameters, including the type and / or case number of each list 146L.

[0111] The surgical plan 131 may be associated with the anatomical model 129 before any modifications, or may 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 modifications may include removal of material using one or more of drilling, milling, resectioning, reaming, and cutting operations. The modifications may include one or more fragmentation states of the anatomical model 129, including pre- and / or post-registration of any associated fragments.

[0112] The display module 136 may be adapted to present one or more parameters of the fracture classification scheme 141 associated with the virtual anatomical model 129 on the user interface 142. The display module 136 may be adapted to display the parameter(s) associated with the classification scheme 141 in the first display window 144-1. The display module 136 may be configured to present one or more parameters of the respective classification scheme 141 in response to selection of a bone type and / or fracture location. The display module 136 may be adapted to present one or more parameters associated with the classification scheme 141 in response to selection of a bone type (e.g., humerus, femur, tibia, etc.) and / or fracture location (e.g., proximal humerus fracture location) from one or more menus 146L and / or another portion of the user interface 142. The data module 135 may be adapted to cause the display module 136 to enter input associated with the parameter(s) of the fracture classification scheme 141 into the respective list 146L and / or another portion of the user interface 142. The fracture classification scheme 141 may be selected automatically and / or manually in response to one or more selections associated with the anatomy, the patient, and / or the case. The input may include other parameters of the associated fracture classification scheme 141, such as bone type (e.g., humerus), location (e.g., proximal end segment), type (e.g., 2-part, 3-part, or 4-part), group (e.g., surgical neck fracture) and subgroup(s) (e.g., with larger tuberosity fracture), and qualifier(s) and / or modifier(s) of each list 146L.

[0113] The data module 135 may be adapted to access the 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 the display window 144 of the graphical user interface 142. The data module 135 may be configured to select the 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 the fracture pattern 143 in response to one or more of the parameters of the fracture classification scheme 141 of the selected virtual anatomical model 129 being selected or otherwise specified.

[0114] A surgeon or clinical user may select a virtual anatomical model 129 according to various defect severities, such as minor, major, non-pathological, fracture, etc. Defect parameters may be established for various defects and may be arranged by classification, subclassification, etc. A surgeon, assistant, or other user may interact with button 146B (e.g., see question mark button 146Q) for an explanation of the defect parameters (e.g., see second display window 144-2 in FIG. 4). In implementations, selection of a virtual anatomical model 129 from list 146L may generate a help screen, displayed with one or more fracture classification options in response to selection of button 146Q. The fracture classification options may be associated with a respective fracture classification scheme 141, including any of the fracture classification schemes disclosed herein. A surgeon or clinical user may select from various classification parameters to practice and / or train on surgical procedures, including the treatment of fractured bones.

[0115] With continued reference to FIG. 2 and with reference to FIG. 5, a selected virtual anatomical model 129 may be displayed in one or more view windows 144 of the user interface 142. In the implementation of FIG. 5, various views of the virtual anatomical model 129 may be displayed in view windows 144-2, such as a second set of view windows 144-2A through 144-2D. Each virtual anatomical model 129 may include one or more components 129C. The components 129C may include various representations of tissue, such as bone and soft tissue. Bone(s) may be represented by respective bone volume(s) 129B. Soft tissue(s) may be represented by respective soft tissue volume(s) 129S. Various representations of soft tissue, such as tendons, ligaments, muscle structures, and other soft tissue, may be utilized. The anatomical model 129 may establish a portion of a joint 129J. Bone volume(s) 129B may include at least articular surface 129A, which may be sized to cooperate with adjacent articular surfaces to establish joint 129J. While four viewing windows 144-2A through 144-2D are shown in FIG. 5 , it should be understood that fewer than three or more than four viewing windows 144 may be utilized in accordance with the teachings disclosed herein. A surgeon or clinical user may interact with one or more of objects 146 to view various aspects of anatomical model 129. In implementation, a surgeon or clinical user may interact with list(s) 146L to select a respective anatomical object (e.g., humerus).

[0116] With continuing reference to FIGS. 2 and 5 , and with reference to FIG. 6 , a surgeon or clinical user may interact with user interface 142 to view one or more aspects of anatomical model 129. User interface 142 may include one or more viewing windows 144-3, such as a third set of viewing windows 144-3A through 144-3D. A user may interact with list 146L to select a particular portion of soft tissue 129S, such as the rotator cuff. Display module 136 may be adapted to display one or more components 129C of anatomical model 129, such as attachment regions 129R. Attachment regions 129R may be established along the interface between bone volume 129B and respective soft-tissue volumes 129S. A surgeon or clinical user may interact with one of objects 146 to specify a transparency for one or more of these selected components 129C, such as one or more of soft-tissue volumes 129S. 2-3 and 6, and with reference to FIG. 7, a surgeon or clinical user may interact with user interface 142, such as by interacting with one of buttons 146B or another object 146, to select an attachment view in list 146L such that display module 136 may display a view of attachment region 129R with soft tissue omitted (see, e.g., FIG. 6). Attachment region 129R may be displayed in one or more display windows 144-4, such as a fourth set of display windows 144-4A-144-4D.

[0117] 8 with continuing reference to FIGS. 2 and 7, a surgeon or clinical user may interact with user interface 142 to view an isolated view of bone volume 129B. Virtual anatomical model 129 may be displayed in one or more viewing windows 144-5, such as a fifth set of viewing windows 144-5A through 144-5D. Display module 136 may be adapted to display one or more aspects of bone volume 129B, such as cortical bone volume 129C and / or trabecular bone volume 129C. In implementation, cortical bone volume 129C may be displayed as a phantom, and trabecular bone volume 129C may be displayed as a two-dimensional or three-dimensional solid.

[0118] Virtual anatomical model 129 may include one or more volumes 129V. One or more characteristics of volume 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 implementation, volume 129V may include first volume 129V1 and second volume 129V2. First (e.g., cortical bone) volume 129V1 may represent cortical bone. Second (e.g., trabecular bone) volume 129V2 may represent trabecular bone. Cortical bone volume 129CO may establish first volume 129V1. Trabecular bone volume 129CA may establish second volume 129V2. First volume 129V1 and second volume 129V2 may include one or more characteristics, such as material composition and / or structure, that may be the same or different. In implementations, the first volume 129V1 and the second volume 129V2 may differ in density, which may be associated with different bone densities of the associated anatomical structures.

[0119] With continuing reference to Figures 2 and 8, and with reference to Figure 9, one or more fracture patterns 143 may be selected or assigned to each virtual anatomical model 129. In implementation, the data module 135 may be configured to access the one or more fracture patterns 143 from the database(s) 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.

[0120] The fracture pattern 143 may extend along a boundary region 129BR between the first volume 129V1 and the second volume 129V2 (see, e.g., FIG. 8). The boundary region 129BR may be established along the interface between the cortical bone volume 129CO and the cancellous bone volume 129CA (see, e.g., FIG. 8). The boundary region 129BR may follow along the outer surface of the cancellous bone volume 129CA and / or the inner surface of the cortical bone volume 129CO.

[0121] A surgeon or clinical user may interact with user interface 142 to view one or more aspects of a selected or assigned fracture pattern 143. Spatial module 137 may be adapted to locate the assigned or selected fracture pattern 143 relative to each bone volume 129B. In the implementation of FIG. 9 , display module 136 may be adapted to display one or more views of bone volumes 129B and associated fracture patterns 143 in one or more display windows 144, such as sixth set of display windows 144-6A through 144-D. A surgeon or clinical user may interact with one or more objects, such as list 146L, to select a fracture view.

[0122] 10A-10B, with continuing reference to FIGS. 2 and 9, an embodiment of the anatomical model 129 of FIG. 9 is shown. Each fracture pattern 143 may be generated automatically and / or in response to user interaction with the user interface 142. In implementations, a user may interact with the user interface 142 to manually specify the geometry of the fracture pattern 143.

[0123] 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 spaced apart from one another. The two or more segments 143S may meet at one or more junctions 143J. Each segment 143S may be a continuous loop and / or may be established between a pair of junctions 143J. In some implementations, each of the segments 143S may extend along the surface of a portion of the bone volume 129B, such as the outer surface of the cancellous bone volume 129CA. In other implementations, one or more of the segments 143S may extend along the surface of the cortical bone volume 129CO (see, for example, FIG. 8). Each of the segments 143S is a linear or non-linear path extending between two junctions 143J. In some implementations, each of the segments 143S may include one or more undulations. The relief may represent fracture lines observed in previous case(s) and / or hypothetical case(s), based on empirical data, parametric modeling, or the like.

[0124] 10C-10D, with continued reference to FIGS. 2, 9, and 10A-10B, various techniques may be utilized to establish the fracture pattern 143. The spatial module 137 may be adapted to establish or identify one or more landmarks L relative to the bone volume 129B and / or another portion of the virtual anatomical model 129. In an implementation, the comparison module 138 may be adapted to determine one or more landmarks L based on a comparison of the anatomical model 129 with one or more previous cases. In an implementation, a surgeon or clinical user may interact with a viewing window 144, such as viewing window 144-6A or 144-6B, to adjust the position of one or more landmarks L (e.g., see landmark L'). The spatial module 137 may be adapted to adjust the position of one or more segments 143S in response to adjusting one or more associated landmarks L (e.g., see segment 143S' and associated joint 143J').

[0125] The display model 136 may be adapted to display a separated view of the fracture pattern 143 relative to the bone volume 129B and / or attachment region 129R. In the implementation of FIG. 11 , the surgeon or clinical user may interact with one or more display windows 144-7, such as the seventh set 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 volume 129C0 (see FIG. 8 ). Selectively hiding the cortical bone volume 129C0 may assist the surgeon or clinical user in observing the relative position between the fracture pattern 143 and the attachment region(s) 129R.

[0126] 12, with continuing reference to Figures 2 and 10, various techniques may be utilized to establish fracture pattern 143 for virtual anatomical model 129. Display module 136 may be configured to display virtual anatomical model 129 in one or more viewing windows 144-8, such as an eighth set of viewing windows 144-8A through 144-8D.

