JP2004283575A - Plate for holding bone flap - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a bone flap holding plate for holding a bone flap and covering a bar hole concerning the bone flap holding plate to return the bone flap, which is cut in a craniotomy operation, and hold it. <P>SOLUTION: The plate 10 is made of a metallic plate, so as to cover the bar hole 33 formed in a skull bone 30 in the case of the craniotomy operation, and is formed in a three-dimensional shape to be adapted to the shape of the skull bone of the part. Consequently, the bar hole 33 is covered, and the bone flap 34 fitted to the cut part 35 is held. In this case, it is favorable that the obtained shape is the one for covering the bar hole 33 which is formed in the temple part of the skull bone, and also that a pawl part 14 to be inserted to a spongin part of the cut part in the skull bone or to a small hole formed in the skull bone is arranged. Besides, it is favorable that the plate includes holes 11, 12 for inserting fixing screws and fixing temporal muscle, and also that the thickness of the plate is 0.1-0.6mm. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates to a bone flap holding plate for holding a bone flap resected by a craniotomy operation back to a craniotomy.

  In neurosurgery, for example, a craniotomy operation may be performed to treat a cerebral aneurysm or the like. In this craniotomy operation, for example, the scalp of the temporal region is incised, three holes called bar holes are opened in the temporal region of the skull, and the bone is cut off based on the hole, and the cut bone is cut. After removing the valve and opening the skull, from the opening to treat the root of the aneurysm with a titanium clip so that blood flow does not flow into the aneurysm, return the bone flap to the opening and fix it, It is performed by the procedure of stitching the wound of the scalp.

  As a fixing tool for returning the bone flap to the opening and fixing it, an elongated plate having screw holes formed at both ends or a quadrilateral frame body having screw holes formed at four corners. Plates and the like were used, and these plates were applied between the skull body and the bone flap, and were fixed with screws through screw holes.

  On the other hand, Patent Literature 1 below discloses a surgical connector in which a plurality of ring-shaped portions are connected by three curved ribs extending outward from each ring-shaped portion to form a grid-shaped plate. ing. And it is described that this surgical connector can be easily deformed to fit a bone structure having a compound curvature.

In addition, a bone replacement material made of hydroxyapatite, which blocks a bar hole formed by craniotomy surgery or the like, is also commercially available. The bone replacement material has a shaft inserted into the bar hole and a flange engaged with the periphery of the bar hole.
JP-A-10-277053

  However, the above-described elongated plate having screw holes formed at both ends and a plate having a quadrilateral frame having screw holes formed at four corners are used only for fixing the bone flap to the skull. As a result, a large opening such as a bar hole could not be closed, and the opening such as a bar hole was left as it was.

  For this reason, there has been a problem that the barhole portion is in a depressed state after the treatment. In particular, the bar hole formed in the temple portion has a disadvantage that the temporal muscles arranged in the portion are displaced, so that the bar hole is easily depressed and the human phase after the operation is changed.

  In addition, the lattice-shaped plate described in Patent Literature 1 can be easily deformed into a shape having a compound curve, but it is difficult to deform the plate into a complicated shape such as a temple portion of a skull. It is believed that there is.

  Furthermore, since bone augmentation material composed of hydroxyapatite has a porous tissue, body fluids and the like may permeate into the interior during surgery and cause bacterial contamination and the like. Attention is required.

  Therefore, an object of the present invention is a bone flap holding plate for holding a bone flap resected in a craniotomy operation back to a craniotomy and holding the bone flap and covering a burr hole. It is another object of the present invention to provide a plate for holding a bone flap.

  In order to achieve the above object, a first aspect of the present invention is a bone flap holding plate for holding a bone flap resected in a craniotomy operation back to a craniotomy, which is formed of a metal plate. The present invention provides a plate for retaining a bone flap, wherein the plate covers a bar hole formed in the skull and has a three-dimensional shape adapted to the shape of the skull in that portion.

  According to the above invention, the bony hole formed in the skull at the time of craniotomy operation and a three-dimensional shape conforming to the shape of the skull in that portion are formed. When the plate (hereinafter, referred to as a plate) is brought into contact with the skull body, the plate is fitted and arranged. As a result, the burr hole can be covered to have the original skull shape, and the bone flap can be held without shifting. In addition, since it is formed of a metal plate, problems such as bacterial contamination hardly occur.

