DE102019102047A1 - Surgical skull holder - Google Patents

Abstract

The present invention relates to a surgical skull holding device (1000) for use in medical treatment. The skull holding device (1000) comprises a skull clamp (100). The skull clamp has a first arm (101) and a second arm (103), both the first arm (101) and the second arm (103) each having at least one pin (101s, 103s) around the skull between them record or jam. The skull holder device (1000) further comprises a first rod (401) and a first connection arrangement (301) for connecting the first rod (401) to the skull clamp (100).

Description

The present invention relates to a surgical skull holding device according to claim 1 and a first rod according to claim 10.

During a series of surgical procedures in the head area, the patient's head must be held in the desired position. In practice, skull clamps are used for this. They become stationary, e.g. B. attached to the operating table, and have pins that apply pressure from different sides of the head on the bony skull to clamp the skull between them.

An object of the present invention is to provide a further surgical skull holding device and a rod for such a skull holding device.

The object of the invention is achieved by a surgical skull holding device (also briefly: skull holding device) with the features of claim 1 and the rod (also referred to herein as the first rod) with the features of claim 10.

To this end, the present invention proposes a surgical skull holding device for use in medical treatment.

The skull holding device comprises a skull clamp with a first arm and a second arm. Both the first arm and the second arm, if present, each have at least one pin. The pins and / or other elements for contacting and holding the skull are optionally provided. The sections carrying the pins or contact elements, e.g. B. the arms are arranged so that the skull can be picked up or jammed between them.

Optionally, one or both of the arms has a section that rises horizontally in sections and rises in sections therefrom. The horizontal sections of the two arms can be connected to one another in an adjustable manner, for example by means of a ratchet or toothed rail.

The skull holding device optionally further comprises a first rod and optionally a first connection arrangement or connection device for connecting the first rod to the skull clamp.

The connection can be made directly, e.g. B. the first connection arrangement can be connected directly to a section of one of the arms, or indirectly, e.g. For example, the first connection arrangement can in turn be connected to a section of a clamp or clamping device connected to the arm, which can optionally also be provided.

According to the invention, a rod (here: first rod) is also proposed which, preferably at one end portion thereof, has a rail (alternatively: plate) which extends radially and / or perpendicularly to the longitudinal axis of the first rod or is connected thereto for connection to a Skull clamp for a surgical skull holding device, for example for the skull holding device according to the invention. Its design, features or elements can each be configured as disclosed herein.

Embodiments according to the invention can have one or more of the features mentioned above and / or below in any combination, provided that the specific embodiment is not technically impossible for the person skilled in the art.

In all of the following explanations, the use of the expression “may be” or “may have” etc. is to be understood as synonymous with “is preferred” or “preferably” etc. and is intended to explain an embodiment according to the invention.

Whenever numerical words are mentioned herein, the person skilled in the art understands them as indicating a lower limit in terms of numbers. If this does not lead to a contradiction recognizable to the person skilled in the art, the person skilled in the art, for example, always reads “at least one” or “at least one” when specifying “a” or “a”. This understanding is just as much encompassed by the present invention as the interpretation that a numerical word such as “a” can alternatively be meant as “exactly one” wherever this is technically possible for the person skilled in the art. Both are encompassed by the present invention and apply to all numerical words used herein.

If spatial information such as “above”, “below”, “horizontally” etc. is given here, then these are preferably to be understood as intended use of the object according to the invention. If in doubt, they refer to the representation in the figures.

Advantageous further developments of the present invention are the subject of subclaims and embodiments.

When an embodiment is mentioned here, it represents an exemplary embodiment according to the invention.

In some embodiments, the first rod, preferably at an end portion thereof, has a rail that extends radially and / or perpendicular to the longitudinal axis of the first rod.

The longitudinal axis of the first rod can be the longitudinal axis of its elongated section or base body, optionally that section which is intended in a fastening device, for. B. the first connection arrangement.

The rail preferably extends radially in both directions, so in at least one view it therefore preferably projects both to the left and to the right over the rod or its elongated base body.

The rail is preferably flat on its top and / or bottom. Elements such as screws, hooks, clamps, etc. projecting beyond the main plane of extension of the upper side and / or the lower side are preferably not provided, are not part of the rail and / or are not connected to the rail.

The rail is preferably longer than it is wide. It can be a plate or have a strip shape.

The rail is preferably perforated (through holes or blind holes).

Such holes or openings can have an internal thread.

The first rod is preferably welded to a threaded ring which is itself welded to a set screw, and this can be welded and ground to the plate.

The rail preferably closes the first rod upwards or towards one end of the rod.

In some embodiments, the cranium holding device further includes at least one bracket and a second connector assembly configured to connect the bracket to the rail. More than one bracket is also encompassed by the present invention. The connection arrangements with which the optionally several brackets are connected to the rail can be the same or different from one another.

The first and the second connection arrangement differ optionally, in particular in the number of the axes of rotation, degrees of freedom, through openings, etc. defined by them.