[0127] The spatial module 137 can be configured to generate a virtual fracture volume 147 that can be associated with the fracture pattern 143. The virtual fracture volume 147 can substantially or generally follow the length of the respective fracture pattern 143 (see, e.g., FIGS. 10A-10D). For purposes of this disclosure, the term "substantially" means ±10 percent of the stated relationship or value, unless otherwise indicated. Configurations (e.g., definitions) 145 (FIG. 2) can be established according to the virtual fracture volume 147.

[0128] With continued reference to FIGS. 2 and 12 , and with reference to FIG. 13A , various techniques may be utilized to establish the virtual fracture volume 147. The display module 136 may be adapted to display the virtual fracture volume 147 in one or more viewing windows 144, such as viewing windows 144-8E, 144-8F ( FIG. 13B ). The virtual fracture volume 147 may be established by extruding a shape along the length of the fracture pattern 143. The display module 136 may be adapted to display the virtual fracture volume 147 in viewing windows 144-8E, 144-8F. Various shapes may be utilized, such as straight or curved segments, ellipses (e.g., circles), polygons (e.g., rectangles), and / or complex shapes. The geometry of the virtual fracture volume 147 may be selected to facilitate separation of the physical anatomical model. In implementation, the virtual fracture volume 147 may be dimensioned to span between the outer surface of the cancellous bone volume 129CA and the outer surface of the cortical bone volume 129CO. 13B discloses an isolated view of the virtual fracture volume 147 of FIG. 13A in viewing window 144-8F. In other implementations, the fracture volume 152′ may be spaced apart from the outer surface of the cortical bone volume 129CO (volume 152′ is shown in dashed lines in FIG. 13A).

[0129] Fracture volume 147 can have a variety of structures. It can be homogeneous or have two or more heterogeneous regions. In implementations, fracture volume 147 can be substantially hollow or contain one or more voids that can serve to weaken localized regions of the associated physical anatomical model.

[0130] 14 , with continued reference to FIGS. 2 and 13A-13B, virtual anatomical models 129 may be utilized to establish physical anatomical models 148. Comparison module 138 may be configured to generate one or more configurations 145 ( FIG. 2 ) associated with virtual anatomical model(s) 129. Comparison module 138 may be adapted to generate configurations 145 in response to specifying one or more parameters associated with each virtual anatomical model 129, including any of the parameters disclosed herein, such as parameter(s) of a fracture classification scheme 141.

[0131] Configuration 145 may specify various information for forming an instance of an associated physical anatomical model 148, which may be based on each virtual anatomical model 129. Configuration 145 may include one or more files in a predetermined data structure or format. In implementations, configuration 145 may include other information, such as a coordinate set and / or material selection(s) associated with the volume(s) of physical anatomical model 148. Each physical anatomical model 148 may 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.

[0132] Configurations 145 may specify fracture paths (e.g., fracture patterns) 150 that may be associated with physical anatomical models 148. Each fracture path 150 may be established according to an assigned fracture pattern 143 such that the fracture patterns 143 may be reproducible. Configurations 145 may specify coordinate data and / or other information for establishing fracture paths 150 according to the assigned fracture pattern 143. Configurations 145 may be generated such that each physical anatomical model 148 may be separable along fracture path 150 to establish one or more fragments and establish a fragmentation state of physical anatomical model 148 (see, e.g., fragment 348F in FIGS. 19-20 ).

[0133] Physical anatomical model 148 may include body 148M. For purposes of this disclosure, unless otherwise indicated, alphanumeric suffixes associated with each indicator of the virtual anatomical model will be utilized in a similar manner when describing similar aspects of the physical anatomical model. Body 148M may include outer surface 148E associated with a bony anatomical profile, including any of the bones disclosed herein. In implementations, the bony anatomical profile may be associated with a long bone, such as the humerus, femur, or tibia. Physical anatomical model 148 may be secured to at least one fixture 166 to establish assembly 168 (shown in dashed lines in FIG. 14 ).

[0134] Physical anatomical model 148 may include one or more physical components 148C. Each component 148C may represent an associated component 129C of a respective virtual anatomical model 129. A component 148C of physical anatomical model 148 may include any of the components 129C of a respective virtual anatomical model 129, such as bone volume 148B. Representations of one or more of components 129C may be omitted from physical anatomical model 148 to provide customized training (e.g., different levels of difficulty) for a surgeon or clinical user.

[0135] The physical anatomical 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 body 148M. One or more of the extensions 148X may represent a respective soft tissue volume(s) 148S, including any of the soft tissues disclosed herein. The soft tissue volumes 148S may be attached to the bone volume 129B at respective attachment regions 148R.

[0136] Body 148M of physical anatomical model 148 may include one or more volumes 148V. Body 148M may include first volume 148V1 and second volume 148V2. First volume 148V1 may establish outer surface 148E of body 148M. First volume 148V1 may represent cortical bone. Second volume 148V2 may represent cancellous bone.

[0137] At least one fracture path 150 may be established along the physical anatomical model 148. The fracture path 150 may be established according to a predetermined fracture pattern 143 (see, for example, FIG. 13A ). The body 148M may include the fracture path 150. The fracture path 150 may establish one or more local regions 148L of the physical anatomical model 148. The fracture path 150 may divide the body 148M into one or more local regions 148L. The fracture path 150 may include one or more segments 150S. Each of the segments 150S may establish a loop around a respective local region 148L (see also the fracture volume 152 in FIG. 14 ). The outer surface 148E along at least one of the local regions 148L may 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 may extend from the outer surface 148E of the body 148M adjacent one or more segments 150S of the fracture path 150.

[0138] Body 148M of physical anatomical model 148 may include at least one, or two or more, physical fracture volumes 152. Physical fracture volumes 152 may be established along fracture path 150. Body 148M may be separable along fracture volumes 152 to establish one or more fragments (see, e.g., fragment 348F in FIGS. 19-20 ). Physical fracture volumes 152 may establish frangible connection(s) between local regions 148L of physical anatomical model 148 and each other and / or body 148M.

[0139] Fracture path 150 may extend along boundary region 148BR between adjacent volumes 148V of physical anatomical model 148, such as between first volume 148V1 and second volume 148V2. Fracture volume 152 may be established along fracture path 150 such that fracture volume 152 may be at least partially embedded within one or more of volumes 148V, such as first volume 148V1 of body 148M. Body 148M may be separable along fracture volume 152, establishing one or more fragments. In implementations, physical fracture volume 152 may be spaced apart from an outer surface of body 148M of physical anatomical model 148 (see, e.g., fracture volume 152′ in FIG. 13A ).

[0140] Volumes 148V of physical anatomical model 148 may have various characteristics. First volume 148V1 may have a first characteristic. Second volume 148V2 may have a second characteristic. Fracture volume 152 may have a third characteristic. The first, second, and / or third characteristics may be the same or different from one another. The first, second, and third characteristics may include respective first, second, and third material strengths. The second and / or third material strengths of second volume 148V2 and fracture volume 152 may be less than the first material strength of first volume 148V1. The first material strength may represent cortical bone. The second material strength may represent cancellous bone. The lesser material strength may establish a relatively weak region(s) in physical anatomical model 148 to facilitate fragmentation of physical anatomical model 148 in a reproducible manner. Fracture volume 152 may incorporate any of the materials disclosed herein, such as a silica-based material.

[0141] 2 and with reference to FIGS. 15A-15C and 16A-16C, in an implementation, the spatial module 137 may be adapted to extrude a virtual fracture volume 247 along one or more segments 243S of each fracture pattern 243. The display module 136 may be adapted to display the fracture volume 252 in one or more viewing windows 144 (e.g., viewing windows 144-10A-144-10F). The virtual fracture volume 247 may extend between an outer surface of the cortical bone volume 229C0 and an outer surface of the cancellous bone volume 229CA. The fracture volume 247 may be extruded such that the fracture volume 252 may extend inward of the outer surface of the cancellous bone volume 229CA. The fracture volume 247 may be at least partially surrounded by the cancellous bone volume 229CA. Display module 136 may be adapted to display virtual fracture volume 247 and / or other aspects of virtual anatomical model 229 in one or more viewing windows 144-10, such as tenth set of viewing windows 144-10A through 144-10F. Display module 136 may be adapted to display fracture volume 252 relative to soft tissue volume 229S and / or attachment region 229R (see, e.g., FIGS. 16A-16C).

[0142] 17 , with continuing reference to FIG. 2 , the planning system 120 may establish one or more virtual indicators 354 for the fracture pattern 343 and / or the virtual anatomical model 329. Each of the virtual indicators 354 may be associated with the fracture pattern 343. The display module 136 may be adapted to display one or more of the virtual indicators 354 for the fracture pattern 343 in the ninth display window 144-9. Each of the virtual indicators 354 may function as a visual aid and may provide information related to the fracture pattern 343 to the surgeon or clinical user.

[0143] Various virtual indicators 354 may be utilized to convey clinically useful information to a surgeon or clinical user, including any of the indicators disclosed herein. Various techniques may be utilized to establish the virtual indicators 354. The comparison module 138 may be adapted to generate one or more virtual indicators 354 along or otherwise adjacent to one or more segments 343S and / or joints 343J of the fracture pattern 343. The virtual indicators 354 may be generated automatically and / or in response to user interaction with the user interface 142 and / or another portion of the planning system 120. The indicators 354 may have various geometric configurations, including various shapes and sizes. The indicators 354 may include one or more features that may differ from the anatomy, including different visual (e.g., shape, pattern, color, shading, etc.) and / or tactile (e.g., texture) features. The indicators 354 may be established according to one or more visual or color schemes. In implementations, indicators 354 may be assigned one or more artificial colors to establish visual contrast from adjacent portion(s) of virtual anatomical model 329, which may be assigned respective color(s) that may correspond to the natural color(s) of the respective portion(s) of the anatomical structure. The visual contrast may assist the surgeon in identifying indicators 354. For purposes of this disclosure, the term "natural" color means a color that substantially corresponds to the expected or actual color of the respective tissue, and the term "artificial" color means a color that does not naturally occur for the respective tissue. Artificial colors may include yellow, orange, red, green, blue, etc. The visual contrast may assist the surgeon in identifying the physical instance of the indicator as well as any deviations in the placement of any pieces relative to each other and / or relative to the rest of the body of the associated physical anatomical model.

