JP2003180706A - Fixing implement for craniotomy piece of skull - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a fixing implement capable of stably fixing lower and upper discs to the skull even if the cut surfaces of the skull and the cramiotomy piece are inclined. <P>SOLUTION: The fixing implement for the cramiotomy piece of the skull comprises the upper and lower discs 1 and 2 and the connection part 3 of them. A large number of racks or other locking parts 4 are provided to the surface of the connection part 3 and a ball or other shaft part 5 is provided to the lower end of the connection part 3 to make it possible to obliquely lock the connection part 3 with the lower disc. A stopper 6 having a hole 14 permitting the connection part to pass and the pawl 15 locked with the locking parts to prevent the stopper from going backward is provided to the center of the upper disc and the hole part 2a capable of locking the ball or other shaft part 5 of the connection part is provided to the center of the lower disc and the skull is clamped and fixed by the stopper 6 so as to hold the skull 7 between the upper and lower discs through the connection part 3. <P>COPYRIGHT: (C)2003,JPO

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a device for fixing a cranial craniotomy piece for incising a part of a skull by brain surgery and returning and fixing the craniotomy piece removed after the surgery.

[0002]

2. Description of the Related Art Conventionally, as a fixing device for the cranial craniotomy piece as described above, (1) Japanese Utility Model Laid-Open No. 50-110090 "Cranial bone repair tool" and (2) Japanese Patent Laid-Open No. 9-2063.
Japanese Patent No. 11 (Patent No. 3011896) discloses "a device for fixing a bony bone removed during a surgical operation to a skull after surgery".

The former device has a thin plate-like body, and a stem having a plurality of detent teeth formed on its peripheral surface, a main body having a collar which is connected to the stem and can be applied to the inner surface of the perforated portion of the skull. A skull repair tool comprising a retainer plate having a protrusion formed on the inner surface of a central hole.

The latter invention has a first board and a second board having a through hole in the center and a pin inserted into the through hole, and forms a slit extending in the radial direction from the through hole in the center. is doing. The pins and disks are made of metals or metal compounds that do not cause physiological rejection reactions.

[0005]

DISCLOSURE OF INVENTION Problems to be Solved by the Invention At the time of craniotomy in brain surgery, perforated portions at three corners or four corners or more are provided, and a craniotomy piece is taken out from the skull by a cranial line cutting between the perforated portions. Needs to put this craniotomy piece back and fix it with a lid.

The device for fixing the cranial craniotomy piece is to fix the craniotomy piece by returning it to its original position. Normally, when the skull is cut, a cutting surface is formed at a right angle to the plane of the skull.
Depending on the position of the surgeon's hand and the site of the opening, cutting may not always be performed at a right angle, but the position and direction of the cutting device may change and the cutting device may tilt.

In (1) of the above-mentioned conventional examples, since the collar and the stem of the main body are integrally manufactured, the collar and the stem cannot be separated from each other and must be used as they are molded. I won't. In addition, the fixation of the skull by the engagement of the stem and the restraining plate is easy when the cut surface is in the direction perpendicular to the plane of the skull by simply engaging the detent teeth of the stem with the protrusions of the restraining plate. The brim and the restraining plate can be fixed, and the skull craniotomy can be repaired.

However, when the cut surface is inclined when the skull is cut, the collar of the main body and the stem are fixed to each other. Therefore, if the collar surface is aligned with the inner surface of the skull, the stem should pass along the inclined surface. It is difficult to use because it cannot be fixed, and there is a problem that it cannot be securely fixed.

Further, since the stem is rod-shaped, it can be inserted into the perforated portion, but there is a problem that it cannot be used because the gap is narrow on the craniotomy line.

In (2), the first board having the through hole in the center, the second board, and the pin inserted into the through hole are separately manufactured, and the head provided at the pin end is A means for engaging the first disc and engaging the second disc with the pin so as to clamp the post-operative skull, and fixing using a device capable of riveting and nut tightening is disclosed. .

