JP3181095U - Skull plate - Google Patents

Abstract

Disclosed is a skull plate that can suppress displacement when fitted to a bone defect portion of a skull and can suppress depression into the inside of the skull.
A plate-like main body 2 having an upper surface, a lower surface, and a side surface connected to each of the upper surface and the lower surface, and at least two protrusions 3 positioned on the side surface are provided. A skull plate 1. When viewed from above, at least one of the at least two protrusions 3 has a curved shape with an outer edge protruding outward. Each of the at least two protrusions 3 is located away from each other.
[Selection] Figure 1

Description

  The present invention relates to a skull plate used for cranioplasty.

  Conventionally, a cranioplasty for repairing a bone defect part by fitting a skull plate (hereinafter also referred to as “plate”) to the bone defect part of the skull has been performed (for example, Patent Document 1). reference). The plate used for cranioplasty has a slightly smaller shape than the bone defect so that it can be smoothly fitted to the bone defect, so that when it is fitted to the bone defect, a clearance is formed between it and the bone defect. The The conventional plate has the following problems due to this clearance.

  That is, the conventional plate has a problem that when it is fitted to the bone defect portion, the position is easily displaced due to the clearance, and the time required for positioning is long. Further, the conventional plate has a problem that it easily falls into the inside of the skull due to the clearance. If the plate falls into the inside of the skull, the brain may be compressed, and a step occurs at the boundary between the plate and the skull, so that the quality of life of the patient is lowered.

JP 2005-160646 A

  The subject of this invention is providing the plate for skulls which can suppress the position shift when fitted in the bone defect part of a skull, and can suppress the fall to the inside of a skull.

As a result of intensive studies to solve the above-mentioned problems, the inventor has found a solution means having the following configuration and has completed the present invention.
(1) A plate-shaped main body having an upper surface, a lower surface, and side surfaces connected to the upper surface and the lower surface, and at least two protrusions positioned on the side surfaces. Skull plate.
(2) The skull plate according to (1), wherein at least one of the at least two protrusions has a curved shape with an outer edge convex outward when viewed from above.
(3) The skull plate according to (1) or (2), wherein each of the at least two protrusions is located away from each other.
(4) The skull plate according to any one of (1) to (3), wherein at least one of the at least two protrusions is formed integrally with the main body.
(5) When viewed from above, when at least one of the at least two protrusions has a width of the base end portion as W and a distance from the base end portion to the front end portion as L, the W and the L are , W ≧ L, The skull plate according to any one of (1) to (4).
(6) The skull plate according to any one of (1) to (5), wherein at least one of the at least two protrusions is continuous with the main body in a side view.
(7) The skull plate according to any one of (1) to (6), wherein at least one of the at least two projections has a thickness that decreases toward the distal end.
(8) Any one of the above (1) to (7), wherein at least one of the at least two protrusions has an upper part and a lower part, and the lower part approaches the upper part toward the tip part. A skull plate according to claim 1.
(9) At least one of the at least two protrusions further includes a side portion connected to each of the upper portion and the lower portion and located from the distal end portion to the proximal end portion, (8) A skull plate according to claim 1.
(10) At least one of the at least two projecting portions has a lower portion, and the lower portion has a pair of slope portions intersecting each other, and each of the pair of slope portions in a bottom view. The shape is a triangle, and one of the three vertices of the triangle is located on the distal end side, and the other two are located on the proximal end side, any one of (1) to (9) A skull plate according to claim 1.
(11) The skull plate according to (10), wherein an angle formed by the pair of slope portions is an obtuse angle.
(12) The skull plate according to any one of (1) to (9), wherein at least one of the at least two protrusions has a lower portion, and the lower portion has a curved region.
(13) When the thickness of each of the at least two protrusions is D1, and the thickness of a portion of the skull located in the vicinity of the bone defect is D2, the D1 and the D2 satisfy D1 <D2. The skull plate according to any one of (1) to (12), which has a relationship.

  According to the present invention, it is possible to suppress positional deviation when fitted to the bone defect portion of the skull, and it is possible to shorten the time required for positioning and shorten the operation time. In addition, it is possible to maintain the quality of life of the patient by suppressing the inward depression of the skull.