  According to a second aspect of the present invention, there is provided a plate for holding a bone flap, which covers the bar hole formed in the temple portion of the skull and has a three-dimensional shape adapted to the shape of the skull in the portion according to the first aspect. Things.

  According to the above-mentioned invention, it is possible to cover the barhole formed in the temple of the skull having a particularly complicated shape in a fitted state, and it is possible to prevent the depression of the portion and the displacement of the bone flap.

  A third aspect of the present invention provides the bone flap retaining plate according to the first or second aspect, wherein the plate has a spongy portion that can be inserted into the spongy portion of the cut portion of the skull or the skull. Things.

  According to the invention, the plate can be easily fixedly arranged by inserting the claw portion into the spongy portion of the cut portion of the skull or the skull, thereby improving workability. In addition, it is possible to prevent the plate from shifting during or after the operation.

  A fourth aspect of the present invention provides the bone flap retaining plate according to any one of the first to third aspects, wherein the plate has a hole for inserting a fixing screw and fixing a temporal muscle. Things.

  According to the above invention, a screw can be inserted through the hole and fixed to the skull body or the bone flap, and the temporal muscle can be fixed by binding the temporal muscle using the hole. .

  According to a fifth aspect of the present invention, there is provided the bone flap retaining plate according to any one of the first to fourth aspects, wherein the plate has a thickness of 0.1 to 0.6 mm.

  According to the above invention, since the thickness is thin, it can be bent, and even if the shape of the skull varies slightly depending on the individual patient, the plate can be slightly bent at the operating site to be adapted to the skull of the individual patient. Can be modified.

  According to a sixth aspect of the present invention, in any one of the first to fifth aspects, a cut-and-raised portion is formed inside a rounded peripheral portion of the bone flap holding plate, and a tip of the cut-and-raised portion is formed. The present invention provides a plate for holding a bone flap having a claw portion formed by bending a portion outwardly of the peripheral portion.

  According to the above invention, the claw portion is formed on the plate, and the peripheral portion of the plate is continuously formed rounded without being cut off in the middle by a slit or the like. Therefore, by inserting the nail portion into the spongy portion of the cut portion of the skull or the skull, the plate can be easily fixed and arranged, and the plate can be firmly covered without denting the bar hole. Therefore, the depression of the barhole can be reliably prevented. In particular, in the barhole near the temple part, even if only a part of the barhole is depressed, a change in the human phase after the operation is conspicuous, so that the plate can be used effectively.

  According to a seventh aspect of the present invention, in any one of the first to fifth aspects, the plate for retaining a bone flap covers the bar hole and forms a three-dimensional shape adapted to the shape of the skull in that portion. A bone valve holding plate body, and a claw member attached to the bone valve holding plate body and inserted into the spongy portion or the skull of the cut portion of the skull, and rounding the bone valve holding plate. A hole for inserting the claw portion of the claw member is formed inside the peripheral edge portion, and an insertion portion for fixing the claw member is formed further inside the hole for inserting the claw member, The claw member has a claw inserted into the claw insertion hole, and an attachment portion inserted into the insertion portion and fixed to the bone flap holding plate body. Is provided.

  According to the above invention, the claw member is not formed integrally with the plate, but is formed separately, and is later attached to the plate body for holding a bone flap (hereinafter, referred to as a plate body). I have. Therefore, unlike the nails formed integrally with the plate, no bending stress is applied when bending, ensuring the strength of the nails and preventing the nails from breaking during or after surgery it can.

  Further, when the mounting portion of the claw member is inserted into the insertion portion formed in the plate, a slight clearance is generated between the mounting portion and the insertion portion. Even after being inserted into the spongy portion of the cut portion, or a hole separately provided in the skull, the position of the plate can be finely adjusted by sliding the plate body.

  According to an eighth aspect of the present invention, in any one of the first to seventh aspects, at least two slits are formed in parallel with the bone flap holding plate, and a band-shaped portion sandwiched by the slits is outwardly formed. An object of the present invention is to provide a plate for retaining a bone flap, which is formed by bending and has a thread insertion hole for binding and fixing the temporal muscle.