[0144] 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. One or more of the virtual indicators 354 may include a display path 354P. The display path 354P may substantially or generally follow the length of one or more segments 343S of the fracture pattern 343. One or more of the virtual indicators 354 may include a visual contrast (e.g., color, shading, 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., scale 456G in FIGS. 21A-21C). In the implementation of FIG. 22, the virtual indicators 554 may include a silhouette 554S. The silhouette 554S may be associated with the periphery of an orthopedic implant that can be fixed to adjacent bone fragments (see, e.g., implant 1582 in FIGS. 42C-42D). Silhouette 554S may include one or more shapes representing apertures sized to receive respective fasteners to secure the implant to bone (see, eg, FIG. 42C).

[0145] In implementations, the physical anatomical model 448 may incorporate one or more electrical circuits to provide feedback to the surgeon or clinical user associated with the registration of the fragment 448F. The display path 456P may include adjacent portions 456P1, 456P2. The adjacent portions 456P1, 456P2 may incorporate a conductive material, such as copper or another metallic material. The adjacent portions 456P1, 456P2 may be coupled to the evaluation device 457 and may cooperate to establish the circuit 455. The evaluation device 457 may be configured to provide feedback to the surgeon or clinical user, such as an audible signal, a visual indicator (e.g., a reading or graphic), or other indicator, in response to establishing contact between the adjacent portions 456P1, 456P2.

[0146] 18-20, with continued reference to FIGS. 2 and 17, various states of physical anatomical model 348 are disclosed. FIG. 18 may be associated with a first state (e.g., initial, intact, or pre-fragmented) of physical anatomical model 348. FIG. 19 may be associated with a second state (e.g., fragmented) of physical anatomical model 348 of FIG. 18. FIG. 20 may be associated with a third state (e.g., fragmented) of physical anatomical model 348 of FIG. 18.

[0147] Body 348M and / or other portions of physical anatomical model 348 may include one or more physical indicators 356. Each of virtual indicators 354 may be associated with a physical indicator 356 incorporated into physical anatomical model 348. Each physical indicator 356 may be associated with a respective virtual indicator 354. Configuration 145 ( FIG. 2 ) associated with each physical anatomical model 348 may specify coordinate data and other features associated with virtual indicators 354 to establish one or more of physical indicators 356. Each physical indicator 356 may be established along an outer surface and / or within the thickness of physical anatomical model 348. Each of physical indicators 356 may be associated with fracture path 350 and / or fracture volume 352.

[0148] 18-20, one or more physical indicators 356 may include a shape 356S that may span a segment of fracture path 350. Shape 356S may be established along outer surface 348E of body 348M. Shape 356S may span between at least two of localized regions 348L. Physical indicator 356 may include one or more indication paths 356P. Each indication path 356P may substantially or generally follow the length of one or more segments 350S of fracture path 350. Indication paths 356P may be established along outer surface 348E of body 348M.

[0149] One or more physical indicators 356 may include visual contrast between fracture path 350 and adjacent portions of physical anatomical model 348. Indicator 356 may include visual contrast between body 348M and fracture volume 352. In an implementation, visual contrast may be established by marking(s) having color(s) and / or shading(s) that may differ from adjacent portions of physical anatomical model 348. In an implementation, shape(s) 356S and / or display path(s) 356P may establish visual contrast with adjacent portions of physical anatomical model 348. Physical anatomical model 348 may additionally and / or alternatively incorporate other physical indicators 356. In the implementation of FIGS. 21A-21C , 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 fracture path 450. The graduations 456G may facilitate assessment of the surgeon's repair, including the relative alignment between adjacent fragments 448F. Each graduation 456G may extend across the fracture path 450.

[0150] The body 348M of the physical anatomical model 348 may be separable along the fracture path 350 to establish one or more fragments 348F associated with the fragmentation state of the physical anatomical model 348 (see, for example, FIGS. 19-20 ). Each fragment 348F may be associated with a respective one of the local regions 348L of the physical anatomical model 348 or with the remainder of the body 348M. The fragments 348F may include respective portions of the bone volume 348B. In implementations, the soft tissue volume(s) 348S may be attached to the fragment(s) 348F (shown in dashed lines in FIG. 19 ). The fracture path 350 and / or the physical fracture volume 352 may be dimensioned so that each of the fragments 348F may include a portion(s) of the volume(s) 348V, such as a portion of the first volume 348V1 and / or a portion of the second volume 348V1 (see, for example, volumes 1429V1', 1429V2' of the virtual anatomical model 1429' in FIG. 41B).

[0151] The surgeon or clinical user may interact with physical anatomical model 348 to register fragments 348F relative to each other and / or to other portions (e.g., remainders) of physical anatomical model 348. The surgeon or clinical user may utilize one or more of physical indicators 356 to obtain feedback regarding the fit of the placement of fragments 348F relative to the initial state of physical anatomical model 348, such as relative to the volume of physical anatomical model 348 prior to creation of fragments 348F (see, e.g., FIG. 18 ).

[0152] The physical indicators 356 may provide an indication of the alignment and / or distance of each fragment 348F relative to adjacent fragment(s) 348F and / or another portion of the physical anatomical model 348. In the implementation of FIG. 19 , 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 from perfect registration of the fragment 348F relative to a pre-fragmentation state of the physical anatomical model 348 (see, e.g., FIG. 18 ). In the implementation of FIG. 20 , the fragments 348F may be registered closely together such that any physical gap(s) G between portions of the indicator 456 may be reduced relative to the arrangement of FIG. 19 .

[0153] 21A-21C, scale 456G may be utilized to facilitate assessment of the repair of the fragmentation state of physical anatomical model 448. Each of scales 456G may include segments 456G1, 456G2 established on either side of fracture path 450. Segments 456G1, 456G2 may be associated with local volumes 448L on either side of fracture path 450. Separating physical anatomical model 448 may occur to establish fragments 448F associated with each local volume 448L. Separating physical anatomical model 448 may occur such that segments 456G1, 456G2 may be associated with adjacent fragments 448F. The surgeon may register or otherwise position the fragments 448F such that the segments 456G1, 456G2 of the scale 456G may be misaligned, substantially aligned, or otherwise adjacent to one another to provide visual feedback to the surgeon regarding the respective local volumes 448L prior to fragmentation of the physical anatomical model 448. A predetermined threshold may be associated with the scale 456G. Registration of the fragments 456G may be evaluated based on the alignment of the segments 456G1, 456G2 of the scale 456G falling below, meeting, or exceeding the predetermined threshold.

[0154] 22, physical indicator 556 may include a silhouette 556S. Silhouette 556S may be associated with the periphery of an orthopedic implant that can be secured to adjacent bone fragments (see, for example, implant 1582 in FIG. 42C). Silhouette 556S may include one or more shapes representing openings sized to receive respective fasteners to secure the implant to bone.

[0155] With continuing reference to FIG. 2, and with reference to FIGS. 23 and 24, other techniques may be utilized to establish a fracture pattern in the virtual anatomical model and an associated fracture path in the physical anatomical model. The planning system 120 may be adapted to establish a fracture path 643 that includes one or more voids 643V. The voids 643V may establish perforations in adjacent volumes 629V of the virtual anatomical model 629. The voids 643V may terminate at a boundary region 629BR between adjacent volumes 629V1, 629V2. Volume 629V1 may be established by cortical bone volume 629CO. Volume 629V2 may be established by cancellous bone volume 629CA.

[0156] One or more physical voids 650V may be established in physical anatomical model 648 along or otherwise adjacent to fracture path 650. A void 650V may be associated with each void 643V. A void 650V may be printed or otherwise formed with adjacent portions of physical anatomical model 648. A void 650V may facilitate failure of physical anatomical model 648 along fracture path 650 to establish one or more fragments.

[0157] Various techniques may be utilized to establish the fragmentation state of the physical anatomical model. Referring to FIG. 25 , a fracture tool 760 for engaging a physical anatomical model is disclosed. The fracture tool 760 may include a body 760M and an interface portion 760I. A handle 760H may extend from the body 760M. In implementations, 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.

[0158] 26 with continuing reference to FIG. 25 , interface portion 760I may be adapted to engage with a physical anatomical model 748. The physical anatomical model 748 and fracture tool 760 may establish an orthopedic system 761. A surgeon or clinical user may be provided with fracture tool 760 and one or more physical anatomical models 748 in a kit. The physical anatomical models 748 may be the same or different. Each physical anatomical model 748 may be established according to any of the techniques disclosed herein.

[0159] 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 volume 752 established along each fracture path 750. A fracture tool 760 may be adapted to separate the body 748M of the physical anatomical model 748 along the fracture path 750 and / or the fracture volume 752 to establish one or more fragments 748F ( FIG. 27E ).

[0160] Various techniques may be utilized to establish engagement between the physical anatomical model 748 and the fracture tool 760. The physical anatomical model 748 may include one or more interfaces 748I. The interfaces 748I may extend inward from the outer surface 748E of the physical anatomical model 748. Each interface 748I may be associated with a localized region 748L of the physical anatomical model 748. Each interface 748I may be established along, adjacent to, or spaced apart from the fracture path 750 and associated fracture volume 752. An interface portion 760I may be insertable into each of the interfaces 748I of the physical anatomical model 748, although an opposite arrangement may also be utilized. The interface portion 760I may be dimensioned to mate with a selectable one of the interfaces 748I. In implementations, the interface portion 760I and the interface 748I may include multiple threads that cooperate with each other to establish a connection between the fracture tool 760 and the physical anatomical model 748.

