JP2013153990A - Bone flap with fixing hole - Google Patents

Abstract

PROBLEM TO BE SOLVED: To enable fixing of a bone flap even in the presence of cumbersome work of accurately drilling a small hole with a diameter of 1-2 mm by an air drill or an electric drill during surgery, by pre-drilling a fixing hole for fixing the bone flap in a desired position, concurrently with the formation of the bone flap, according to three-dimensional data, when the bone flap is formed by applying cutting work to an artificial bone block.SOLUTION: When a bone flap with a fixing hole for fixing the bone flap formed from an artificial bone is formed in a defective part of a biological bone, a CT value obtained from computed tomography (CT) is converted to three-dimensional data by a computer; an artificial bone block is NC-cutting-worked on the basis of the three-dimensional data to form the bone flap; and the fixing hole for fixing the bone flap to the defective part of the biological bone is drilled concurrently with the formation of the bone flap.

Description

  The present invention relates to a bone valve with a fixing hole in which a fixing hole for fixing a bone valve formed of an artificial bone to a defect portion of a living bone is formed simultaneously with the formation of the bone valve.

  When a part of a bone is lost due to an accident or a natural malformation, a bone material is generally formed by using a living bone (your own bone) to fill the defect, so-called bone flap. In a case where living bone cannot be used, a bone flap is formed using an artificial bone typified by hydroxyapatite.

  In forming artificial bone flaps, hydroxyapatite, which is a material for artificial bones, is provided in the form of blocks such as rectangular parallelepipeds and cylinders as products, so the shape of the artificial bone block is suitable for filling the defect during surgery. To cut. Conventional cutting has been performed manually using a tool such as a drill or a diamond bar, but the latest method employs CNC cutting by a machine. In CNC cutting, three-dimensional CAD data is created from CT values obtained from computed tomography (CT), and the computer controls the machine according to this data to cut the artificial bone block to form a bone flap. This is a processing method (see Patent Document 1), whereby a filling material matching the defect A is accurately formed.

  On the other hand, even if the bone flap is formed by the processing system shown in Patent Document 1, the fixing means for fixing the bone flap to the defect portion is an elongated shape in which screw holes are formed at both ends after the bone valve is formed. A plate-shaped fixing bracket (see Patent Document 2) or a square plate-shaped fixing bracket (see Patent Document 3) with screw holes formed at four corners is placed between the bone flap and the remaining living bone. A method of fixing with screws is adopted.

JP 2003-126124 A JP 2006-230787 A JP 2004-283575 A

  However, as disclosed in Patent Document 2 and Patent Document 3, in the method of screwing and fixing using a fixing bracket, when the area of the bone flap and the remaining living bone is small, The complicated operation of marking the position corresponding to the screw hole of the fixing bracket on both of the remaining living bones and accurately opening a small hole with a diameter of 1 to 2 mm at both marking positions with an air drill or an electric drill. There were problems such as being necessary inside.

  The present invention has been made in view of the above-described problems. In forming a bone flap by cutting an artificial bone block, fixing for fixing the bone flap at a desired position based on three-dimensional data in advance is performed. By drilling the hole at the same time as the formation of the bone flap, it is possible to fix the bone flap without the complicated operation of accurately drilling a small hole with a diameter of 1 to 2 mm with an air drill or an electric drill during surgery. For the purpose.

  In order to achieve the above object, the bone valve with a fixed hole according to claim 1 is a computer tomography (CT) method for forming a bone valve with a fixed hole for fixing a bone valve formed with an artificial bone to a defect part of a living bone. The CT value obtained from the above is converted into three-dimensional data by a computer, and an artificial bone block is NC-cut based on the three-dimensional data to form a bone flap, and the bone flap is fixed to a living bone defect. A fixing hole is formed at the same time as the formation of the bone flap.

  A bone valve with a fixed hole according to claim 2 is a bone valve with a fixed hole according to claim 1, wherein the fixed hole is a hole for drilling the bone valve in a vertical direction. is there.

  A bone valve with a fixed hole according to claim 3 is the bone valve with a fixed hole according to claim 1, wherein the fixed hole is a hole for drilling the bone valve in a horizontal direction. is there.

  A bone valve with a fixed hole according to claim 4 is the bone valve with a fixed hole according to claim 1, wherein the fixed hole is a hole for drilling the bone valve obliquely downward. is there.

  According to the bone flap with a fixed hole of the present invention, a CT value obtained from computed tomography (CT) in forming a bone valve with a fixed hole for fixing a bone valve formed with an artificial bone to a defect part of a living bone. Is converted into three-dimensional data by a computer, an artificial bone block is NC-cut based on the three-dimensional data to form a bone flap, and a fixing hole for fixing the bone flap to a defect part of a living bone is boned. By drilling at the same time as the formation of the valve, it is possible to accurately drill the fixed hole at the desired position in advance using three-dimensional data, and accurately drill a small hole with a diameter of 1 to 2 mm with an air drill or electric drill during surgery. The complicated work of opening it is no longer necessary.