It is a schematic explanatory drawing which shows the fitting state of the plate for skulls which concerns on one Embodiment of this invention, and the bone defect part of a skull. It is a schematic explanatory drawing which shows the bottomed recessed part vicinity of the skull shown in FIG. It is a figure which shows the fitting state shown in FIG. 1, and is a schematic cross-section explanatory drawing which shows the state which has accommodated the projection part of the skull plate in the bottomed recessed part of a skull. It is a top view (top view) which shows the plate for skulls shown in FIG. It is a side view which shows the plate for skulls shown in FIG. 4, (a) is X1 arrow view of FIG. 4, (b) is X2 arrow view of FIG. 4, (c) is X3 arrow view of FIG. is there. In FIG. 5, the plurality of through holes shown in FIG. 4 are omitted. It is sectional drawing which shows the plate for skulls shown in FIG. 4, (a) is the sectional view on the aa line of FIG. 4, (b) is the expanded sectional view on the bb line of FIG. 4, (c) is FIG. It is a cc line expanded sectional view. In FIG. 6, the plurality of through holes shown in FIG. 4 are omitted. It is a partial expansion perspective view which shows the projection part vicinity of the plate for skulls shown in FIG.

  Hereinafter, a skull plate according to an embodiment of the present invention will be described in detail with reference to FIGS.

  As shown in FIG. 1, the plate 1 according to the present embodiment is fitted to the bone defect portion 101 of the skull 100 to repair the bone defect portion 101. The plate 1 of this embodiment includes a main body 2 and a protrusion 3.

  The main body 2 of the present embodiment has a plate shape corresponding to the shape of the bone defect portion 101 and has a slightly smaller shape than the bone defect portion 101. According to such a configuration, the bone defect portion 101 can be smoothly fitted.

  In addition, as shown in FIGS. 5 and 6A, the main body 2 of the present embodiment has an upper surface 21 located on the scalp side and a lower surface 22 located on the brain side when fitted to the bone defect portion 101. And a side surface 23 connected to each of the upper surface 21 and the lower surface 22.

  As shown in FIGS. 6A, 6 </ b> B, and 7, the main body portion 2 of the present embodiment further includes a chamfered portion 24 that is formed by chamfering the intersection of the lower surface 22 and the side surface 23. According to such a configuration, the bone defect portion 101 can be smoothly fitted.

  As shown in FIGS. 1 and 4, the main body 2 of the present embodiment further has a plurality of through holes 25. Each of the plurality of through holes 25 penetrates from the upper surface 21 to the lower surface 22 and functions as a part for lifting the dura mater of the brain. That is, the dura of the brain can be lifted by inserting the tip of a suture made of nylon, polyester, or the like with the dura mated into the through hole 25 from the lower surface 22 side. In addition, each structure of the some through-hole 25 may mutually be the same, and may differ. In the present embodiment, each of the plurality of through holes 25 has the same configuration as each other and is located at substantially equal intervals.

  Examples of the constituent material of the main body 2 include ceramics, metal, and synthetic resin. Examples of ceramics include alumina and zirconia. Examples of the metal include titanium, a titanium alloy, a cobalt-chromium alloy, and stainless steel (SUS). Examples of the synthetic resin include polymethyl methacrylate resin, polyether ether ketone resin, and ultrahigh molecular weight polyethylene resin. The ultrahigh molecular weight polyethylene resin is a polyethylene resin having a weight average molecular weight of 1,000,000 or more, and can be produced, for example, by increasing the reaction time while reacting the ethylene monomer by a low-pressure suspension polymerization method. The weight average molecular weight of the ultrahigh molecular weight polyethylene resin is usually about 1 million to 7 million.

  The thickness of the main body 2 is usually about 3 to 5 mm, but is not limited to this as long as the strength can be maintained. For example, when a metal or the like is used as the constituent material of the main body 2, the thickness of the main body 2 can be about 1 mm.

  On the other hand, as shown in FIG. 5, the protrusions 3 are located on the side surface 23 of the main body 2 described above, and the number thereof is at least two. According to such a configuration, the following effects can be obtained. That is, as shown in FIG. 2 and FIG. 3, at least two bottomed recesses 102 to be described later that accommodate at least two protrusions 3 are located in a portion of the skull 100 that is located near the bone defect 101. If formed, when the plate 1 is fitted to the bone defect portion 101, the at least two protrusions 3 are respectively guided into the corresponding bottomed recesses 102, so that the positioning of the plate 1 can be performed smoothly and It becomes possible to carry out accurately. In addition, when each of the at least two protrusions 3 is accommodated in the bottomed recess 102, the movement of the plate 1 is constrained by the bottomed recess 102, so that a clearance is provided between the main body 2 and the bone defect 101. Even if is formed, it is possible to suppress displacement of the plate 1 fitted to the bone defect portion 101. Furthermore, when each of the at least two protrusions 3 is accommodated in the bottomed recess 102, a lower portion 35 (described later) of the protrusion 3 comes into contact with the bottom surface 102a of the bottomed recess 102, so that the plate 1 is supported. Even if a clearance is formed between the main body portion 2 and the bone defect portion 101, it is possible to suppress the plate 1 from falling into the skull 100.