  According to the above invention, the band-like portion sandwiched by the slits is curved outward, and a thread insertion hole (hereinafter, referred to as a thread insertion hole) for binding and fixing the temporal muscle is formed. Even after being fixed to the bone flap and the skull with a set screw or the like, the medical thread obtained by bundling the ends of the temporal muscles into the thread insertion hole is smoothly inserted using a medical needle or the like. The temporal muscle can be firmly and easily tied to the thread insertion hole and fixed to the plate.

  Moreover, since the band-shaped portion is gently curved, after fixing the plate and covering the scalp, the band-shaped portion hardly bites into the scalp, and even when a hard object is hit or a shock is applied. Since the belt-shaped portion is deformed, it is hard to bite into the scalp, and it is safe.

  According to the plate for holding a bone flap of the present invention, it covers the bar hole formed in the skull at the time of craniotomy operation, and has a three-dimensional shape adapted to the shape of the skull in that portion, so that it covers the bar hole. By abutting the plate, the plate is fitted and arranged at the joint between the bone flap and the skull body, and covers the bar hole to return to the original skull shape, so that the bone flap can be held without shifting. In addition, since it is formed of a metal plate, problems such as bacterial contamination hardly occur.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. The present invention is not limited only to these embodiments.

  FIG. 1 shows a first embodiment of a bone flap retaining plate according to the present invention. FIG. 3A is a perspective view of the same plate viewed from the convex side, and FIG. 2B is a perspective view of the same plate viewed from the concave side.

  The bone flap retaining plate 10 is formed of a biocompatible metal such as titanium, a titanium alloy, and stainless steel.

  The thickness of the plate 10 is not particularly limited, but is preferably 0.1 to 0.6 mm, and more preferably 0.2 to 0.4 mm. If the thickness is less than 0.1 mm, sufficient strength cannot be obtained, and if the thickness exceeds 0.6 mm, it becomes difficult to modify the shape so as to fit an individual patient.

  The plate 10 is formed in a three-dimensional shape so as to cover a bar hole formed in the temple portion of the skull at the time of craniotomy and to fit around the skull shape. The barhole formed in the temple portion may be particularly called a keyhole.

  The plate 10 has a relatively small hole 11 suitable for inserting a screw for fixing to a skull body or a bone flap, and a relatively large rectangular hole 12 suitable for binding and fixing a temporal muscle. have.

  Further, a claw portion 14 protrudes from one of the intersections of the lattice portion 13 surrounding the rectangular hole 12. The claw portion 14 is formed so as to project obliquely outward with respect to the convex curved surface of the plate 10 and has a slightly sharp tip.

  For example, this plate 10 is formed by punching a metal plate made of the above-described material having the above-mentioned thickness into a planar shape having the above-described contour and hole, and then press-forming the plate into a three-dimensional shape. Can be manufactured by

  The surface of the plate 10 may be coated with a biocompatible resin film such as a fluororesin, a silicone resin, or a polyurethane resin.

  FIG. 2 shows a second embodiment of a bone flap retaining plate according to the present invention. FIG. 3A is a perspective view of the same plate viewed from the convex side, and FIG. 2B is a perspective view of the same plate viewed from the concave side.

  The bone flap retaining plate 20 is also made of a metal plate having the same material and thickness as the above-described embodiment, and covers a bar hole formed in the temple portion of the skull at the time of craniotomy, and has a skull shape around it. It is formed into a three-dimensional shape that fits.

  However, in the plate 20, a plurality of holes 21 having the same inner diameter are formed at substantially equal intervals from the periphery to the center of the plate 20. Further, a pair of parallel slits 22 and 23 are formed from one location of the peripheral edge of the plate 20, and a claw portion 24 separated by these slits 22 and 23 is formed. The claw portion 24 is formed so as to slightly protrude from the peripheral edge of the plate 20, and the tip portion is bent slightly obliquely.