[0161] 27A-27E, with continuing reference to FIGS. 25-26, a fracture tool 760 may be utilized to establish a fragmentation state of the physical anatomical model 748. With reference to FIG. 27A, the fracture tool 760 may be moved in a direction D1 toward a selected one of the interfaces 748I. With reference to FIGS. 27B-27C, the interface portion 760I may engage with the interface 748I to establish a connection between the fracture tool 760 and the physical anatomical model 748. With reference to FIGS. 27D-27E, the fracture tool 760 may be movable relative to the physical anatomical model 748 to establish one or more fragments 748F. Each fragment 748F may be associated with a respective local region 748L of the physical anatomical model 748. The fracture tool 760 may be movable in a direction D2 (e.g., translation, etc.) and / or a rotational direction R1 (e.g., twist, pivot, etc.) relative to a longitudinal axis X of the fracture tool 760 to separate the physical anatomical model 748 along an associated fracture path 750 and / or fracture volume 752. The direction D2 may be perpendicular to or otherwise transverse to the axis X. In implementations, the direction D2 may be substantially parallel to the axis X.

[0162] FIG. 28 discloses a fracture tool 860 according to another implementation. 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 receivable within the clamp 860C. The clamp 860C may include one or more clamping elements 860CE. Each of the clamping elements 860CE may include an interface portion 860I. The interface portion 860I may be adapted to engage with the physical anatomical model to establish a fragmented state of the physical anatomical model. The geometric shapes of the clamping elements 860CE and / or the interface portion 860I may be identical or different from one another. The clamping elements 860CE may include a first clamping element 860CE-1 and a second clamping element 860CE-2. In an implementation, the clamping element 860CE may be a set of jaws. The clamping elements 860CE-1, 860CE-2 may be dimensioned such that their respective interface portions 860I may face each other. Each interface portion 860I may have a generally planar surface sized to engage with the physical anatomical model. The fracture tool 860 may have three or more clamping elements 860CE. In the implementation of FIG. 30, the fracture tool 960 may include first, second, and third clamping elements 960CE-1, 960CE-2, 960CE-3 that may cooperate to establish a clamp 960C. The clamping elements 960CE-1, 960CE-2, 960CE-3 may generally oppose one another.

[0163] 28 , the fracture tool 860 may include a drive element 860D that can actuate the clamps 860C. The drive element 860D may be adapted to set the positions of the clamp elements 860CE relative to one another. The drive element 860D may be at least partially received 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 is movable relative to the body 860M to set the distance between the interface portions 860I of the clamp elements 860CE-1, 860CE-2.

[0164] The fracture tool 860 may include a handle 860H that may extend from the body 860M. A 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 implementations, the actuator 860A may include an actuation mechanism (e.g., see 1060AM in FIG. 33 ), such as a ratchet, for setting the position of the drive element 860D relative to the body 860M of the fracture tool 860. The actuator 860A may be adapted to move the drive element 860D in a third direction D3 relative to the axis X of the fracture tool 860 to set the distance between the clamp elements 860CE-1, 860CE-2. A surgeon or clinical user may manipulate actuator 860A to cause clamping elements 860CE-1, 860CE-2 to apply an amount of force to a physical anatomical model positioned between and engaging interface portions 860I of fracture tool 860.

[0165] 29A-29C with continuing reference to FIG. 28 , a fracture tool 860 may be utilized to establish a fragmented state of physical anatomical model 848. With reference to FIG. 29A, physical anatomical model 848 may be positioned at least partially within clamp 860C. Physical anatomical model 848 may be positioned between interface portions 848I of clamp elements 860CE-1, 860CE-2. With reference to FIG. 29B, a surgeon or clinical user may operate actuator 860A to move drive element 860D in direction D3 such that interface portions 848I of clamp elements 860CE-1, 860CE-2 may engage outer surface 848E of physical anatomical model 848.

[0166] 29C , drive element 860D may be movable in direction D3 relative to axis X of fracture tool 860 to separate physical anatomical model 848 along associated fracture path 850 and / or fracture volume 852. A surgeon or clinical user may manipulate actuator 860A to cause interface portion 860I of clamping elements 860CE-1, 860CE-2 to apply an amount of compressive force to body 848M of physical anatomical model 848, causing body 848M to separate along fracture path 850 and / or associated fracture volume 852 to establish one or more fragments 848F. Each fragment 848F may be associated with a respective local region 848L of physical anatomical model 848.

[0167] 31-33 disclose another implementation of a fracture tool 1060. The fracture tool 1060 may include a clamp 1060C. The clamp 1060C may include one or more clamp elements 1060CE. In the implementation of FIGS. 31-33, the clamp element 1060CE may include a first clamp element 1060CE-1 and a second clamp element 1060CE-2. The first and second clamp elements 1060CE-1, 1060CE-2 may be opposed to each other. The geometry of the first clamp element 1060CE-1 may be the same as or different from the geometry of the second clamp element 1060CE-2. The interface portion 1060I of the second clamp element 1060CE-2 may have a generally planar surface sized to engage with a physical anatomical model.

[0168] The first clamping element 1060CE-1 may include a base 1062 and one or more engaging elements 1064. The engaging elements 1064 may be sized to engage with a physical anatomical model. The engaging elements 1064 may be integrally formed with the base 1062 or may be removably securable to the base 1062. The engaging elements 1064 may have a variety of geometric shapes. In the implementation of FIGS. 31-33 , the engaging elements 1064 may be elongated pins. Each engaging element 1064 may establish a respective interface portion 1060I of the fracture tool 1060.

[0169] The engaging element(s) 1064 may be configurable to engage selectable contact points along the physical anatomical model and / or to avoid one or more portions of the physical anatomical model. The base 1062 may include one or more receptacles 1062R. The receptacles 1062R may be established at spaced intervals along the base 1062. In the implementation of FIG. 34 , the receptacles 1062R may be arranged in a grid and referenced to the grid (e.g., alphanumeric). Each receptacle 1062R may be assigned a unique position relative to the base 1062. Each receptacle 1062R may be sized to receive an engaging element 1064.

[0170] The surgeon or clinical user may configure the fracture tool 1060 to engage one or more contact points of the physical anatomical model. The surgeon or clinical user may position one or more engagement elements 1064 in selected receptacle(s) 1062R of the base 1062. The location of each engagement element 1064 may be specified in the surgical plan 131 (FIG. 2) or may be otherwise predetermined. The surgeon or clinical user may arrange the engagement element(s) 1064 in two or more configurations to establish different fragment patterns of the physical anatomical model, which may be associated with a fracture classification scheme 141 and / or respective fracture patterns (FIG. 2).

[0171] 35-36 , with continuing reference to FIG. 34 , engagement elements 1064 may engage selectable contact points 1048CP along body 1048M of physical anatomical model 1048. Physical anatomical model 1048 may include one or more contact indicators 1066 ( FIG. 36 ). Contact indicators 1066 may be established along outer surface 1048E of body 1048M adjacent respective contact points 1048CP. Each of contact indicators 1066 may be associated with a respective one of engagement elements 1064. Contact indicators 1066 may be arranged in or referenced in a three-dimensional grid (e.g., by alphanumeric convention) along outer surface 1048E of physical anatomical model 1048. In implementation, the location of each contact indicator 1066 may be identified according to a respective one of receptacles 1062R. The drive element 1060D may be movable in a third direction D3 (FIG. 35) relative to the axis X of the fracture tool 1060 to set the distance between the second clamp element 1060CE-2 and the engagement element(s) 1064 of the first clamp element 1060CE-1.

[0172] 37-38 , each of the engaging elements 1064 of the first clamping element 1060CE-1 may be adapted to cooperate with the second clamping element 1060CE-2 to apply a compressive force at a respective contact point 1048CP to separate the bodies 1048M along the fracture path 1050 and / or associated fracture volumes 1052 to establish one or more fragments (see, e.g., fragment 1448F in FIG. 41C and fragment 1548F in FIGS. 42A-42B). Each engaging element 1164 may be dimensioned to engage a bone volume 1148B and / or a soft tissue volume 1148S of the physical anatomical model 1148. One or more contact indicators 1166 may be established along each soft tissue volume 1148S.

[0173] FIG. 39 illustrates an exemplary method of flowchart 1280. Method 1280 may be utilized to pre-operatively plan, practice, and / or train for various surgical procedures, such as arthroplasty procedures to restore function to shoulders, ankles, knees, hips, and other joints. Method 1280 may be utilized with any of the planning systems, virtual anatomical models, and / or physical anatomical models disclosed herein. Method 1280 may be utilized to establish physical anatomical model(s) for training and practicing surgical procedures. Method 1280 may be utilized to evaluate the accuracy with which a surgeon may perform a surgical procedure on a physical anatomical model associated with the anatomy of a patient or hypothetical case. Fewer or additional steps are listed below and may be implemented within the scope of this disclosure, and the order of the listed steps is not intended to limit this disclosure. For illustrative purposes, reference is made to system 120 and user interface 142.

[0174] 2 with continuing reference to FIG. 39 , at step 1280-1, one or more virtual anatomical models 129 may be generated. Each virtual anatomical model 129 may be associated with the anatomical structure of a patient 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 bones, ligaments, tendons, 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.

[0175] At step 1280-3, one or more virtual anatomical models 129 may be selected from the 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 models 129. The virtual anatomical models 129 may be stored in a memory of a computing device, such as database 128 or memory 134 of computing device 132.

[0176] 3 with continued reference to FIGS. 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 anatomy, patient classification, fracture classification, and / or case. The parameters may be selected in response to a user interaction with the graphical user interface 142.

[0177] 5-8 with continuing reference to FIGS. 2 and 39, at step 1280-4, the selected virtual anatomical model(s) 129 may be viewed in the graphical user interface 142. Step 1280-4 may include setting parameter(s) in response to a user interaction with the graphical user interface 142. The parameters may be specified in response to a surgeon or clinical user interacting with the user interface 142. One or more of the parameters may be associated with predetermined fracture classification scheme(s) 141. The fracture classification scheme 141 may include any of the fracture classification schemes disclosed herein.