In some embodiments, either the first connection arrangement or the second connection arrangement is designed to precisely define a first axis of rotation and to enable a rod or bracket incorporated therein to rotate exclusively about this first axis of rotation by means of this connection arrangement (in each case, for example, with respect to a fixed point or section, e.g. the arm, a clamp or the rail, to which the connection arrangement is in turn attached).

The other of these two connection arrangements is designed to define at least or exactly a second axis of rotation and a third axis of rotation and to enable a rod or bracket incorporated therein, by means of this connection arrangement to at least or exactly around both the second axis of rotation and the third axis of rotation rotate.

In certain embodiments, the skull holding device further comprises a second rod and a third connection arrangement. The third connection arrangement is configured to receive the second rod with the first rod, preferably releasably, preferably displaceably within the latter, preferably ascertainable. A locking mechanism such as a clamping screw or the like can be provided.

The third connection arrangement is optionally identical in construction to the first connection arrangement.

The second rod optionally has, at least in sections, the same diameter and / or the same profile as the first rod.

In some embodiments, the third connection arrangement is configured to exactly define a fourth axis of rotation and to enable a rod accommodated therein to rotate only about the fourth axis of rotation by means of this connection arrangement.

The above-mentioned axes of rotation can be parallel, skewed, cutting, identical to one another.

For each of the connection arrangements mentioned here, it can apply that the rod which it holds can be locked in several angular positions, preferably continuously, optionally at least within a predetermined angular range which comprises at least 45 °.

In some embodiments, the first connection arrangement has or is connected to a clamp. The clamp is used to connect the first connection arrangement to the first arm, preferably with the at least one pin-carrying section of the first arm, that is, for. B. with the ascending section of the arm.

In some embodiments, the clip is configured to be releasably connectable to the arm.

In some embodiments, the clamp is configured to be slidable along the first arm, e.g. B. in its longitudinal direction.

In some embodiments, the clip has a variety of interfaces, e.g. B. sprockets. These can be arranged in order to enable them to couple instruments or accessories to the terminal, preferably from more than one direction and in their entirety preferably in more than one plane. For this purpose, they are provided, for example, on sections of the clamp which are provided at an angle to one another and / or not lying in the same plane.

In certain embodiments, the clamp has a clamping screw or threaded screw, but optionally not one or not exactly a claw. The clamp preferably has no claw which is displaced or moved in the direction in which the clamp or threaded screw is also displaced for use.

In certain embodiments, the skull holding device has at least one section which is made of aluminum, titanium, stainless steel, plastic, carbon, composite, a fiber-reinforced material or a combination thereof, or has one of the materials mentioned here.

In some embodiments, the ascending portion of at least one arm does not have a protruding rail.

It can apply to the first and the third connection arrangement that they can be displaced or displaced along the rods or projections of the clamp inserted into them. Here or as a result, the position of this connection arrangement is adjusted relative to the rod inserted into it - or vice versa.

It can apply to the first connection arrangement and / or the third connection arrangement that they each have two or exactly two through openings, into which elements to be connected to one another, such as rods, projections or the like, can be inserted in order to be fixed therein. Clamping screws for releasable fixing can be passed through screw openings which are also provided.

In some embodiments, any elements of the cranium holding device are radio lucent or radiopaque.

In some embodiments, the first connection arrangement and the second connection arrangement do not define a common displacement axis of a rod received by these two connection arrangements.

In some embodiments, the first connection arrangement comprises a rod, the second does not comprise the same rod.

In some embodiments, at least one connection arrangement, optionally several, each has two through openings in such a way that at least one of the rods mentioned here can be displaced in one of the through openings, can be locked or locked in it.

In some embodiments, at least one of the rods has a radially projecting or protruding pin, projection, or the like, which prevents the rod from being unintentionally released from a connection arrangement in at least one direction, usually its longitudinal direction. This can depend on the rotational position of the rod within the connection arrangement. So z. B. a groove or a slot can be provided in the connection arrangement, which / which allows a passage of the pin thereby depending on the rotational position of the rod. If the groove and pin coincide, the rod can be pulled out of the connection arrangement. Do not overlap because the rod z. B. has been rotated by a few degrees, the pin can not move into the groove to pull out the rod. It is therefore not possible to pull the rod out in this rotational position of the rod.

In some embodiments, the shackle and / or the second rod are curved in a sectional plane transverse to at least one cross section thereof.

In some embodiments, the bracket and / or the second rod are not closed to form a ring or another circumferential structure.

In some embodiments, the bracket and / or the second rod have a circular or annular cross section.

In some embodiments, the bracket in the second connection arrangement is not rotatably arranged relative to the latter. Optionally, it is not arranged in the second connection arrangement so as to be rotatable about a longitudinal axis thereof or about one of its sections.

In some embodiments, the bracket and / or the second rod are hollow at least in sections, in others they are not hollow in any section.