  In the present embodiment, the number of protrusions 3 is three. In addition, as long as the number of the projection parts 3 is at least two, it will not be limited to this, According to the position of the bone defect | deletion part 101, a shape, a magnitude | size, etc., a desired number can be employ | adopted. As the upper limit of the number of protrusions 3, about 5 is appropriate, but is not limited to this.

  The configuration of the at least two protrusions 3 may be the same or different from each other. When at least two protrusions 3 have the same configuration, the configuration may be substantially the same. In the present embodiment, the three protrusions 3 have substantially the same configuration.

  Examples of the constituent material of the protrusion 3 include the same ceramics, metal, and synthetic resin as exemplified in the main body 2 described above.

  Here, in the present embodiment, as shown in FIG. 4, the outer edges 31 of the three protrusions 3 are curved outwardly in a top view. According to such a structure, the external force which the outer edge 31 receives at the time of a fitting or during a fitting can be disperse | distributed, and the defect | deletion of the outer edge 31 can be suppressed. This configuration is suitable when ceramics or the like is used as the constituent material of the protrusion 3. The top view means a state in which the plate 1 is viewed from the top surface 21 side.

  Moreover, in this embodiment, each of the three projection parts 3 is located away from each other. According to such a structure, the effect by the projection part 3 mentioned above can be acquired with sufficient balance.

  Each of the three protrusions 3 of this embodiment is formed integrally with the main body 2. According to such a configuration, since the connection strength between the protrusion 3 and the main body 2 is improved, the protrusion 3 can be prevented from falling off the main body 2. In addition, the protrusion part 3 can also be comprised by the main body part 2, and can be attached to the main body part 2.

  In the top view, each of the three protrusions 3 of the present embodiment has W and L such that W ≧ L, where W is the width of the base end portion 32 and L is the distance from the base end portion 32 to the tip end portion 33. It is preferable to have a relationship of L. In the present embodiment, W and L have a relationship of W> L. According to such a structure, since the connection area of the projection part 3 and the main-body part 2 becomes large and both connection strength improves, it can suppress that the projection part 3 falls from the main-body part 2. .

  In addition, the base end part 32 shall mean the wide site | part located in the main-body part 2 side among the protrusion parts 3. FIG. Further, the distal end portion 33 means a portion of the protruding portion 3 that is located on the outermost side with respect to the proximal end portion 32. As the width W and the distance L, about 5 to 10 mm is appropriate, but it is not limited to this.

  Here, as shown in FIG. 5, each of the three protrusions 3 of the present embodiment is continuous with the main body 2 in a side view. The side view means a state in which the plate 1 is viewed from the side surface 23 side. Further, as shown in FIG. 6C, the thickness of each of the three protrusions 3 of the present embodiment becomes smaller as it goes toward the tip end portion 33. More specifically, each of the three protrusions 3 of the present embodiment has an upper part 34 and a lower part 35, and the lower part 35 approaches the upper part 34 toward the distal end part 33. According to such a configuration, the following effects can be obtained.

  That is, as shown in FIG. 3, when each of the three protrusions 3 is accommodated in the bottomed recess 102 of the skull 100, the upper part 34 of the protrusion 3 and the surface 103 of the surrounding skull 100 are substantially formed. Since it becomes easy to become the same height and it becomes difficult to produce a level | step difference in the boundary part of both, the accommodating property of the projection part 3 in the bottomed recessed part 102 can be improved. In addition, the external force applied to the lower portion 35 is dispersed at the time of fitting or during fitting, and the plate 1 is supported by bringing the lower portion 35 into contact with the bottom surface 102a of the bottomed recess 102 while suppressing the loss of the lower portion 35. Can do. Such a configuration is suitable when ceramics or the like is employed as the constituent material of the protrusion 3.

  As shown in FIG. 7, each of the three protrusions 3 of the present embodiment is connected to each of the upper part 34 and the lower part 35, and the side part 36 located from the distal end part 33 to the proximal end part 32 is provided. Also have. According to such a structure, since the intensity | strength of the projection part 3 can be maintained, the defect | deletion of the projection part 3 can be suppressed.

  In order to maintain the strength of the protruding portion 3 at the distal end portion 33, the thickness of the portion of the side portion 36 located at the distal end portion 33 is usually about 2.0 to 3.5 mm. It is not limited to this as long as the strength can be maintained. For example, when a metal, an ultrahigh molecular weight polyethylene resin, or the like is employed as the constituent material of the protruding portion 3, the thickness of the portion located at the distal end portion 33 in the side portion 36 can be set to about 1 mm.

  The lower part 35 of this embodiment has a pair of inclined surface parts 351 and 351 intersecting each other. When viewed from the bottom, each shape of the pair of slope portions 351 and 351 of the present embodiment is a triangle. The bottom view means a state where the plate 1 is viewed from the bottom surface 22 side. Of the three vertices 351a, 351b, and 351c of the triangle described above, one vertex 351a is located on the distal end 33 side, and the other two vertices 351b and 351c are located on the proximal end 32 side. Yes. According to such a configuration, the following effects can be obtained.