  The plate 20 for holding the bone flap can insert a fixing screw through the hole 21 and can also bind a temporal muscle or the like. Further, since the claw portion 24 protrudes from the peripheral edge of the plate 20, it is easy to pierce the spongy portion of the cut portion of the skull, a hole provided separately in the skull, and the like.

  3 to 6 show an example of a method for using the plate for holding a bone flap according to the present invention. FIG. 3 is an explanatory view showing a state in which the bone flap is removed from the skull main body, FIG. 4 is an explanatory view showing a state in which the bone flap is returned and fixed to the craniotomy of the skull main body, and FIG. 5 is a view showing the temporal muscle fixed to the plate. FIG. 6 is a partial cross-sectional view schematically illustrating a cross-sectional structure of a skull.

  At the time of craniotomy for treatment of an intracerebral aneurysm or the like, three bar holes 31, 32, and 33 are formed in the temporal region of the skull 30, after the scalp is cut open, as shown in FIG. Then, the bone flap 34 is cut out by cutting the skull 30 based on the bar holes 31, 32, and 33. An aneurysm or the like is clipped from the craniotomy 35 formed by cutting the bone flap 34 in this manner. Specifically, after treating the aneurysm by clipping it with a clip made of titanium or the like, as shown in FIG. 4, the bone flap 34 is fitted and fixed in the craniotomy 35, and as shown in FIG. After the temporal muscles 50 and the like are arranged at the original positions, the scalp is sewn and the operation is completed.

  In this embodiment, after fitting the bone flap 34 into the craniotomy 35, the bone flap 34 is fixed to the skull 30 with the titanium frame-shaped fixing plate 40 and the set screw 41, and formed in the temple portion. The bone flap retaining plate 10 of the present invention is arranged so as to cover the bar hole 33.

  The frame-shaped fixing plate 40 has a quadrangular shape, and holes 42 are formed at four corners thereof. Then, the two holes 42 of the fixing plate 40 are fixed to the bone flap 34 with the set screws 41, and the remaining two holes 42 are fixed to the skull (skull body) 30 with the set screws 41. Is fixed to the skull 30. It is preferable to use about two fixing plates 40.

  On the other hand, the plate 10 for holding a bone flap of the present invention is disposed so as to cover the bar hole 33 formed in the temple and the periphery thereof. At this time, the plate 10 can be easily fixed by piercing the claw portion 14 of the plate 10 into the spongy portion 36 (see FIG. 6) of the cut portion of the skull 30. The spongy portion 36 is a porous and soft tissue formed in the middle of the bone in the thickness direction, and can easily pierce the claw portion 14. The claws 14 thus pierced are firmly fixed because they are sandwiched between the dense portions 37 formed on the front and back surfaces of the skull 30.

  It is also possible to artificially make a small hole in an appropriate position of the skull 30 and insert and fix the claw portion 14 in this hole. Further, by inserting a set screw through the hole 11 of the plate 10 and fixing the set screw to the skull 30 or the bone flap 34, it is possible to more firmly fix the set screw.

  Since the bone flap retaining plate 10 of the present invention is formed into a three-dimensional shape that conforms to the shape of the temple of the skull 30, the bone flap 34 is shifted to the correct position by abutting the plate 10. And the original skull shape can be covered by covering the bar holes 33.

  Further, a part of the temporal muscle 50 shown in FIG. 5 is peeled off from the skull at the time of craniotomy, but after the bone flap 34 is returned to the craniotomy and fixed, as shown in FIG. It can be repositioned and tied and secured to the bone flap retaining plate 10 of the present invention. At this time, the temporal muscle 50 can be bound using the holes 12 and the grid-like portion 13 of the plate 10. As a result, displacement of the temporal muscle 50 can be prevented.

  As described above, by using the bone flap retaining plate 10 of the present invention, the bar hole 33 formed in the temple portion of the skull 30 can be covered and returned to the original skull shape, and the temporal muscle 50 can be bound. Since the fixation can be performed, a depression or the like after the operation does not occur, and a change in the human phase can be prevented.

  In this example, the plate 10 for holding the bone flap shown in FIG. 1 is used, but the plate 20 for holding the bone flap shown in FIG. 2 can be used in a similar manner.