However, according to the present invention, the engagement between the head of the pin and the first board is at a right angle, and when the cutting surface is inclined when cutting out the craniotomy piece from the skull, the pin is inclined. It is difficult for the first disc and the second disc to be in close contact with each other so as to be along the surface of the skull, and there is a drawback that the fixation becomes unstable like the invention of (1).

The object of the present invention is to solve the above-mentioned problems, and even when the cutting surface of the craniotomy piece is inclined, the upper plate and the lower plate for sandwiching the skull can be brought into close contact with the skull, and the connecting portion is used. It is an object of the present invention to provide a device for fixing a craniotomy craniotomy piece that can be fixed securely, does not require a special tool, and can be easily and quickly fixed stably.

[0013]

In order to achieve the above object, the first aspect of the present invention is an apparatus for fixing a skull craniotomy piece, which comprises an upper plate and a lower plate and a connecting portion between the upper plate and the lower plate. A number of racks and other engaging parts are provided on the surface of the part, and balls and other shaft parts are provided at the lower end of the connecting part so that the connecting part can be locked while being inclined with respect to the lower plate, and in the center of the upper plate, A stopper having a hole through which the connecting portion can pass and a pawl that locks with the engaging portion to prevent reversion is provided, and a hole portion that can hold a ball or other shaft portion of the connecting portion in the center of the lower plate. And a skull craniotomy piece fixing device in which the skull is clamped and fixed so as to sandwich the skull between the upper plate and the lower plate via the connecting portion.

In the second aspect of the invention, the connecting portion is locked in the hole of the lower plate through the shaft portion, and the stopper provided on the upper plate prevents the backward movement so that the connecting portion is attached in an inclined state. Is a device for fixing a skull craniotomy piece along the slope of the cut surface of the skull.

As a third aspect of the invention, the lower surface of the stopper is a hemispherical surface, and a device for fixing the skull craniotomy piece oscillatably mounted in the hole of the upper plate is provided.

A fourth aspect of the invention is a device for fixing a craniotomy craniotomy piece in which a lever for removing a claw engaged with a connecting portion is attached to a stopper.

As a fifth aspect of the invention, there is provided a device for fixing a skull craniotomy piece in which the upper and lower discs are discs, the central portion is bulging downward, and the peripheral edge is descending.

A sixth aspect of the invention is a device for fixing a skull craniotomy piece having drainage tube holes cut out from the peripheral portion at positions where the upper and lower discs face each other.

(Operation) According to the first aspect of the present invention, it comprises an upper plate and a lower plate and a connecting portion for connecting the upper plate and the lower plate, and the connecting portion connects the lower plate through the ball or other shaft portion at the lower end. The hole is locked as a bearing, and the hole of the stopper provided in the center of the upper plate can be penetrated while being inclined. By adjusting and fixing the length of the connecting portion with this stopper, it is possible to easily fix the skull with the lower plate and the upper plate sandwiching the skull.

Since the connecting portion is locked to the lower plate around the shaft portion, the connecting portion can be swung or rotated, and when the shaft portion is formed in the width direction of the connecting portion, it can be rotated around this axis. Also, when the shaft portion is a ball, it can be inclined in any direction, and can be attached with a natural inclination along the cut surface of the skull.

The stopper may be preliminarily attached to the hole of the upper plate, or may be separately attached to the hole of the upper plate. If you hold down the upper plate with this stopper with one hand and pull it out with the tip of the connecting part that extends from the lower plate with the other hand, the catch will be fixed by catching the backflow prevention claw, so use another device. No need.

In the present invention, when the upper plate and the lower plate are attached along the upper and lower surfaces of the skull, the connecting portion can be inclined so as to follow the inclination of the cut surface via the shaft or ball at the lower end of the connecting portion, Also, on the upper board, the rotation of the stopper allows the connecting portion to be penetrated while keeping the inclined state, so that it can be fixed in a sufficiently stable manner.

Further, by placing the stopper on the hole at the center of the upper plate and making it a hemispherical surface that can be rotated and adjusted, the engagement between the engaging portion and the claw while the upper plate remains on the skull. The upper and lower panels can be fixed securely.

Regarding the size of the upper plate and the lower plate, a relatively large disk can be used in the perforated portion of the skull, and a small disk may be used for the craniotomy line. When used for a cleaving line, a belt-like one is preferable as the connecting portion because the interval is narrow.