[0178] With continued reference to FIGS. 2-3, 9, and 39, and with reference to FIG. 9, one or more fracture patterns 143 may be assigned to the virtual anatomical model 129 at step 1280-5. The fracture patterns 143 may be assigned to the virtual anatomical model 129 using any of the techniques disclosed herein. The fracture patterns 143 may be assigned to the virtual anatomical model 129 based on one or more parameters, including any of the parameters disclosed herein, such as anatomy, patient classification, fracture classification, and / or case. The assignment of the fracture patterns 143 may occur in response to setting one or more parameters associated with the fracture classification scheme 141. Step 1280-5 may include displaying the virtual anatomical model 129 and / or the assigned fracture patterns 143 in one or more display windows 144 of the graphical user interface 142, such as display windows 144-6A through 144-6D.

[0179] At step 1280-6, one or more aspects of the virtual anatomical model 129 may be defined. Each virtual anatomical model 129 may be defined before, during, and / or after generating the virtual anatomical model(s) 129 at step 1280-1, generating the fracture pattern(s) 143 at step 1280-2, selecting the virtual anatomical model(s) 129 at step 1280-3, viewing the selected virtual anatomical model(s) 129 at step 1280-4, and / or assigning the fracture pattern(s) 143 to the virtual anatomical model(s) 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 parameters may be selected in response to user interaction with the graphical user interface 142 (e.g., FIG. 3 ). The parameters may be associated with one or more fracture classifications 141 (FIG. 2) and / or fracture patterns 143 (eg, FIGS. 2 and 9).

[0180] 12 and 13A-13B, with continuing reference to FIGS. 2 and 39, defining the virtual anatomical model 129 may include, at step 1280-7, generating one or more virtual fracture volumes 147. Each virtual fracture volume 147 may be established using any of the techniques disclosed herein.

[0181] 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. The configurations 145 may be associated with a physical anatomical model 148 that may represent the selected virtual anatomical model 129. Each configuration 145 may be generated in response to selecting a respective virtual anatomical model 129 at step 1280-3, assigning a respective fracture pattern 143 at step 1280-5, and / or defining the selected virtual anatomical model 129 at step 1280-6. The configurations may be established according to 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. Configuration 145 may include data and other information sufficient to establish physical anatomical model 148 based on parameters of selected virtual anatomical model 129, including coordinate information, color, texture and / or elastic modulus of associated tissue, geometric shapes and associated indicators associated with one or more fracture paths 150, etc. Configuration 145 may specify one or more fracture paths 150 established in physical anatomical model 148 according to assigned fracture pattern 143.

[0182] 18 with continuing reference to FIGS. 2 and 39, in an implementation, 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 respective virtual indicator 354 (see, e.g., FIG. 17).

[0183] 36 with continuing reference to FIGS. 2 and 39, configuration 145 may specify one or more indicators, such as a plurality of contact indicators 1066, distributed along physical anatomical model 1048. Each of contact indicators 1066 may be associated with a respective contact element 1064 of fracture tool 1060.

[0184] With continued reference to FIGS. 2, 13A-13B, and 39, and with reference to FIG. 14, one or more physical anatomical models 148 may be fabricated or otherwise formed in step 1280-9. The physical anatomical models 148 may be formed to closely resemble or approximate the geometry of relevant anatomical structures, including soft tissue and bone. In implementation, a surgeon may interact with the physical anatomical model 148 so that portions of the physical anatomical model 148 may feel similar to soft (e.g., cancellous) bone tissue, muscle, and other soft tissues, etc. The physical anatomical models 148 may be printed or otherwise formed according to various parameters selected in the user interface 142. Various parameters, including any of the parameters disclosed herein, such as bone and soft tissue density, cortical bone thickness, indicators, patient age, etc., may be utilized to form the physical anatomical models 148.

[0185] Each physical anatomical model 148 may be fabricated or otherwise formed based on the configuration 145 generated in step 1280-8. Various materials may be utilized to form the physical anatomical models. Physical anatomical model 148, including body 148M, may incorporate metallic and / or non-metallic materials, including any of the materials disclosed herein, such as polymeric materials. In implementations, body 148M may be formed from a substantially rigid material, such as a polymeric material, including photopolymers, silicone, and thermoplastics. Portions of physical anatomical model 148 may be formed from a relatively flexible material, including an elastomeric material, such as rubber or silicone, to establish soft tissue volume(s) representing any of the soft tissues disclosed herein.

[0186] A variety of techniques may be utilized to form the physical anatomical models. Each physical anatomical model may be formed utilizing 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 may have a unitary structure or may have two or more components fixedly attached or otherwise secured to one another to establish a unit.

[0187] In the implementation of FIG. 40 , one or more layers 1382 of material may be printed or otherwise formed on a substrate 1383 to establish a physical anatomical model 1348. The physical anatomical model 1348 may represent a virtual anatomical model, including any of the virtual anatomical models disclosed herein. A device 1384, such as a three-dimensional printer, may be configured to form the layers 1383 according to the data and other information associated with the respective configurations 145. The layers 1383 of material may include any of the structures, materials, color schemes, textures, porosities, etc. disclosed herein. The layers 1383 may have respective elastic moduli that may substantially correspond to the elastic moduli of the respective biomaterials of the anatomical structures. The porosity of the material forming the physical anatomical model 1348 may substantially approximate the porosity or density of the respective tissues.

[0188] In the implementation of FIG. 14 , physical anatomical model 148 may include first volume 148V1 and second volume 148V2. First volume 148V1 may represent cortical bone. Second volume 148V2 may represent cancellous bone. Fracture path 150 may establish one or more local regions 148L of physical anatomical model 148. Configuration 145 established in step 1280-9 may specify fracture volumes 152 that may follow the length of fracture path 150. Physical anatomical model 148 may establish one or more fragments that are separable along fracture path 150 and / or fracture volumes 152 and associated with respective local regions 148L. Physical fracture volumes 152 may establish frangible connections between local region 148L and adjacent local regions 148L and / or body 148M of physical anatomical model 148.

[0189] 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 establish an assembly 168 (shown in dashed lines in FIG. 14 ). The fixture(s) 166 may be positioned relative to a static structure and / or one or more reusable components. The fixture(s) 166 may represent a portion of the surrounding tissue or joint. The surgeon may utilize the fixture(s) 166 to simulate limb rotation or movement in the operating room. The fixture(s) 166 may represent skin tissue and may be formed from a relatively flexible material, such as an elastomeric material. The surgeon may form one or more openings in the fixture 166 to simulate an incision to expose a joint, bone, and / or another portion of the anatomical structure.

[0190] 19-20 , with continued reference to FIGS. 2 and 39 , one or more modifications to the physical anatomical model(s) 348 may be performed at step 1280-11. 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 separating the body 348M of the physical anatomical model 348 along the fracture path 350 and / or the physical fracture volume 352 to establish a fragmented state of the physical anatomical model 348 including one or more fragments 348F (see also fragment 1448F in FIG. 41C and fragment 1548F in FIGS. 42A-42B ). Various techniques may be utilized to establish the fragmented state of the physical anatomical model 348, including any of the techniques and fracture tools disclosed herein (see, e.g., fracture tools 760, 860 in FIGS. 27E and 29C ). In response to a fracture tool applying an amount of force at one or more selected contact points along physical anatomical model 348, such as adjacent respective contact indicator(s), body 348M of physical anatomical model 348 may be separable along fracture path 350 and / or fracture volume 352 to establish fragment(s) 348F (see, e.g., contact points 1048CP and contact indicators 1066 in FIG. 36 ). In the implementation of FIG. 36 , fragments may be established in response to a fracture tool 1060 applying an amount of force at contact points 1048CP along physical anatomical model 1048 adjacent respective contact indicators 1066. The amount of force at the contact points sufficient to fracture physical anatomical model 348 may be determined utilizing a variety of techniques, such as analysis of empirical data, parametric modeling, etc. Separation of physical anatomical model 348 may occur such that one or more physical indicators, such as fracture volume 352 established below outer surface 348E of physical anatomical model 348, may be exposed to establish visual contrast with adjacent portions of physical anatomical model 348 (see, e.g., fracture volume 152′ in FIG. 14 ). The external indicator(s) may present less of a challenge to the surgeon.The surgeon may choose to form the indicators below the outer surface of the physical anatomical model, which may more closely approximate a surgical procedure on the anatomy and may be relatively more difficult.

[0191] A surgeon or clinical user may make various modifications to the fragmented instances of the physical anatomical model 348 to simulate surgical operations to be performed on the anatomical structures and restore function to the patient. The simulated surgical operations may include one or more repairs to the anatomical structures, such as one or more cutting, drilling, reaming, resection, and implantation operations. Each modification may result in a permanent change to the geometry of the physical anatomical model 348. Step 1280-11 may include registering one or more fragments 348F to each other and / or to the remainder of the body 348M of the physical anatomical model 348 (see also FIG. 42B). Step 1280-11 may include securing an orthopedic implant to the registered fragments 1548F and / or the body 1548M of the physical anatomical model 1548 (see, e.g., FIGS. 42C-42D).

[0192] 19-20, with continuing reference to FIGS. 2 and 39, one or more modifications to the physical anatomical model(s) may be evaluated at step 1280-13 utilizing any of the techniques disclosed herein. Step 1280-13 may include determining the state of one or more physical indicators 356 after modifying the physical anatomical model 348 at step 1280-11, and 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 comparing the modified physical anatomical model(s) 348 (e.g., FIGS. 19 and 20) with a previous (e.g., initial or pre-fragmentation) state of the physical anatomical model(s) 348 (e.g., FIG. 18).