  Also, in the embodiment shown in FIGS. 1 and 2, the plate is formed with holes and claws, but even if the plate does not have both holes or claws, it covers the bar hole. By abutting the plate as described above, the fine movement of the bone flap is suppressed, and this has an effect on depression and elevation of the bone flap.

  7 to 11 show a third embodiment of a plate for holding a bone flap according to the present invention. It is to be noted that the same parts as those of the above-described embodiment are denoted by the same reference numerals, and description thereof will be omitted.

  The bone flap retaining plate 60 is also made of a metal plate having the same material and thickness as the previous embodiment, and covers a bar hole formed in the temple portion of the skull at the time of craniotomy, and has a skull shape around it. It is formed into a three-dimensional shape that fits.

  The difference of the plate 60 from the above embodiment lies in the shape of the claw portion 64 and the method of forming the claw portion 64. As shown in FIG. 7, the plate 60 has a cut-and-raised portion 63 formed by a U-shaped cut 62 inside a rounded peripheral portion 61. The cut-and-raised portion 63 is bent toward the outside of the peripheral edge portion 61 to form a claw portion 64. In addition, cut-and-raise refers to, for example, forming a predetermined shape cut in a plate-shaped member, and bending a portion separated from the plate-shaped member by the cut to form a predetermined shape.

  In the case of the third embodiment, the cut-and-raised portion 63 is formed by a U-shaped cut 62. However, the cut 62 may be formed in a V-shape, an arc shape, or the like. It is only necessary that a part which can be cut and raised be separated by the above.

  Further, at a predetermined position of the plate 60, at least two or more slits 65, 65 are formed in parallel. The band portion 66 sandwiched between the slits 65 is curved outward to form a thread insertion hole 67. Since the band portion 66 is gently curved, after the plate 60 is fixed and covered with the scalp, it is difficult for the band portion 66 to bite into the scalp, and even when a hard object is hit or a shock is applied. Since the belt-like portion 66 is deformed, it is difficult to bite into the scalp, and it is safe.

  In the case of the third embodiment, the slits 65 are formed substantially in parallel. However, the slits 65 may be formed obliquely, for example, in a C-shape. What is necessary is just to be able to form. Further, in the above-described first and second embodiments and a fourth embodiment to be described later, the slits 65 may be formed, and the strip portion 66 and the thread insertion hole 67 may be formed.

  The plate 60 is used in the same manner as the first plate 10 and the plate 20 of the second embodiment. After the scalp is cut open, as shown in FIG. The burr holes 31, 32, and 33 are formed, the bone flap 34 is cut out, and the aneurysm and the like are clipped from the craniotomy 35. Thereafter, as shown in FIG. 9, the bone flap 34 is fitted into and fixed to the craniotomy 35, the bone flap 34 is fixed to the skull 30 with the fixing plate 40 and the set screw 41, and the bar formed in the temple portion is formed. The plate 60 is arranged so as to cover the hole 33.

  At this time, the claw portion 64 is formed on the plate 60, and the peripheral edge portion 61 of the plate 60 is continuously formed rounded without being cut off in the middle by a slit or the like. The plate 60 can be easily fixed and arranged by piercing the claw portion 64 into the spongy portion 36 of the cut portion of the skull 30, and the plate 60 can firmly cover the bar hole 33 without denting it. . Therefore, the depression of the bar hole 33 can be reliably prevented. In particular, in the barhole 33 near the temple, even if a part of the barhole 33 is depressed, a change in the human phase after the operation is conspicuous, so that the plate 60 can be applied effectively.

  Further, the thread insertion hole 67 is formed in the plate 60 as described above, and the medical thread in which the temporal muscles 50 are bundled is inserted so that the temporal muscles 50 can be bound and fixed to the plate 60. It has become. The procedure at this time is shown in FIGS. 10 (A), (B) and FIG.

  That is, as shown in FIG. 10 (A), when the bone flap 34 is cut off, the ends of the temporal muscles 50 which are peeled off from the skull 30 and are in a separated state are grouped together with a medical thread 81. And bundle them. Next, the distal end of the medical thread 81 is inserted into a hole provided at the base end of the medical needle 80 and pulled out.