In some embodiments, the first connection arrangement has a locking screw or clamping screw, the longitudinal axis of which, when using the object according to the invention, is perpendicular to the longitudinal direction of the horizontal arms of the skull holding device.

In some embodiments, the second connection arrangement has a locking screw or clamping screw, the longitudinal axis of which, when using the object according to the invention, is perpendicular to the rail and / or parallel to the longitudinal axis of the first rod.

In some embodiments, the second connection arrangement, e.g. B. by means of their locking screw or clamping screw, preferably from below, screwed to the rail.

In some embodiments, the bracket is in the second connection arrangement, e.g. B. screwed by means of the locking screw or clamping screw, preferably from below, to the rail.

In some embodiments, the second connection arrangement is connected to the rail in a rotationally fixed manner, for example by welding, by means of suitable plug connections, by using an anti-rotation device (for example in the form of one or more radially inserted pins), or the like.

In some embodiments, the rail is welded to the first rod, integrally manufactured or otherwise rotationally fixed, non-detachable and / or positively and / or non-positively connected. In other embodiments, the rail can be rotated and / or displaceable relative to the rod or its base body. Such a movement can optionally be permitted or prevented by means of a fixing device. A fixing device can e.g. B. be a clamping device.

In some embodiments, the rail sits on the end of the first rod and / or covers its elongated body or base body.

In some embodiments, the longitudinal axis of the first rod runs through the rail.

In some embodiments, the skull holding device has both at least one rail and at least one bracket.

In some embodiments, the rail is wider than it is strong or high. For example, it may be 2 cm to 10 cm or more wide, its thickness e.g. B. can be between 0.5 cm to 2 cm or more.

The length of the rail can preferably be between 10 cm and 40 cm.

The splint preferably does not carry any pins for contacting the bony skull.

In some embodiments, the rail has one or more through openings and / or one or more blind openings. Such openings can have threaded inserts or threaded bores.

Such openings can be accessible from an upper side, underside, end face and / or from lateral boundary surfaces.

The aforementioned openings, through openings, bores, threaded bores, etc. can serve to attach further instruments, aiming devices or gel pads, for example as a hand rest, to the rail.

In some embodiments, the second connection arrangement is on one side, e.g. B. the top in use, not beyond the rail. This can advantageously prevent the surgeon from getting stuck on the splint, for example with a glove or smock sleeve.

In some embodiments, at least any one of the connection arrangements has two clamping sections, each of which surrounds a through opening, and which can preferably be reversibly limited in diameter by means of only one locking screw or clamping screw for clamping, e.g. B. a staff. Both clamping sections can preferably be provided such that they can be rotated relative to one another. For this purpose, z. B. a ring gear can be provided. The rotatability relative to one another can optionally also be canceled and / or granted again by means of the locking screw or clamping screw.

In some embodiments, a rod is a rod, tube, or the like.

In some embodiments, at least one of the arms has a section, e.g. B. the ascending section, with a shaped in the form of a double T or an H on. A central section is bounded by edge webs in its longitudinal course.

The edge webs can protrude above a level of the central section, the central section can be closed, that is to say it cannot be a through opening or not consist of through openings.

A section is optionally provided in which the width of the central section is constant. This section is optionally at least 1, 2 or 3 cm long.

One or more of the above and the following advantages can be achieved with embodiments according to the invention.

An advantage of the present invention is that the surgeon has a large number of degrees of freedom for adjusting his instruments fixed to the head holding device by means of the connection arrangements.

In addition, when using a first and a second rod, he is optionally enabled to rotate in at least or exactly three degrees of freedom. The greater number of degrees of freedom is preferably shifted closer to the connection of the attachment comprising the rods and brackets to the arm, which can have advantages with regard to the stability and strength of the structure.

Furthermore, the splint mentioned here (or splint, see the following figures) can be of particular use to him in his work, since it enables him to support his arm, hand and the like.

As described herein in embodiments, the skull holding device according to the invention can allow him not to get caught on closures, handles, screw ends and the like.

In addition, because of its design and / or because of its connection to one of the arms of the skull holding device, the splint can enable a plurality of brackets to be fastened next to one another on the splint. These can extend in one and the same direction from the rail, e.g. B. in the space between the arms (e.g. instruments) or pointing outwards (e.g. navigation; imaging, etc.). The bracket can be attached to the top and / or bottom of the rail, they can be rotatably and thus pivotally connected to the rail. The plate shape of some embodiments allows broad-based support of the instrument or accessories (for example by simultaneous connection in openings in the rail that are relatively far apart), which can increase stability.

Since the rail is preferably flat and long, its dimensions can be chosen to be comparatively generous, so that it offers space for coupling to a large number of interfaces or instruments, etc., without this increasing its weight to a considerable extent.