[0193] 41A-41C disclose virtual anatomical model 1429, virtual anatomical model 1429′, and physical anatomical model 1448, according to an implementation. Virtual anatomical model 1429′ may be a fragmented instance of virtual anatomical model 1429 and may include one or more fragments 1429F′. In an implementation, virtual anatomical model 1429′ may represent a four-part fracture of an articular portion of a long bone, such as the proximal humerus. Physical anatomical model 1448 may be a physical instance of virtual anatomical model 1429′ and may include one or more fragments 1448F registered or otherwise positioned relative to each other and / or the remainder of body 1448M of physical anatomical model 1448. Virtual anatomical models 1429, 1429′ and physical anatomical model 1448 may be established and positioned using any of the techniques disclosed herein, including any of the steps of method 1280.

[0194] In implementations, the virtual anatomical model 1429 may include one or more virtual indicators 1454. The virtual indicators 1454 may be associated with a predetermined order for registering or otherwise positioning the local regions 1429L relative to each other and / or relative to 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 respective one of the virtual indicators 1454. The surgeon may utilize the physical indicators 1456 to determine the order for positioning the fragment(s) 1448F relative to each other and / or relative to the remainder of the body 1448M of the physical anatomical model 1448, which may facilitate training the surgeon on the associated fracture and treatment options.

[0195] 42A-42D disclose various states of a physical anatomical model 1548 according to one implementation. FIG. 42A discloses a fragmented state of the physical anatomical model 1548, which may include one or more fragments 1548F registered or otherwise positioned relative to each other and / or to the body 1548M of the physical anatomical model 1548. In an implementation, the physical anatomical model 1548 of FIGS. 42A-42D may represent a four-part fracture of the articular portion of a long bone, such as the proximal humerus. In the implementation of FIG. 42B, one or more of the fragments 1548F may be registered or otherwise positioned relatively closer to each other and / or to the body 1548M than in the arrangement of FIG. 42A.

[0196] 42C-42D with continuing reference to FIG. 42B , orthopedic system 1571 can include at least one, or two or more implants 1582. Implants 1582 can be associated with respective implant models 130 ( FIG. 2 ). A surgeon or clinical user can position implant 1582 relative to body 1548M and / or segments 1548F of physical anatomical model 1548. A surgeon or clinical user can position one or more fasteners (e.g., compression screws) 1584 through implant 1582 and into body 1548M and / or segments 1548F to secure segments 1548F to one another and / or to body 1548M. Physical anatomical model 1548 and implants 1582 of FIGS. 42A-42D can be established and positioned using any of the techniques disclosed herein, including any of the steps of method 1280.

[0197] The techniques disclosed herein can be utilized to establish other virtual and physical anatomical models that represent anatomical structures. The techniques disclosed herein can be utilized to establish 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 utilized with various fixtures, including reusable fixtures that can represent the anatomical structures.

[0198] FIG. 43 discloses another implementation of a virtual anatomical model 1629 in the viewing window 144-11 of the planning system 120 (FIG. 2). The virtual anatomical model 1629 may represent a shoulder joint. The virtual anatomical model 1629 may include one or more components 1629C, such as one or more bone volumes 1629B and / or one or more soft tissue volumes 1629S. The virtual anatomical model 1629 may include a first bone volume 1629B-1 and a second bone volume 1629B-2. The first bone volume 1629B-1 may be associated with the scapula. The second bone volume 1629B-2 may be associated with the humerus. The soft tissue volumes 1629S may be associated with respective portions of the rotator cuff. The bone volumes 1629B-1, 1629B-2 and the soft tissue volume 1629S may establish a portion of a joint 1629J. Joint 1629J may be associated with a shoulder joint. One or more of bone volumes 1629B may be associated with a respective fracture volume 1647. Fracture volumes 1647 may be established using any of the techniques disclosed herein. Virtual anatomical model 1629 may be positioned relative to a virtual fixture 1686. Virtual fixture 1686 may have a variety of geometric shapes, such as a generally planar shape.

[0199] 44A-44B disclose a physical anatomical model 1648. The physical anatomical model 1648 may be associated with the virtual anatomical model 1629 of FIG. 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 a respective virtual anatomical model 1629. The components 1648C may include one or more bone volumes 1648B, such as bone volumes 1648B-1 and 1648B-2. The bone volumes 1648B-1 and 1648B-2 may represent the bone volumes 1629B-1 and 1629B-2 of the virtual anatomical model 1629. The physical anatomical model 1648 may include one or more soft tissue volumes 1648S, which may be associated with soft tissue volumes 1629S of the virtual anatomical model 1629. The physical anatomical model 1648 may be separable along associated fracture paths 1650 and / or fracture volumes 1652. The fracture paths 1650 and / or fracture volumes 1652 may be associated with respective fracture patterns 1647 ( FIG. 43 ). The physical anatomical model 1648 may include one or more physical indicators 1656, including any of the indicators disclosed herein.

[0200] Physical anatomical model 1648 may be fixedly attached or otherwise secured to at least one physical fixture 1666 to establish assembly 1668. Physical fixture 1666 may be associated with virtual fixture 1686. In implementation, virtual fixture 1686 may serve as a substrate for forming physical anatomical model 1648 (see, e.g., substrate 1383 in FIG. 40 ).

[0201] The physical anatomical model 1648 may be separable along the fracture path 1650 and / or fracture volume 1652 to establish one or more fragments 1648F. The surgeon or clinical user may secure the fragments 1648F using implants 1682. The surgeon or clinical user may secure the fragments 1648F to each other and / or to the body 1648M of the physical anatomical model 1648 using one or more fasteners (e.g., compression screws) 1686.

[0202] FIG. 45 discloses another implementation of a virtual anatomical model 1729. The virtual anatomical model 1729 may represent an ankle joint. The virtual anatomical model 1729 may be displayed in the display window 144-12 of the user interface 142 ( FIG. 2 ). The virtual anatomical model 1729 may include one or more bone volumes 1729B that may cooperate to establish a joint 1629J. The joint 1629J may be associated with the ankle joint. The bone volumes 1729B may be associated with each bone of the ankle joint (e.g., the tibia, fibula, talus, calcaneus, etc.). One or more of the bone volumes 1729B may be associated with a respective fracture volume 1747.

[0203] FIG. 46 discloses another implementation of a virtual anatomical model 1829 in the viewing window 144-14 of the planning system 120. The virtual anatomical model 1829 may represent a patient's limb, such as a lower leg including an ankle joint. The virtual anatomical model 1829 may be positioned relative to a virtual component 1888. The virtual component 1888 may represent an anatomical structure and may be associated with a physical component 1890 ( FIG. 47A ). The virtual component 1888 may be generic or associated with a different patient than the virtual anatomical model 1829.

[0204] FIG. 47A discloses a physical anatomical model 1848. FIG. 47B discloses an embodiment of the physical anatomical model 1848 of FIG. 47B. The physical anatomical model 1848 may be associated with the virtual anatomical model 1829 of FIG. 46. The physical anatomical model 1848 may represent a patient's limb, such as a lower leg including an ankle joint. A physical component 1890 ( FIG. 47A ) may be associated with the virtual component 1888. The physical component 1890 may be a reusable component and may have a variety of configurations. In implementations, the physical component 1890 may represent an anatomical structure, such as a foot. One or more components of the physical anatomical model 1848 may be at least partially received within the physical component 1890. A surgeon or clinical user may utilize an implant 1882 to secure one or more pieces 1848F of the physical anatomical model 1848.

[0205] 48-49 disclose a virtual anatomical model 1929 according to one implementation. The anatomical model 1929 may include a first anatomical model 1929-1 and a second anatomical model 1929-2 that may be adjacent to the first anatomical model 1929-1. FIG. 49 illustrates the anatomical model 1929 with 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 muscles, ligaments and / or tendons, and / or other tissues. Each anatomical model 1929 may be associated with a surgical plan (e.g., surgical plan 131 of FIG. 2). In an implementation, the anatomical model 1929 may be associated with each bone of a patient's limb. The bones may be adjacent to one another. The anatomical model 1929-1 may include portions associated with a patient's joint, including any of the joints disclosed herein, such as the ankle joint. Anatomical model 1929-1 may be associated with the patient's tibia, and anatomical model 1929-2 may be associated with the patient's fibula.

[0206] Anatomical models 1929-1, 1929-2 may be associated with respective virtual fracture volumes 1947 (indicated by 1947-1, 1947-2). Each fracture volume 1947-1, 1947-2 may be established by a respective fracture pattern 1943 (indicated by 1943-1, 1943-2). Fracture pattern 1943 may be established utilizing any of the techniques disclosed herein. Fracture pattern 1943 and associated fracture volume 1947 may be established based on an associated fracture classification scheme 141 ( FIG. 2 ). In implementation, fracture pattern 1943 may be sized to substantially follow the perimeter of respective anatomical model 1929. The perimeter may be associated with the inner or outer cortical wall of the bone. Fracture volume 1947 may be sized to span both sides of the perimeter of fracture pattern 1943 such that fracture volume 1947 may extend substantially through the body of virtual anatomical model 1929.

[0207] A portion of the virtual fracture volume 1947 may be established by extruding a shape along the perimeter of the fracture pattern 1943. The fracture volume 1947 may include a portion (e.g., a region) within the perimeter of the fracture pattern 1943, such that the fracture volume 1947 may have a continuous (e.g., enclosed) three-dimensional profile. The fracture volumes 1947 may have a variety of geometries, such as substantially planar or complex geometric shapes. In the implementation of FIG. 49, each of the fracture volumes 1947 has a contoured shape associated with the profile of the fracture pattern 1943. FIG. 50 discloses the fracture volumes 1947-1, 1947-2 in the orientations of FIGS. 48-49. FIG. 51 discloses the fracture volumes 1947-1, 1947-2 in a different orientation.

[0208] Various techniques may be utilized to establish the geometry of the portion of the interior fracture volume 1947 around the fracture pattern 1943, such as manual sculpting or automated techniques. Automated techniques may include a "hole-closing" operation, in which the interior of the object is filled with a two-dimensional or three-dimensional mesh. The spatial module 137 (FIG. 2) may be configured to generate the fracture pattern 1943 and associated fracture volume 1947 using any of the techniques disclosed herein.