  Then, as shown in FIG. 10 (B), the medical needle 80 is inserted from one end of the thread insertion hole 67 of the plate 60 from the tip thereof, and the medical needle 80 is pulled as it is, thereby connecting the medical thread 81. The thread is inserted through the thread insertion hole 67, and is extracted to the opposite side of the thread insertion hole 67.

  Thereafter, the medical thread 81 is pulled, the portion where the ends of the temporal muscles 50 are bundled is pulled to the vicinity of the thread insertion hole 67, and the temporal muscles 50 are attached to the band portion 66 by the medical thread 81, thereby attaching the temporal muscle 50 to the plate 60. (See FIG. 11).

  As described above, according to the thread insertion holes 67 formed in the plate 60, even after the plate 60 is fixed to the bone flap 34 and the skull 10 with the set screw or the like, the ends of the temporal muscle 50 are put together. The medical thread 81 tied to the band is smoothly inserted into the thread insertion hole 67 using the medical needle 80 or the like, and the temporal muscle 50 is firmly and easily tied to the band-shaped portion 66 and fixed to the plate 60. It becomes possible.

  FIG. 12 shows a fourth embodiment of the bone flap retaining plate according to the present invention. It is to be noted that the same parts as those of the above-described embodiment are denoted by the same reference numerals, and description thereof will be omitted.

  The bone flap holding plate 70 is also made of a metal plate having the same material and thickness as the above-described embodiment, and covers a bar hole formed in the temple portion of the skull at the time of craniotomy, and has a skull shape around it. It is formed into a three-dimensional shape that fits.

  The plate 70 is different from the above embodiment in that the claw portions are formed separately. As shown in FIG. 12, the plate 70 covers the burr holes 31, 32, and 33, and has a three-dimensional shape corresponding to the shape of the skull 10 at the portion thereof. And a claw member 74 attached to the main body 71.

  The plate body 71 has a claw insertion hole 72 for inserting the claw 74a of the claw member 74 inside the rounded peripheral portion 61. Further, a pair of insertion portions 73, 73 for fixing the claw member 74 are formed inside the claw portion insertion hole 72 and on both sides thereof.

  In the case of this embodiment, the claw member 74 has a substantially T-shape. The claw member 74 a is inserted into the claw insertion hole 72, and is inserted into the insertion portions 73, 73 and fixed to the plate body 71. Mounting portions 74b, 74b. The claw member 74 may have a Y-shape or an L-shape. The claw member 74 may be appropriately shaped according to the shapes of the claw insertion hole 72 and the insertion portion 73 formed in the plate main body 71. It is determined.

  Then, after the claw portion 74a is inserted into the claw portion insertion hole 72, the attachment portions 74b, 74b are inserted into the insertion portions 73, 73, whereby the claw member 74 can be attached to the plate body 71. The attachment portions 74b, 74b of the claw member 74 are inserted into the insertion portions 73, 73 of the plate body 71, and then the claw portion 74a of the claw member 74 is inserted into the claw insertion hole 72 of the plate body 71. It can also be attached by doing.

  According to the plate 70, the claw member 74 is not formed integrally with the plate as in the other embodiments, and no bending stress is applied when the claw portion is bent. Can be secured, and the nail portion 74a can be prevented from breaking during or after the operation.

  Further, when the mounting portions 74b, 74b of the claw member 74 are inserted into the insertion portions 73, 73 formed in the plate body 71, a slight clearance is provided between the mounting portions 74b, 74b and the insertion portions 73, 73. Occurs. Therefore, even after inserting the claw portion 74a of the claw member 74 into the spongy portion 36 of the cut portion of the skull 10 or a hole separately provided in the skull, the plate main body 71 is slid to finely adjust the arrangement position. be able to.

  When the bone flap resected in a craniotomy operation is returned to the craniotomy and held, the present invention fits the joint between the bone flap and the skull body and shifts the bone flap to the original skull shape. It can be used as a bone flap holding plate that can be held so as not to be held.