In some embodiments, the first bar is optionally not centered under the rail. This can allow greater flexibility by rotating the first rod to rotate the less protruding leg of the rail into or further into the space between the arms and the protruding part. This can allow, if a larger distance between the attachments attached to the arms is needed during operations, to create this by rotating the shorter legs of the rail or opposite rails (i.e. those with less protrusion from the first rod) into this space , but not the longer legs. Reverse handling can also be considered if instruments have to extend further into the space between the arms. In this case, the longer leg can be screwed into this space. Overall, the rail, if it optionally has legs of different lengths, allows a larger working area and / or radius.

In some embodiments, target devices and / or other instruments can be attached to the rail. For this purpose, the above-mentioned openings can be used; alternatively or additionally, the rail can have one or more interfaces, such as further toothed rings, on at least one surface thereof (top, bottom, front, or any other).

In some embodiments, the rail can serve as a rest, for example as a hand rest. Optionally, a gel pad can be put on or be.

In some embodiments, the stirrups are compatible with commercially available clamps (e.g. Leyla, Greenberg systems) due to their design (e.g. the thin stirrup with a round cross section). This can advantageously save costs for the development of new terminals.

The first bar can advantageously be at any angle to the fixed arms.

The attachment and / or navigation connections can advantageously be attached to the terminal. This offers considerable freedom and flexibility when attaching additional instruments.

The connection arrangement advantageously allows a large number of additional instruments and navigation connections to be attached.

Advantageously, the rail is secured against inadvertent falling out by means of the fall protection of the first rod. The same can apply to other elements such as the bracket or the second rod.

The attachment (rod with rail, with or without a bracket, possibly with a clamp) can advantageously be detached from the respective arm using the proposed clamp connections, in particular by releasing only one main clamp (see the reference symbol 201 in the figures), advantageously without tools.

• 1 zeigt eine erfindungsgemäße chirurgische Schädelhaltevorrichtung in einer exemplarischen ersten Ausführungsform in perspektivischer Ansicht von rechts oben;
• 2 zeigt Ausschnitte der chirurgischen Schädelhaltevorrichtung der 1 in Seitenansicht;
• 3 zeigt in 1 gezeigte Elemente in Perspektive;
• 4 zeigt das in 3 Gezeigte von vorne;
• 5 zeigt eine alternative Ausführungsform des in 3 Gezeigten;
• 6 zeigt das in 3 Gezeigte von oben;
• 7 zeigt den in 1 mit dem zweiten Arm verbundenen Aufbau in Perspektive;
• 8 zeigt Ausschnitte des in 7 Gezeigten von vorne und leicht oben;
• 9 zeigt eine erfindungsgemäße chirurgische Schädelhaltevorrichtung in einer exemplarischen zweiten Ausführungsform in perspektivischer Ansicht von rechts oben;
• 10 zeigt eine erfindungsgemäße chirurgische Schädelhaltevorrichtung in einer exemplarischen dritten Ausführungsform in perspektivischer Ansicht von rechts oben;
• 11 zeigt die Schädelhaltevorrichtung der 10 von der Seite;
• 12 zeigt den in 10 mit dem zweiten Arm verbundenen Aufbau in Perspektive;
• 13 zeigt das in 12 Gezeigte von der Seite;
• 14 zeigt den zweiten Arm der Schädelhaltevorrichtung einer der vorangegangenen Figuren mit Blick auf dessen Vorderseite; und
• 14a zeigt einen Schnitt A-A aus 14.

The present invention is explained below by way of example with reference to the attached, in part simplified figures, in which identical reference numerals designate identical or similar components. In the figures:

• 1 shows a surgical skull holding device according to the invention in an exemplary first embodiment in a perspective view from the top right;
• 2nd shows sections of the surgical skull holding device of the 1 in side view;
• 3rd shows in 1 shown elements in perspective;
• 4th shows that in 3rd Shown from the front;
• 5 shows an alternative embodiment of the in 3rd Shown;
• 6 shows that in 3rd Shown from above;
• 7 shows the in 1 structure connected to the second arm in perspective;
• 8th shows excerpts of the in 7 Shown from the front and slightly above;
• 9 shows a surgical skull holding device according to the invention in an exemplary second embodiment in a perspective view from the top right;
• 10th shows a surgical skull holding device according to the invention in an exemplary third embodiment in a perspective view from the top right;
• 11 shows the skull holding device of the 10th of the page;
• 12th shows the in 10th structure connected to the second arm in perspective;
• 13 shows that in 12th Shown from the side;
• 14 shows the second arm of the skull holding device of one of the preceding figures with a view of its front; and
• 14a shows a section AA out 14 .

1 shows an exemplary surgical skull holding device according to the invention 1000 in a light perspective from above.

The skull holder 1000 shows a skull clamp 100 with a first arm 101 and a second arm 103 on.

The first arm 101 has one (based on its arrangement in 1 ) horizontal section 101h and a section ascending from it 101a on.

The second arm also points 103 (based on its arrangement in 1 ) a horizontal section 103h and a section ascending from it 103a on.

The ascending section 101a , 103a can alternatively also be referred to as "protruding" or "protruding".