[0209] FIG. 52 discloses a cross-sectional view of virtual anatomical model 1929-1 and respective fracture volumes 1947-1. In the implementation of FIG. 52, fracture volumes 1947-1 may extend completely, or at least substantially, through the volume of anatomical model 1929-1. Fracture volumes 1947-1 may be established within anatomical model 1929-1 to facilitate at least partial or complete separation of adjacent portions of an associated physical anatomical model. Virtual anatomical model 1929 may be utilized to establish a physical anatomical model utilizing any of the techniques disclosed herein. Anatomical model 1929 and fracture volumes 1947 may be associated with the same and / or different structures, materials, porosities, etc., including any of those disclosed herein, to establish the physical anatomical model. Configuration 145 for creating a physical anatomical model ( FIG. 2 ) may specify geometries associated with fracture volumes 1947-1, 1947-2 to establish a physical fracture path (e.g., pattern) and associated fracture volume of the physical anatomical model.

[0210] 53-55 disclose various states of a physical anatomical model 2048 including a fracture path (e.g., pattern) 2050. The physical anatomical model 2048 may be formed utilizing any of the techniques disclosed herein.

[0211] Physical anatomical model 2048 may include body 2048M. Body 2048M may include outer surface 2048E associated with a bony anatomical profile, including any of the bones disclosed herein. Physical anatomical model 2048 may include one or more physical components 2048C. Each component 2048C may represent an associated component of a respective virtual anatomical model 129 ( FIG. 2 ). Components 2048C of physical anatomical model 2048 may include any of the components disclosed herein, such as respective bone volumes 2048B.

[0212] The fracture path 2050 may be established according to an assigned virtual fracture pattern and / or virtual fracture volume, such as virtual fracture pattern 1943 and / or virtual fracture volume 1947 in FIGS. 48-49 . The body 2048M of the physical anatomical model 2048 may include at least one, or two or more, physical fracture volumes 2052. The physical fracture volumes 2052 may be established along the fracture path 2050. The physical fracture volumes 2052 may extend completely, or at least substantially, through the volume of the body 2048M to facilitate partial and / or complete separation. The fracture volumes 2052 may extend completely, or at least substantially, through the body 2048M of the physical anatomical model 2048, spanning between opposite sides of the circumference of the fracture path 2050.

[0213] The physical fracture volume 2052 may establish one or more local regions 2048L of the physical anatomical model 2048. The fracture volume 2052 may be adapted to divide the body 2048M into two or more local regions 2048L associated with respective components 2048C. The physical fracture volume 2052 may establish frangible connection(s) between the local regions 2048L of the physical anatomical model 2048 and each other and / or the body 2048M. The body 2048M may be separable along the fracture volume 2052 to establish one or more fragments.

[0214] Physical anatomical model 2048, including body 2048M and physical fracture volume 2052, may have a variety of properties, which may include any of the properties disclosed herein. The properties of body 2048M and physical fracture volume 2052 may be the same or different from one another. The properties may include respective material strengths. Physical fracture volume 2052 may have a lower material strength to facilitate fragmentation of physical anatomical model 2048 in a reproducible manner. Fracture volume 2052 may incorporate any of the materials disclosed herein.

[0215] The physical fracture volume 2052 may include one or more indicators adapted to selectively communicate a state of the physical anatomical model 2048 in response to external force(s), such as compressive, tensile, shear, bending, and / or torsional forces. A variety of indicators may be utilized. The physical fracture volume 2052 may be compressible or otherwise movable to provide an indication, such as tactile feedback, in response to compression by the surgeon. The fracture volume 2052 may incorporate a compressible material, such as an elastomer. The fracture volume 2052 may yield in response to relative movement between adjacent components 2048C. Material characteristics may be selected such that the fracture volume 2052 may hold adjacent components 2048C together after application of a force to the fracture volume 2052. Material characteristics may be selected to facilitate simulation of semi-mobile, partial, and / or complete amputations. A semi-mobile amputation may facilitate articulation between the resulting fragments.

[0216] FIG. 53 may be associated with a first state of physical anatomical model 2048, prior to the application of an external (e.g., compressive) force to fracture volume 2052. FIG. 54 may be associated with a second state of physical anatomical model 2048, in which an amount of compressive force is applied to fracture volume 2052, partially deforming fracture volume 2052. The amount of compressive force may exceed a first (e.g., lower) preselected limit, which may partially deform fracture volume 2052. The deformation may be non-permanent. Exceeding the first preselected limit may cause a portion of fracture volume 2052 to bulge (e.g., FIG. 54). FIG. 55 may be associated with a third state of physical anatomical model 2048, in which a different (e.g., greater) amount of compressive force may be applied to fracture volume 2052. The amount of compressive force may exceed a second (e.g., higher) preselected limit, which may permanently deform (e.g., separate) fracture volume 2052. The preselected limit(s) may be established by various physical material characteristics of the fracture volume 2052. The external force(s) may be generated by a surgical device 2053. In implementation, the surgical device 2053 may be a fastener such as a compression screw that may be utilized to attach the components 2048C to one another. Permanent deformation may provide an indication that the amount of compression exceeds the preselected limit.

[0217] Other techniques may be utilized to provide an indication of the amount of external force applied to the physical fracture volume. In the implementation of FIG. 56, the physical anatomical model 2148 may include a fracture volume 2152 having at least one, or two or more cavities (e.g., fluid reservoirs) 2152C. The cavities 2152C may enclose or otherwise retain a fluid F. Applying a (e.g., compressive) force to the fracture volume 2152 that exceeds a (e.g., higher) preselected limit may cause the fracture volume 2152 to rupture, releasing a portion of the fluid F from the cavities 2151C. The rupture may provide an indication that the preselected limit has been exceeded.

[0218] In the implementation of FIG. 57 , physical anatomical model 2248 may include physical fracture volume 2252. One or more objects 2259 may be at least partially and / or completely embedded in fracture volume 2252. Objects 2259 may have one or more physical characteristics that may differ from the material of physical fracture volume 2252. In an implementation, objects 2259 may be granules having a generally spherical geometric shape. The granules may be relatively harder than the material of fracture volume 2252. Applying a force (e.g., compressive) to fracture volume 2252 that exceeds a (e.g., higher) preselected limit may cause objects 2259 to release (e.g., eject) from fracture volume 2252, providing an indication that the preselected limit has been exceeded.

[0219] 58 discloses a physical anatomical model 2348 including a fracture path (e.g., pattern) 2350. The physical anatomical model 2348 may be formed utilizing any of the techniques disclosed herein. The physical anatomical model 2348 may include a body 2348M. An outer surface 2348E of the body 2348M may be associated with an anatomical profile of a bone, including any of the bones disclosed herein, such as the humerus. The fracture path 2350 may be established according to an assigned virtual fracture pattern and / or virtual fracture volume utilizing any of the techniques disclosed herein.

[0220] 59-60 with continuing reference to FIG. 58, a virtual anatomical model 2329 is disclosed according to one implementation. The virtual anatomical model 2329 may be established utilizing any of the techniques disclosed herein. The virtual anatomical model 2329 may be associated with a virtual fracture pattern 2343 and / or a virtual fracture volume 2347 (FIG. 60). In an implementation, a fracture path 2350 (FIG. 58) may be established based on the virtual fracture pattern 2343 and / or the virtual fracture volume 2347.

[0221] The virtual fracture pattern 2343 may include a first (e.g., lateral) virtual fracture path 2343-1 and a second (e.g., medial) virtual fracture path 2343-2 ( FIG. 60 ). The fracture paths 2343-1, 2343-2 may be spaced apart from one another. A virtual fracture volume 2347 may be bounded between the virtual fracture paths 2343-1, 2343-1.

[0222] The fracture paths 2343-1, 2343-2 may have various two-dimensional and / or three-dimensional geometries. Each of the fracture paths 2343-1, 2343-2 may include one or more undulations. Each of the fracture paths 2343-1, 2343-2 may include one or more segments 2343S. Each of the segments 2343S may be a linear or non-linear path extending between two junctions 2343J. The lateral and medial virtual fracture paths 2343-1, 2343-2 may be spaced apart from each other over the entirety or at least a majority of their respective lengths. The lateral fracture path 2343-1 may be sized to substantially surround the medial fracture path 2343-2.

[0223] Various techniques may be utilized to establish the virtual fracture paths 2343-1, 2343-2. ​​In some implementations, the fracture paths 2343-1, 2343-2 may be established independently of one another. In other implementations, the medial fracture path 2343-2 may be established by a preselected offset distance 2343D from the lateral fracture path 2343-1 ( FIG. 60 ), or vice versa. The medial fracture path 2343-2 may be established by following the length of the lateral fracture path 2343-1 at a preselected offset distance 2343D, or vice versa. The medial fracture path 2343-2 may have one or more segments 2343S offset from the lateral fracture path 2343-1 by a distance 2343D′ that may differ from the preselected offset distance 2343D (e.g., FIG. 63 ). The portion of the virtual fracture volume 2347 established by the distance 2343D' may be associated with a relatively weaker region than the portion associated with the preselected offset distance 2343D, which may facilitate reproducible cutting (e.g., fracture) in the target area of ​​the physical anatomical model 2348.

[0224] The outer and inner virtual fracture paths 2343-1, 2343-2 may be established based on the profile of the virtual anatomical model 2329. The virtual fracture paths 2343-1, 2343-2 may be established for a bone volume 2343B, such as cortical bone volume 2329CO and / or cancellous bone volume 2329CA (see, e.g., FIGS. 60 and 63). In implementation, the outer fracture path 2343-1 may be dimensioned to substantially follow the profile of the outer wall of the bone volume 2343B, which may be associated with the cortical bone volume 2329CO. The inner fracture path 2343-2 may be dimensioned to substantially follow the profile of another portion of the virtual anatomical model 2329, such as the inner wall of the cortical bone volume 2329CO. The segment(s) 2343S of the medial fracture path 2343-2 may be established along the inner wall of the cortical bone volume 2329CO and / or at least partially in the cancellous bone volume 2329CA. In the implementation of FIG. 63, the segment(s) 2343S of the medial fracture path 2343-2 may be spaced from (e.g., medially of) the inner wall of the cortical bone volume 2329CO.