1A and 1B show a first embodiment of a plate for holding a bone flap according to the present invention, in which FIG. 1A is a perspective view of the plate seen from the convex side, and FIG. 2B is a perspective view of the plate seen from the concave side. 2A and 2B show a second embodiment of a plate for holding a bone flap according to the present invention, wherein FIG. 2A is a perspective view of the plate seen from the convex side, and FIG. 2B is a perspective view of the plate seen from the concave side. It is explanatory drawing which shows the state which removed the bone flap from the skull main body. It is explanatory drawing which shows the state which returned and fixed the bone valve to the craniotomy of the skull main body. It is explanatory drawing which shows the state which fixed the temporal muscle to the plate. It is a fragmentary sectional view showing typically section structure of a skull. FIG. 8 shows a third embodiment of a plate for holding a bone flap according to the present invention, wherein (A) is a perspective view of the plate seen from the concave side, and (B) is a perspective view of the plate seen from the convex side. It is explanatory drawing which shows the state which removed the bone flap from the skull main body at the time of using the valve holding plate. It is explanatory drawing which shows the state which fixed the bone flap to the craniotomy of the skull main body using the plate for bone flap holding. Fig. 4A shows a procedure for fixing a temporal muscle to the plate for holding a bone valve, Fig. 4A is a perspective view showing a state in which a medical thread is inserted through a hole of a medical needle, and Fig. 4B is a medical view. FIG. 3 is a perspective view showing a state in which a thread for use is inserted through a thread insertion hole for ligating temporal muscle. It is a perspective view which shows the state which fixed the temporal muscle to the plate for bone valve retention. It is a perspective view showing a 4th embodiment of a plate for bone valve maintenance by the present invention.

Explanation of reference numerals

10, 20, 60, 70 Bone flap retaining plates 11, 12, 21 Holes 14, 24, 64, 74a Claws 30 Skulls 31, 32, 33 Burholes 34 Bone flaps 35 Open heads 36 Spongiosa part 40 Fixing plate 50 Temporal muscle 61 Peripheral edge 63 Cut-and-raised portion 65 Slit 66 Band-shaped portion 67 Thread insertion hole 71 Bone valve holding plate body 72 Claw insertion hole 73 Insertion portion 74 Claw member 74b Mounting portion

Claims (8)

  A bone flap holding plate for holding a bone flap resected in a craniotomy operation back to a craniotomy, which covers a bar hole formed of a metal plate and formed in a skull during a craniotomy operation, A plate for retaining a bone flap, wherein the plate has a three-dimensional shape that conforms to the shape of the skull.   2. The plate for retaining a bone flap according to claim 1, wherein the plate covers a bar hole formed in the temple portion of the skull and has a three-dimensional shape adapted to the shape of the skull in that portion.   The plate for retaining a bone flap according to claim 1, wherein the plate has a spongy portion that can be inserted into the spongy portion of the cut portion of the skull or the skull.   The plate for retaining a bone flap according to any one of claims 1 to 3, wherein the plate has holes for inserting a fixing screw and for fixing a temporal muscle.   The plate for retaining a bone flap according to any one of claims 1 to 4, wherein the thickness of the plate is 0.1 to 0.6 mm.   A cut-and-raised portion is formed inside the rounded peripheral portion of the bone flap holding plate, and a claw portion is formed by bending a tip portion of the cut-and-raised portion toward the outside of the peripheral edge portion. Item 6. A plate for retaining a bone flap according to any one of Items 1 to 5. The bone flap holding plate covers the burr hole and has a three-dimensionally shaped bone flap holding plate body conforming to the shape of the skull in that portion, and is attached to the bone flap holding plate body, Claw member inserted into the spongy portion or skull of the cut part of the skull,
A hole for inserting the claw portion of the claw member is formed inside the rounded peripheral portion of the bone flap retaining plate, and the claw member is fixed further inside the claw insertion hole. The insertion part of is formed,
The claw member includes a claw inserted into the claw insertion hole, and an attachment portion inserted into the insertion portion and fixed to the bone valve holding plate body. 6. The plate for retaining a bone flap according to any one of 5. At least two slits are formed in parallel with the bone flap holding plate, and a band-shaped portion sandwiched by the slits is formed by curving outward, and has a thread insertion hole for binding and fixing the temporal muscle. The plate for retaining a bone flap according to any one of claims 1 to 7, wherein the plate is provided.

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