The horizontal sections 101h and 103h can be non-detachably or releasably connected. In each of these cases, they can be connected to one another in an adjustable manner relative to one another. As in the example, the 1 a tooth splint 105 be provided, a ratchet, or the like.

One, two or more sprockets 107 , 109 can be used to attach accessories or instruments to the skull clamp 100 be provided, e.g. B. on one of the horizontal sections, as here for the horizontal section 101h shown. Other interfaces or docking points for attaching accessories or instruments to the skull clamp 100 can z. B. on the horizontal sections 101h and 103h or the ascending sections 101a and 103a be provided. For this purpose, they can be provided integrally or connected (screwed, welded, etc.).

Both the first arm 101 as well as the second arm 103 carry by means of their ascending sections 101a or. 103a at least one pin each for jamming the skull between them, the ascending section 101a here are two pens as an example 101s and the ascending section 103a a pen 103s wearing.

The first arm 101 is in its ascending section 101a with a clamp 201 connected which is more detailed in 7 is shown.

the clamp 201 can optionally along the ascending section 101a be slidably provided. The range in which shifting is possible can optionally be limited, for example by webs, steps, the choice of the diameter or another dimension of the arm 101 at this point, etc.

the clamp 201 can be a clamp shoe 201a and an optionally rotationally fixed or integral projection 201b exhibit. In 1 is the lead 201b exemplarily designed as a cylindrical section.

The lead 201b or another section of the clamp 201 can have an interface or coupling point for connecting an instrument or accessories, e.g. B. in the form of a ring gear 201c .

On the lead 201b is a first connection arrangement 301 , which here has three through openings as an example, of which exactly two optionally have a variable inner diameter, releasably clamped in one of these through openings. The first connection arrangement 301 is as long as not clamped to the projection 201b rotatable. Tightening a clamping screw 301a e.g. B. by means of a screw handle or handle H the first connection arrangement is jammed 301 with the lead 201b or against this.

In a further passage opening with a variable diameter of the first connection arrangement 301 is a first staff 401 introduced. It can also rotate within the through opening receiving it and / or its height with respect to the first connection arrangement 301 be moved as long as the clamping screw 301a has not been tightened or prevented in any other way.

How 1 shows, sets the first connection arrangement 301 thus a first axis of rotation, which is related to the 1 the longitudinal axis of the projection 201b corresponds, and a second longitudinal axis, which is the longitudinal axis shown in dash-dot lines L of the first staff 401 corresponds.

A third axis of rotation, which of the first connection arrangement 301 is defined, is made possible by a twisting arrangement, which here is optionally a combination of two sprockets 301c is designed, as it is optionally also in other 1 Connection arrangements shown may be present. It corresponds to 1 the longitudinal axis of the clamping screw 301a , or is parallel to this.

The first staff 401 has a first end section 401a (below in 1 ) and a second end section 401b (above in 1 ).

The first end section 401a Here is an example of a free end, which optionally has a radially projecting locking pin 401c wearing.

The locking pin 401c can ensure that within the first connection arrangement 301 first rod rotatable when not locked 401 only in a small rotation angle range along its longitudinal direction from the through opening of the first connection arrangement 301 can be pulled out because the locking pin 401c only in the area of a clamping opening 301d together with the first staff 401 can be passed through the through opening.

Locking pins similar to that locking pin 401c can optionally be provided on any of the rods described herein.

The first staff 401 shows a rail 403 on. This is optional with the second end section 401b connected or manufactured integrally.

The rail 403 can with the first stick 401 welded, integrally manufactured or otherwise rotationally fixed, non-detachable and / or positively and / or non-positively connected. Is, as in the present example, on a possibility of rotation between the rod 401 and rail 403 dispensed with, a mechanism for permitting and preventing rotation can also be dispensed with, which can advantageously lead to projections and instabilities which would be caused by such a mechanism not being provided at this prominent location on which the surgeon is working must or occur.

The rail 403 can with the first stick 401 result in a T-shape. The rail 403 can have two opposite ends 403a and 403b have on which the rail 403 ends freely.

The rail 403 can openings 403c or through openings 405 for attaching additional devices or instruments. These can be on any surface of the rail 403 provided and / or accessible from there.

The rail can be used for manufacturing and cost reasons 403 have a straight course, optionally no curved course. Has the rail 403 a curved or otherwise non-straight course, it is advantageously convex to Skulls, ie their ends are farther from a center of the skull clamp than a central section of the splint 403 . The straight course allows the track to be curved or angled away from the center 403 the largest possible free space between rods in which the surgeon can find space to operate.

The rail 403 has coupling points to which accessories or instruments can be attached directly or indirectly.

These coupling points include through openings 405 which at one or both ends 403a and 403b can be provided, and which z. B. can be equipped with a thread.

A second connection arrangement 501 is at the left end of the rail 403 connected to the latter, here by way of example by means of its left passage opening 405 . A similar or identical connection arrangement 501 is at the right end of the rail 403 connected, here exemplarily by means of their right through opening 405 .