According to the second aspect of the present invention, the connecting portion is locked in the hole of the lower plate through the shaft portion, and the stopper provided on the upper plate prevents the backward movement so that the connecting portion is attached in an inclined state.
Since the connecting portion is arranged along the slope of the cut surface of the skull, the upper and lower discs are in close contact with the skull and are stable even when the connecting portion is not in a state of being perpendicular to the upper disc or the lower disc.

In the third aspect of the invention, the lower surface of the stopper is a hemispherical surface so that the stopper can be rotatably mounted in the hole of the upper plate. Therefore, even if the cut surface of the skull is inclined, it depends on the inclination of the connecting portion. The stopper rotates so that it can be fixed easily along the inclination. Therefore, the lower plate and the upper plate are stably fixed parallel to the skull, and the connecting portion can be reasonably inclined from the shaft part of the lower plate and can be securely fixed by the stopper.

In the fourth aspect of the invention, the fixed state of the upper plate and the lower plate cannot be released unless the pawls are removed from the connecting part once the connecting part is fixed. Can be returned to. It is convenient for over-tightening the upper plate and for re-operation.

In the fifth aspect of the invention, since the upper plate and the lower plate are disks and the central portion is bulging downward, if a stopper is formed above this bulging portion, there will be no abnormal protrusion,
Since the peripheral portion is descending, the peripheral portion can be stably fixed to the skull surface by tightening with the stopper. Similarly, the peripheral part of the lower plate is also elastically and closely fixed to the surface of the skull via the central bulge.

In the sixth aspect of the invention, the drainage tube hole cut out from the peripheral portion is provided at the position where the upper plate and the lower plate are opposed to each other, so that the body fluid and the like leaching from the inside of the skull and the peripheral region are discharged to the outside through the tube. It became easier.

[0030]

BEST MODE FOR CARRYING OUT THE INVENTION In the case of brain surgery, the procedure for craniotomy is one to several points (14 to 1
A perforated portion of about 6 mm) is provided (see FIG. 4). After that, cut between the perforated parts with a craniotome (trade name) or a wire saw (craniotomy line) and cut off, and remove the craniotomy piece (cut out part). After the operation, the craniotomy piece is returned to its original position and fixed to the skull, but the perforated part has a relatively large upper plate and lower plate (diameter about 20 m).
m) is used, and a slightly smaller disc is used for the cranial line part (see FIG. 5A).

By using a thin belt-like connecting portion having a slight width, the connecting portion can be used not only for the perforating portion of the skull but also for insertion into a narrow cut surface as a craniotomy line. A rod-shaped connecting portion may be used.

By using a physiologically harmless material such as titanium or titanium alloy as the material for the upper plate, the lower plate and the connecting portion, the human body is not adversely affected.

According to the present invention, even if the cutting surface of the skull is inclined without using another tightening device, the lower plate is tilted by the pivoting of the connecting portion by the shaft, and the upper plate is tilted by the stopper. It can be set according to, and the upper plate and the lower plate can be fixed closely to the plane of the skull.

[0034]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS The embodiments shown in the drawings will be described below.
FIG. 1 is a perspective view showing an upper board 1, a lower board 2 and a connecting portion 3 separately. Reference numeral 4 denotes an engaging portion which is provided on the surface of the connecting portion at regular intervals and has a saw-tooth shape with an inclination so that the thickness thereof gradually widens downward. Although the engaging portion 4 is formed on one surface of the belt-shaped connecting portion 3, it may be formed on the outer peripheral surface when it is rod-shaped.

Reference numeral 5 is a shaft portion formed at the lower end of the connecting portion.
Although the shaft portion 5 is a ball in FIG. 1, the shaft portion 5 is not limited to this and may be a shaft portion extending in the width direction of the connecting portion.

2 and 3 show examples of use of the skull fixing device of the present invention. Since the upper plate and the lower plate are disks and the central part is bulging downward, if a stopper is formed above this bulging part, there will be no abnormal protrusion.
Since the peripheral portion is descending, the peripheral portion can be stably fixed to the skull surface by tightening with the stopper.