It is a conceptual diagram which shows the defect | deletion part of a living bone. It is a perspective view which shows embodiment of the bone valve with a fixed hole by this invention. It is a conceptual diagram which shows embodiment which covers and compensates the bone flap with a fixing hole to the defect | deletion part of a living bone. It is a principal part enlarged view of embodiment which compensates the biological bone defect | deletion part shown in FIG. It is a perspective view which shows the conventional bone flap.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. FIG. 1 is a conceptual diagram showing a state in which a part of a bone is lost due to an accident or a natural malformation. In this figure, a part A of the maxilla below the left eye is lost due to a fracture. As a method for filling the bone defect A, generally, a member for filling the defect using a living bone (own bone), that is, a so-called bone flap is formed, and the bone flap is used as the defect A. In the case where the living bone cannot be used, a bone flap B as shown in FIG. 5A is formed using an artificial bone typified by hydroxyapatite. In order to make up for the bone defect A using the bone flap B, as shown in FIG. 5B, the bone flap B is covered with the defect A, but the bone flap B cannot be fixed as it is. As shown in FIG. 5 (c), two fixing brackets K are prepared, and both ends of the bone flap B and the remaining living bone C are screwed and fixed with four screws using the two fixing brackets K.

  However, in the method of screwing and fixing using the fixing bracket K, after forming the bone flap B, the position corresponding to the screw hole KJ of the fixing bracket K is marked on both the bone flap B and the remaining living bone C. Then, a complicated work of accurately opening a small hole having a diameter of 1 to 2 mm at the marked position of the bone flap B and the remaining living bone C with an air drill or an electric drill is required.

  In order to form a bone flap of an artificial bone, hydroxyapatite, which is a material of the artificial bone, is provided in the form of a block such as a rectangular parallelepiped or a cylinder as a product. Therefore, the artificial bone block is suitable for filling a defect during surgery. Cut into shape. Conventional cutting has been performed by hand using a tool such as a drill or a diamond bar, but a recent method employs three-dimensional cutting by a machine, so-called CNC cutting. For CNC cutting, preoperative planning is made from CT values obtained from computed tomography (CT), the desired bone flap is designed with CAD, and three-dimensional CAD data is created. Is a processing method of forming a bone flap by cutting an artificial bone block by controlling the bone, and at that time, a fixing means for fixing the bone flap to a living bone defect can be formed simultaneously with the formation of the bone flap As one embodiment of the fixing means, a bone valve BM having a fixing hole MJ as shown in FIG. 2 is formed.

  Since the fixing hole MJ drilled in the bone flap BM by this method can be created in advance with an accurate position, angle, and direction based on the three-dimensional data, the diameter 1 to The complicated work of accurately opening a 2 mm small hole is eliminated, and the operation time can be shortened.

  In order to compensate the bone defect A using the bone flap BM, as shown in FIG. 3, the bone flap BM is covered with the defect A, and the bone flap BM is fixed to the remaining living bone C. 4 (a) to 4 (c) show specific fixing methods. Generally, as shown in FIG. 4 (a), the fixing hole MJ drilled in the bone valve BM is a bone. This is a hole for drilling the valve BM in the vertical direction, and the remaining living bone C is drilled with a vertical hole and fixed with a thread D and the vertical hole drilled in the bone valve BM.

  When the bone defect A, that is, the bone flap BM has a large thickness, as shown in FIG. 4B, the fixing hole MJ is a hole for drilling the bone flap BM in the horizontal direction, and the remaining living body A horizontal hole is drilled in the bone C and screwed and fixed to the horizontal hole drilled in the bone flap BM from the side surface of the living bone C left. Alternatively, as shown in FIG. 4C, the fixing hole MJ is a hole for drilling the bone flap BM obliquely downward, and is screwed and fixed to the remaining living bone C from above with a screw.

  In this case, if a pin made of hydroxyapatite, which is the same material as the bone flap, is used instead of the screw, the possibility of affecting the ecosystem as a foreign object can be minimized.

  As is clear from the above description, according to the bone valve with a fixed hole of the present invention, in forming a bone valve with a fixed hole for fixing a bone valve formed with an artificial bone to a defect part of a living bone, computer tomography is performed. The CT value obtained from (CT) is converted into three-dimensional data by a computer, the artificial bone block is NC-cut based on the three-dimensional data to form a bone flap, and the bone flap is replaced with a bone defect portion. By drilling a fixation hole for fixation at the same time as the formation of the bone flap, the fixation hole can be precisely drilled at a desired position based on three-dimensional data in advance, and an air drill or electric drill can be used during surgery. The complicated work of accurately opening a small hole having a diameter of 1 to 2 mm is eliminated.

A Bone defect BM Bone flap MJ fixation hole

Claims (4)

  In forming a bone flap with a fixed hole for fixing a bone flap formed of an artificial bone in a defect part of a living bone, a CT value obtained from computer tomography (CT) is converted into three-dimensional data by a computer, and the 3 Forming a bone flap by NC cutting an artificial bone block based on the dimensional data, and simultaneously forming a fixing hole for fixing the bone flap to the defect of the living bone. Bone flap with a fixed hole.   2. The bone valve with a fixing hole according to claim 1, wherein the fixing hole is a hole for drilling the bone valve in a vertical direction.   The bone valve with a fixing hole according to claim 1, wherein the fixing hole is a hole for horizontally drilling the bone valve.   The bone valve with a fixing hole according to claim 1, wherein the fixing hole is a hole for drilling the bone valve obliquely downward.

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