The second connection arrangements 501 again have a clamping screw that can be tightened and loosened again using the handle. Other locking mechanisms that do not act by screwing, but z. B. toggle lever, eccentric or the like are also considered.

The second connection arrangement 501 has an insertion opening 501a on, in which a bracket 601 is inserted. The bracket can by means of the second connection arrangement 501 in one level, in the settings of the 1 exemplary in the horizontal plane. The axis of rotation around which this pivoting takes place is determined by the second connection arrangement 501 defines and corresponds in the example to 1 the longitudinal axis of the clamping screw, the free end 503 more or less with the top surface of the rail 403 completes.

In the in 1 shown embodiment allows the second connection arrangement 501 a rotation of the bracket 601 around exactly one axis of rotation, namely the one discussed above. The coat hanger 601 can do this in a rotationally fixed or positive manner in the second connection arrangement 501 be introduced.

The coat hanger 601 can in turn be used to attach instruments, hooks, spreaders or the like. Its profile can be circular, ring-shaped or other.

1 optionally shows a further connection arrangement 501 of the type mentioned above, which also with the aforementioned rail 403 connected is.

The above description of the 1 has been limited to superstructures or attachments with the first arm 101 connected or supported on this.

Descriptions of items related to the first arm 101 connected, apply analogously to the same or similar elements connected to the second arm 103 are connected, which can be seen not least from the figures. In order to avoid repetitions, their description is omitted. Instead, the description of such elements is related to the first arm 101 pointed out.

The following description of the 1 deals with superstructures or attachments with the second arm 103 connected or supported on this. In the following, those elements will be dealt with that differ from elements that are related to the first arm 101 are different.

The second arm 103 is with its ascending section 103a also with a clamp 201 connected, as already discussed above. With the clamp 201 a first connection arrangement is connected 301 , as was also discussed above.

In the first connection arrangement 301 sticks a second stick 402 , which is optionally a spring 402d which has a twisting of the second rod 402 in the first connection arrangement 301 prevented. However, it should be noted that this feather 402d like other anti-rotation mechanisms (non-round cross-section, etc.) is optional, and that also the first rod 401 could have such a spring.

A groove shared with the tongue 402d anti-twist protection for the second rod 402 in the first connection arrangement 301 forms, can in the first connection arrangement 301 be provided. Alternatively, the spring can be in the first connection arrangement 301 be provided, however, the groove on the second rod 402 . Another alternative, instead of a tongue-and-groove system, can be provided with another anti-rotation device. However, anti-rotation protection is always optional.

How 1 shows, the second stick is inserted 402 with a further end section thereof, which optionally has an interface at the front, e.g. B. one Sprocket 402e carries in a further connection arrangement 701 , referred to herein as the third connection arrangement. The third connection arrangement 701 can like the second connection arrangement 301 be designed.

The third connection arrangement 701 connects the second rod 402 with another first stick 401 . Like the second stick 402 can the first staff 401 optionally have an anti-twist device, e.g. B. in the form of a spring 401d , a groove, or the like.

Like the one related to the first arm 101 first rod described 401 the first staff can do this too 401 with a rail 403 as described above, connected or integrally made.

The first connection arrangement 301 , which both by means of the clamp 201 with the second arm 103 as well as with the second stick 402 connected, preferably allows rotation about exactly two axes of rotation or defines them.

The third connection arrangement 701 with which the second stick 402 is also connected, preferably allows or defines rotation about exactly one axis of rotation.

2nd shows the surgical skull holder 1000 of the 1 of the page.

Handles that are used to tighten or lock clamping screws are in 2nd with the reference symbol H designated.

3rd shows the first stick 401 of the 1 including rail 403 and two by means of two second connection arrangements 501 with the rail 403 connected bracket 601 in perspective.

4th shows that in 3rd Shown from the front.

It can be seen that the rail 403 not in the middle of the first stick 401 must sit, although this is also possible according to the invention. The T-shape mentioned here can also be a T with unequal legs.

5 shows an alternative embodiment of the in 3rd Shown.

Different from the embodiment of the 3rd are the temples 601 (one or both) not curved, but straight in their longitudinal extension.

The temples 601 of the 5 can, one or both, at least in sections have a round diameter. This is optional.

As in 4th the rail is not with the same projection on the left or right over the first bar 401 arranged.

6 shows that in 3rd Shown from above.

The arrows indicate the (only) direction of rotation in which the bracket 601 around one by means of a cross X designated axis of rotation in the second connection arrangement 501 can turn. A turning z. B. an insertion section 601a the coat hanger 601 within the second connection arrangement 501 can - optionally regardless of whether the connection arrangement 501 by means of the handle H and the clamping screw connected to it is tightened or not - be impossible, for example by welding the bracket 601 in the second connection arrangement 501 , by a tongue and groove system or the like. This configuration advantageously allows a high load on the bracket, in particular by means of torque, for example by the bracket 601 planned extensions.