[0225] With continued reference to FIGS. 59-60 and with reference to FIGS. 61-62, 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 ( FIG. 60 ) along its respective length. The width 2343W of each fracture path 2343-1, 2343-2 may be substantially constant or may vary along its respective length. Side walls 2343SW may be established between adjacent sides of the fracture paths 2343-1, 2343-2 to bound the virtual fracture volume 2347. In implementation, the side walls 2343SW may be established by one or more facets between adjacent sides of the fracture paths 2343-1, 2343-2.

[0226] The virtual fracture volume 2347 may be assigned one or more characteristics, which may be the same as or different from adjacent portions of the virtual anatomical model 2329, including any of the characteristics disclosed herein, such as various material characteristics. In implementations, the virtual fracture volume 2347 may be associated with a relatively weaker material than the material associated with the adjacent portion(s) of the virtual anatomical model 2329, such as a cortical bone volume 2329 associated with cortical bone and / or a trabecular bone volume 2329 associated with cancellous bone.

[0227] The novel devices and methods of the present disclosure provide versatility in planning, practicing, and training surgical procedures utilizing physical anatomical models. The physical anatomical models may represent various anatomical structures, including anatomical structures associated with various fracture classifications. Surgeons may interact with the disclosed systems to become familiar with selected anatomical structures and various surgical procedures that may be utilized to perform surgical plans, including repair of fractures that may be associated with different fracture classifications. The physical anatomical models may represent various tissue types and may incorporate one or more indicators to facilitate training. The indicators may assist the surgeon in determining the accuracy with which to perform a surgical procedure on the physical anatomical model.

[0228] Although different non-limiting embodiments are illustrated as having particular components or steps, embodiments of the present disclosure are not limited to those particular combinations, and some of the components or features from any of the non-limiting embodiments may be used in combination with features or components from any of the other non-limiting embodiments.

[0229] It should be understood that like reference numerals identify corresponding or similar elements throughout the several views. It should be further understood that while particular component arrangements are disclosed and illustrated in these exemplary embodiments, other arrangements may also benefit from the teachings of the present disclosure.

[0230] The foregoing description should be interpreted as illustrative and not in any limiting sense. Those skilled in the art will appreciate that certain modifications may fall within the scope of the present disclosure. For these reasons, the following claims should be studied to determine the true scope and content of the present disclosure.

Claims

1. a body including an outer surface associated with an anatomical profile of a bone, the body including a fracture path establishing one or more localized regions; the body being separable along the fracture path to establish one or more fragments associated with respective ones of the one or more localized regions; Physical anatomical model.

2. The physical anatomical model of claim 1 , wherein the fracture path comprises one or more segments, each of the one or more segments establishing a loop around a respective one of the local regions.

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

4. the body including a first volume and a second volume; the first volume establishes the outer surface of the body and represents cortical bone; the second volume represents cancellous bone; The physical anatomical model of any one of claims 1 to 3.

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

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

7. The physical anatomical model of any one of claims 4 to 6, wherein the first volume has a first characteristic and the fracture volume has a second characteristic that is different from the first characteristic.

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

9. further comprising one or more extensions extending from the outer surface of the body adjacent the fracture path, the one or more extensions representing soft tissue. The physical anatomical model of any one of claims 1 to 8.

10. the body including one or more indicators associated with the fracture path; The physical anatomical model of claim 1 .

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

12. the one or more indicators include an indication path along the outer surface of the body, the indication path being dimensioned to follow a length of the fracture path. The physical anatomical model of claim 10.

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

14. the fracture volume is spaced from the outer surface of the body; 14. The physical anatomical model of claim 13.

15. the one or more indicators include a shape established along the exterior surface of the body, the shape spanning between at least two of the localized regions; The physical anatomical model of any one of claims 10 to 14.

16. the shape being a silhouette associated with the periphery of an orthopedic implant that is fixable to adjacent bone fragments; 16. The physical anatomical model of claim 15.

17. further comprising a fracture volume associated with the fracture path, the fracture volume extending substantially through the body such that the body is separable along the fracture volume to establish the one or more fragments. The physical anatomical model of claim 1 .

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

19. 19. The physical anatomical model of claim 17 or claim 18, wherein the fracture volume comprises at least one indicator adapted to selectively communicate a state of the physical anatomical 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. 21. The physical anatomical model of any one of claims 17 to 20, wherein the fracture volume is adapted to release a quantity of fluid in response to an external force exceeding a preselected limit.

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

23. The physical anatomical model of any one of claims 1 to 22, wherein the body comprises a polymeric material.

24. The physical anatomical model of any one of claims 1 to 23, wherein the anatomical profile of the bone is associated with a long bone.

25. a physical anatomical model including a body having a fracture path; a fracture tool adapted to separate the body along the fracture path to establish one or more fragments; An orthopedic system comprising:

26. the body including a first volume and a second volume; the first volume establishes an outer surface of the body and represents cortical bone; the second volume represents cancellous bone; 26. The orthopedic system of claim 25.

27. the fracture tool includes a clamp having a first clamping element and a second clamping element; the first clamping element includes a plurality of configurable engagement elements dimensioned to engage selectable contact points along the body; each of the engaging elements is adapted to cooperate with the second clamping element to apply a compressive force to the respective contact point to separate the bodies along the fracture path and establish the one or more fragments; 27. An orthopaedic system according to claim 25 or claim 26.

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

29. 1. A system for practicing a surgical procedure, comprising: a computing device including a processor coupled to a memory, the processor: accessing a virtual anatomical model from the memory, the virtual anatomical model being associated with an 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 generating a configuration associated with a physical anatomical model representing the virtual anatomical model, the configuration configured to specify a fracture path established according to the assigned fracture pattern; system.

30. the processor is configured to generate the configuration such that the physical anatomical model is separable along the fracture path to establish one or more fragments.

30. The system of claim 29.

31. the processor is configured to generate a fracture volume that follows the length of the fracture pattern, the configuration being established according to the fracture volume; 31. A system according to claim 29 or claim 30.

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

33. The fracture volume may be associated with weaker material than adjacent portions of the virtual anatomical model.

33. A system according to claim 31 or claim 32.

34. the configuration specifying one or more indicators associated with the fracture path; A system according to any one of claims 29 to 33.

35. the one or more parameters are associated with a predetermined fracture classification scheme; 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 predetermined fracture classification scheme. A system according to any one of claims 29 to 34.

36. the virtual anatomical model includes a first volume and a second volume; the first volume represents cortical bone; the second volume represents cancellous bone; 31. A system according to claim 29 or claim 30.

37. the processor is configured to generate the fracture pattern, the fracture pattern extending along a boundary region between the first volume and the second volume.

37. The system of claim 36.

38. the processor is configured to generate a fracture volume that follows the length of the fracture pattern, the configuration being established according to the fracture volume; 38. A system according to claim 36 or claim 37.

39. the configuration specifying one or more indicators associated with the fracture path; A system according to any one of claims 36 to 38.

40. the one or more indicators: a display path that follows the length of the fracture path; a plurality of graduations distributed along the length of the fracture path; a shape that spans the fracture path; and and visual contrast between the fracture path and adjacent portions of the physical anatomical model.

41. At least one of the indicators includes a silhouette, the silhouette associated with a periphery of an orthopedic implant fixable to adjacent bone fragments.

41. A system according to claim 39 or claim 40.

42. the processor is configured to generate a fracture volume based on the fracture pattern such that the fracture volume extends substantially through a body of the physical anatomical model such that the body is separable along the fracture volume to establish one or more fragments.

30. The system of claim 29.

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

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

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

46. 1. A method for establishing a physical anatomical model for a surgical procedure, comprising: selecting a virtual anatomical model associated with an anatomical structure; assigning a fracture pattern to the virtual anatomical model based on one or more parameters; generating a configuration associated with a physical anatomical model representing the virtual anatomical model, the configuration specifying a fracture path established according to the assigned fracture pattern; A method comprising:

47. the one or more parameters are associated with a predetermined fracture classification scheme; assigning the fracture pattern occurs in response to setting the one or more parameters associated with the predetermined fracture classification scheme.

47. The method of claim 46.

48. and displaying the virtual anatomical model and the assigned fracture pattern in a graphical user interface.

48. The method of claim 46 or claim 47.

49. and further comprising setting the one or more parameters in response to user interaction with the graphical user interface.

49. The method of claim 48.

50. forming the physical anatomical model based on the configuration; the fracture path establishes one or more localized regions of the physical anatomical model; the physical anatomical model is separable along the fracture path to establish one or more fragments associated with each of the localized regions; 50. The method of any one of claims 46 to 49.

51. forming the physical anatomical model includes printing layers of material on top of each other to establish the physical anatomical model; 51. The method of claim 50.

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

53. the configuration specifies a fracture volume that follows the length of the fracture path; the physical anatomical model is separable along the fracture volume to establish the one or more fragments; 52. The method of claim 50 or claim 51.

54. the configuration specifying one or more indicators associated with the fracture path; 54. The method of any one of claims 46 to 53.

55. the one or more indicators include a plurality of contact indicators distributed along the physical anatomical model; each of the contact indicators is associated with a respective contact element of a fracture tool, and in response to causing the fracture tool to apply an amount of force to a contact point along the physical anatomical model adjacent a respective contact indicator, a body of the physical anatomical model is separable along the fracture path to establish one or more fragments; 55. The method of claim 54.

56. the configuration specifies fracture volumes on either side of the fracture path such that the fracture volumes extend substantially through a body of the physical anatomical model; the physical anatomical model is separable along the fracture volume to establish one or more fragments; 56. The method of claim 46, claim 54 or claim 55.

Images