The upper and lower plates shown in the figure are both greatly enlarged and displayed, but this does not determine the size ratio between the skull and the fixing device. Usually, the upper and lower discs have a diameter of about 2 cm or less. FIG. 2 shows an example in which the hole is a relatively large hole, and FIG. 3 shows a case in which a craniotomy line is a relatively narrow cut surface.

In FIG. 2, the connecting portion 3 is a stopper 6
It is fixed by. Reference numeral 7 is a skull, and 8 is a perforated portion. Reference numeral 11 indicates a craniotomy piece.

FIG. 3 is a cross-sectional view showing a case where the cut surface of the cleaved line 9 is inclined and is viewed from the side surface of the connecting portion. The connecting portion 3 has a small thickness and extends along the gap of the cranial line 9 and is fixed by a stopper 6 provided on the upper plate 1. Since the shaft portion 10 extending in the width direction of the connecting portion is provided at the lower end of the connecting portion 3, the connecting portion is set to be inclined around the shaft portion so as to follow the inclined surface.

In both cases of FIG. 2 and FIG. 3, the connecting portion 3 is inserted from below the hole 2a of the lower plate 2 so as to fit the lower plate to the lower part of the craniotomy line on the inner surface of the skull, and the perforation is performed. The connecting portion 3 protruding upward from the portion 8 or the cranial line 9 is provided with the hole portion 1a of the upper board 1.
Through the hole of the stopper 6 attached to the upper plate, the upper plate and the stopper are pushed down by hand and the connecting portion is pulled up by hand, and the skull 7 and the craniotomy piece 11 are clamped and fixed. Although the upper end of the remaining connecting portion 1 is cut, the states of FIGS. 2 and 3 show the state before cutting.

FIG. 4 is an explanatory view of the skull 7 and the craniotomy piece 11.
The figure shows the case where the perforated portions 8 are provided at four places and the space between them is cut by a cleave line 9.

FIG. 5 is a plan view showing an embodiment of the upper board 1 and the lower board 2, in which a and b, c and d, and ho and f respectively represent a pair of the upper and lower boards. In cases (1) and (2), since the upper plate 1 and the lower plate 2 are provided with a plurality of openings 12, 13 on the surfaces thereof, in addition to the effect of evaporating the liquid leaching between the skull and the dura, It has the effect of saving the amount. The size, number, and form of the openings are not limited to the illustrated example.

In the example shown in FIG. 5A, the hole 1a of the upper board 1 is rectangular, and the rectangular stopper 6 is rotatably supported in advance in this hole (see FIG. 10).

The stopper 6 is not limited to the illustrated example. For example, the hole 1a of the upper plate may be a circular or hemispherical concave portion, and the stopper 6 having the hole 14 and the claw 15 that can penetrate the connecting portion may be provided thereon (see FIGS. 11 and 12). In the case of FIG. 12, the connecting portion 3 is locked in the inclined state and can be securely fixed.

In the case of C and D of FIG. 5, a circular hole 16 is formed in the upper plate, and a rectangular hole is formed in the lower plate. 17, 1
Reference numeral 8 denotes a discharge tube hole, which is formed by notching the corresponding peripheral portions of the upper plate and the lower plate. It can be used to drain the liquid that seeps into the skull.

Similar to a and b, a large number of openings are provided in the peripheries of the holes of the upper and lower plates.

(E) and (f) are examples in which the diameters of the upper and lower discs are made slightly smaller, and have sizes suitable for use in the craniotomy line of the skull.

FIG. 6 is an enlarged perspective view showing an engaged state of the upper plate, the lower plate and the connecting portion, and is fixed by the claw 15 through the connecting portion 3.

FIG. 7 is an enlarged perspective view showing a shaft portion 10 in the width direction as another embodiment of the connecting portion.

8 and 9 are enlarged sectional views of the stopper.
FIG. 8 is a reference diagram showing an engaged state of the claw 15, and FIG. 9 shows a case where a lever 19 for releasing the claw 15 is added.