7 shows the in 1 with the second arm 103 connected structure in perspective, but without arm 103 .

The attention in 7 lies on the exemplary design of the clamp 201 . Your clamp shoe 201a , for which the handle is optional H and the clamping screw connected to it 201d can count, can be designed in this - or any other inventive - embodiment as a U-profile. The U-profile does not require claws, but surrounds a section of the arm, especially the ascending section.

8th shows excerpts of the in 7 Shown from the front and slightly above.

9 shows a surgical skull holding device according to the invention 1000 in an exemplary second embodiment in a perspective view from the top right.

This embodiment corresponds essentially to that of FIG 1 . Only the differences to the execution of the 1 are to be mentioned below. They only affect the structure that is on the second arm 103 supports.

Starting from a clamp shoe 201a the clamp 201 how he too from 1 is known, the projection extends 201b ' form-fitting. Different from the lead 201b of the 1 However, if this is not designed as a straight section, it has both a (related to 9 ) horizontal section and a section rising from it, which in 9 runs vertically. The section referred to herein as horizontal and the Sections referred to herein as ascending can be perpendicular to each other, they can be at a different angle to each other, but they are not parallel and also do not have a common longitudinal axis.

A hinge between the horizontal section and the ascending section can be provided. However, there is preferably no joint. The horizontal section and the ascending section are optionally made in one piece or integrally. Alternatively, they are welded together.

The first connection arrangement 301 again connects the lead 201b ' with the first stick 401 in a way like this 1 is known and in 9 for the first arm 101 is also shown.

At the clamp 201 can optionally be a ring gear at the front or at an upper end thereof 201e or another interface can be arranged, for example for coupling further accessories, such as further holders, positioning devices and / or instruments, etc.

A tongue and groove connection or other anti-twist protection on the first rod 401 can be provided, but is unnecessary.

A pin lock on the first stick 401 protection against unwanted pulling out can be provided is in 9 however not shown. Such a securing against pulling out, which can be designed as a pin securing device, can be optionally provided here as well as on any other rod mentioned here.

The lead 201b ' can have at least one interface or coupling point at any point, for example in the form of a ring gear 201c . This is optional.

10th shows a surgical skull holding device according to the invention 1000 in an exemplary third embodiment in a perspective view from the top right.

This embodiment corresponds in many aspects to that of FIG 9 . Deviating from that, however, both arms are here 101 and 103 with a combination of a clamp 201 with a head start 201b ' and a first stick 401 connected as in 9 only with regard to the second arm 103 is shown.

One of the in 10th shown terminals 201 is with handle H mounted facing forward (left in 10th ), the other with a handle H pointing backwards. From the latter it can be seen that the clamping shoe too 201a a ring gear 201d or can have a differently designed interface, not just the projection 201b .

The left in 10th shown rail 403 is compared to the rail shown on the right 403 inclined by 90 °. This is made possible by the first connection device or connection arrangement 301 .

On the inclined left rail 403 it can be seen that the projection 201b` is not only in its in 10th horizontally shown section an interface like a ring gear 201c may have, but also at its section protruding from the horizontally shown section at an angle (which is here vertical) such an interface, here sprocket 201e , can have. In this way, the clamp allows 201 connecting an accessory from above, not just in a horizontal direction. In addition, this can advantageously increase the number of interfaces. The provision of as many interfaces as possible on the terminal 201 can also offer the advantage that a large number of accessories or instruments can be combined with the optionally height-adjustable clamp along the arm 201 if necessary, also have their height adjusted. This would be different if the interface in question were e.g. B. be attached to the arm itself and thus always at the same height above the horizontal section.

Due to the height adjustment of the interfaces of the terminal 201 based on z. B. the operating table can advantageously height adjustment mechanisms with one of the arms 101 , 103 connected instruments or accessories are not required.

the clamp 201 can thus have a variety of interfaces, e.g. B. sprockets, which allow coupling of instruments or accessories preferably from more than one direction and in their entirety preferably in more than one plane.

A spring-loaded button serves as an example of a safety device 111 to the rack 105 secure against a sliding movement by engaging the teeth of the toothed rail with projections, teeth or the like. If it is moved or withdrawn against the spring action, it gives up its clamping or locking action, the two horizontal sections 101h and 103h can be used to adjust the skull clamp 100 to be moved relative to each other on the patient to be treated, which increases the distance from pins 101s and 103s changed to each other.

11 shows the skull holding device of the 10th of the page.

12th shows the in 10th structure connected to the second arm in perspective.

13 shows that in 12th Shown from the side.

14 shows the second arm 103 with a view of its front but without clamp 201 what the view of the profile of the ascending section 103a allowed.

A section through this section is in 14a shown. The profile shown has the shape of a double T or an H with a central section M and two, this middle section M in the longitudinal course of the ascending section 103a delimiting, edge webs R . The bridges R stand above a level of the middle section M forth. In other words, the middle section lies M in relation to the border webs adjacent to it R set back, optionally on both the front and back of the ascending section 103a .

The width B of the middle section M changes as in the example of 14 optionally with increasing distance from the horizontal section 103h . In the example of the 14 it tapers upwards and it widens downwards.

Optionally, however, at least one section is also provided, in which the width B is constant. This section is optionally at least 1, 2 or 3 cm long.

The width B can be such that the tip of the clamping screw 201d (or one placed on the free end of it, in 14 element not shown) in selected height sections of the ascending section 103a Space between the bridges R higher, but no longer, which the user either cannot miss or attach the clamp 201 on the ascending section 103a basically prevented.

This configuration is advantageously used to prevent the clamp at the height of the ascending section 103a want to attach in which the clamp 201 must not be attached. Reasons why beyond a predetermined, in 14 end height designated E the clamp 201 can no longer be applied can be varied. So it can be determined that a minimum distance between the location where the terminal 201 is attached, and that of a tip holding arrangement 120 , must be observed. Likewise, on the ascending section, which overall tapered upward 103a from a certain height above the horizontal section 103h the required strength of the arm may no longer be given to the clamp 201 including the forces acting on them in use. Or the overall tapering ascending section 103a from a certain height is no longer wide enough to be inside the clamping shoe 201a to lie on opposite sides of it and to be able to support it.

Reference list

1000

Skull holding device

100

Skull clamp

101

first arm

101h

horizontal section of the first arm 101

101a

ascending section of the first arm 101

101s

pen

103

second arm

103h

horizontal section of the second arm 103

103a

ascending section of the second arm 103

103s

pen

105

Tooth splint

107

Sprocket

109

Sprocket

111

Security device

120

Tip holding arrangement

201

Clamp

201a

Clamp shoe

201b

head Start

201c

Sprocket

201d

Clamping screw

201e

Sprocket

201b '

head Start

301

first connection arrangement

301a

Clamping screw

301c

Combination of two sprockets

301d

Clamp opening

401

first staff

401a

End section

401b

End section

401c

Locking pin

401d

feather

402

second staff

402d

feather

402e

Sprocket

403

rail

403a

The End

403b

The End

403c

openings

405

Through opening

501

second connection arrangement

501a

Insertion opening

503

free end of the clamping screw

601

hanger

601a

Insertion section

701

third connection arrangement

B

width

E

Final height

H

Handle

L

Longitudinal axis of the first bar

M

Middle section

R

Edge bars

Claims (10)

A surgical skull holder (1000) for use in medical treatment, the skull holder (1000) comprising: - A skull clamp (100) with a first arm (101) and a second arm (103), both the first arm (101) and the second arm (103) each having at least one pin (101s, 103s) for receiving or Jamming the skull between them; - a first rod (401) which, preferably at one end section (401b) thereof, has a rail (403) extending radially and / or perpendicular to the longitudinal axis (L) of the first rod (401); and - a first connection arrangement (301) for connecting the first rod (401) to the skull clamp (100). Surgical skull holding device (1000) after Claim 1 , wherein: - the first connection arrangement (301) is a clamping device. Surgical skull holding device (1000) after Claim 1 or 2nd , further comprising: - a bracket (601); - a second connection arrangement (501) configured to connect the bracket (601) to the rail (403). Surgical skull holding device (1000) according to one of the preceding claims, wherein the first connection arrangement (301) or the second connection arrangement (501) is configured to exactly define a first axis of rotation and to enable a rod (401) or bracket (601) accommodated therein, by means of this connection arrangement (301, 501) exclusively around to rotate the first axis of rotation, and the other of these two connection arrangements (301, 501) being configured to define at least a second axis of rotation and a third axis of rotation and to enable a rod (401) or bracket (601) accommodated therein, by means of this connection arrangement (301, 501) to rotate at least both the second axis of rotation and the third axis of rotation. Surgical skull holding device (1000) according to one of the preceding claims, further comprising: - a second rod (402); - a third connector assembly (701) configured to connect the second rod (402) to the first rod (401). Surgical skull holding device (1000) after Claim 5 , wherein the third connection arrangement (701) is configured to exactly define a fourth axis of rotation and to enable a rod (402) accommodated therein, by means of this connection arrangement (701) to rotate exclusively around the fourth axis of rotation. Surgical skull holding device (1000) according to one of the preceding claims, wherein the first connection arrangement (301) has a clamp (201) or is connected thereto, for connecting the first connection arrangement (301) to the first arm (101), preferably to the at least one a pin (101s) supporting portion of the first arm (101). Surgical skull holding device (1000) after Claim 7 , the clamp (201) being displaceable along the first arm (101). Surgical skull holding device (1000) after Claim 7 or 8th , wherein the clamp (201) has a threaded screw, but not claws. Rod (401) which, preferably at one end section (401b) thereof, is radially and / or has a rail (403) extending perpendicular to the longitudinal axis (L) of the first rod (401) or connected thereto, for connection to a skull clamp (100) for a surgical skull holding device (1000).

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