FIG. 10 shows another embodiment of the stopper 6, which is pivotally supported on the upper board 1 in advance. 11 and 12 show another embodiment of the stopper. The lower surface is hemispherical and the claw 15 is formed. The connecting portion 3 is engaged with the claw 15 of the stopper 6 to fix the connecting portion 3 in an inclined state. Upper board 1
Since the stopper 6 is rotatable, the upper plate and the lower plate can be stably fixed.

[0052]

According to the present invention, the connecting portion of the lower plate is rotatable by the shaft so that the upper plate and the lower plate holding the skull can be in close contact with the skull even when the cut surface of the craniotomy piece is inclined. Also, on the upper board, the stopper can be rotated so that the connecting portion can be securely fixed. Therefore, it is possible to provide a device for fixing a skull craniotomy piece that stably clamps the skull between the upper plate and the lower plate, does not require a special tool, and can fix the skull simply and quickly.

[Brief description of drawings]

FIG. 1 is an exploded perspective view of an upper board, a lower board, and a connecting portion.

FIG. 2 is a cross-sectional view of the fixing device in a state of being used for a piercing portion of a skull.

FIG. 3 is a cross-sectional view of a fixing device used on a portion of the skull inclined at the craniotomy line.

FIG. 4 is a side view showing an example of cutting a skull.

FIG. 5 is a plan view showing an embodiment of an upper board and a lower board.

FIG. 6 is an enlarged cross-sectional view showing a locked state of the connecting portion and the stopper.

FIG. 7 is an enlarged perspective view showing another embodiment of the shaft portion of the connecting portion.

FIG. 8 is an enlarged cross-sectional view showing an engagement state between a stopper claw and a connecting portion.

FIG. 9 is a cross-sectional view showing an example of a lever that releases a stopper claw.

FIG. 10 is an enlarged sectional view showing another embodiment of the stopper.

FIG. 11 is an enlarged sectional view showing still another embodiment of the stopper.

FIG. 12 is an enlarged cross-sectional view showing a state where the connecting portion is inclined and fixed by the stopper.

[Explanation of symbols]

1: Upper board 1a: hole 2: Lower plate 2a: hole 3: Connection part 4: Engagement part 5: Shaft 6: Stopper 7: Skull 8: Perforated part 9: Crest line 10: Shaft 11: Craniotomy piece 14: Hole 15: Nail 17, 18: Drainage tube hole

Claims (6)

[Claims] 1. A device for fixing a skull craniotomy piece, which comprises an upper plate and a lower plate and a connecting portion between the upper plate and the lower plate, and a plurality of racks and other engaging portions are provided on the surface of the connecting portion and are connected to each other. A ball or other shaft portion is provided at the lower end of the portion so that the connecting portion can be locked by inclining with respect to the lower plate, and the center of the upper plate is locked with a hole through which the connecting portion can pass and the engaging portion. And a stopper having a claw for preventing reversal, and a hole for locking the ball and other shafts of the connecting part is provided in the center of the lower plate, and the upper plate and the lower plate are connected via the connecting part. A device for fixing a skull craniotomy piece, characterized in that the skull is clamped and fixed so as to sandwich the skull between them. 2. The connecting portion is locked in the hole of the lower plate through the shaft portion, and the stopper provided on the upper plate prevents the backward movement so that the connecting portion is attached in an inclined state, and the connecting portion is cut into the skull. The device for fixing a skull craniotomy piece according to claim 1, wherein the device is arranged so as to follow the inclination of the surface. 3. The skull craniotomy fragment fixing device according to claim 1, wherein the lower surface of the stopper is a hemispherical surface, and the stopper is mounted on the hole of the upper plate so as to be swingable. 4. The device for fixing a skull craniotomy piece according to claim 1, wherein a lever for removing a claw engaged with the connecting portion is attached to the stopper. 5. The upper plate and the lower plate are disks, and the central portion is downwardly bulged so that the peripheral edge is lowered.
A device for fixing a skull craniotomy piece as described. 6. The device for fixing a skull craniotomy piece according to claim 1, wherein a drainage tube hole cut out from a peripheral portion is provided at a position where the upper plate and the lower plate face each other.