  That is, each of the pair of inclined surface portions 351 and 351 of the present embodiment functions as a portion that contacts the bottom surface 102 a of the bottomed recess 102 of the skull 100. Therefore, in the present embodiment, as shown in FIG. 2, the bottom surface 102 a of the bottomed recess 102 has a shape corresponding to the pair of slope portions 351 and 351 described above. Here, such a shape can be formed by, for example, two osteotomy. More specifically, at a site located in the vicinity of the bone defect portion 101 in the skull 100, if osteotomy is first performed in the direction of arrow d and then osteotomy is performed in the direction of arrow e, a total of two bones By cutting, the bottom surface 102a of the bottomed recess 102 can be formed in the specific shape described above. Therefore, according to the above-described configuration, the bottomed recess 102 having the specific bottom surface 102a can be relatively easily formed in a portion of the skull 100 located in the vicinity of the bone defect portion 101, thereby shortening the operation time. be able to. In addition, the order of osteotomy is not limited to the order of the arrow d direction and the arrow e direction described above, but can be the order of the arrow e direction and the arrow d direction.

  In the present embodiment, as shown in FIG. 7, the angle θ formed by the pair of slope portions 351 and 351 is an obtuse angle. According to such a configuration, the strength of the pair of slope portions 351 and 351 in the vicinity of the intersecting line portion 351d is improved, so that defects near the intersecting line portion 351d can be suppressed. This configuration is suitable when ceramics or the like is used as the constituent material of the protrusion 3.

  In the present embodiment, as shown in FIG. 3, when the thickness of each of the three protrusions 3 is D1, and the thickness of a portion of the skull 100 located near the bone defect 101 is D2, D1 And D2 have a relationship of D1 <D2. According to such a configuration, the above-described bottomed recess 102 can be reliably formed in a portion of the skull 100 located in the vicinity of the bone defect portion 101. In addition, what is necessary is just to measure thickness D1, D2 by the maximum thickness among each site | part.

  Next, a method for manufacturing a skull plate according to an embodiment of the present invention will be described taking the case of manufacturing the plate 1 as an example. The manufacturing method of the plate 1 of the present invention includes the following steps (I) to (III).

(I) A step of obtaining three-dimensional data of the skull 100 based on a plurality of tomographic data of the skull 100 having the bone defect portion 101 and obtaining bone shape data of the bone defect portion 101 based on the obtained three-dimensional data.
(II) A step of creating a drawing of the main body 2 based on the obtained bone shape data, further describing at least two protrusions 3 in the drawing, and obtaining a processed drawing.
(III) A step of obtaining the processing data of the plate 1 based on the obtained processing drawing and manufacturing the plate 1 based on the obtained processing data.

  Note that the three-dimensional data in the above-described step (I) can be obtained using an image diagnostic apparatus such as computed tomography (CT) or nuclear magnetic resonance imaging (MRI). In the step (II) described above, it is preferable to position the bottomed concave portion 102 formed in the skull 100 when obtaining the processed drawing. Thereby, cranioplasty can be performed smoothly.

  Moreover, when a metal, synthetic resin, etc. are employ | adopted as a constituent material of the main-body part 2 and the protrusion part 3, manufacture of the plate 1 in process (III) mentioned above can be performed by cutting etc.

  On the other hand, in the case where ceramics or the like is employed as the constituent material of the main body 2 and the protrusion 3, the production of the plate 1 in the above-described step (III) usually includes a firing step. Therefore, in this case, the compact 1 of the plate 1 is produced from the green compact in consideration of the shrinkage rate due to firing, and the compact 1 is fired to obtain the plate 1.

  Next, a cranioplasty according to an embodiment of the present invention performed using the plate 1 described above will be described. The cranioplasty of this embodiment includes the following procedures (i) to (iii).

(I) First, the plate 1 is sterilized and then brought into the operating field.
(Ii) Next, at least two bottomed recesses 102 for accommodating each of the at least two protrusions 3 of the plate 1 are formed in a portion of the skull 100 of the patient located near the bone defect 101.
(Iii) The plate 1 is fitted to the bone defect portion 101 while guiding at least two protrusions 3 into the corresponding bottomed recesses 102, respectively.

  The cranioplasty using the plate 1 of the present embodiment can be performed through the above procedures.

  As mentioned above, although several embodiment which concerns on this invention was illustrated, this invention is not limited to embodiment mentioned above, It cannot be overemphasized that it is arbitrary, unless it deviates from the summary of this invention. .

  For example, in the above-described embodiment, the lower portion 35 of the protruding portion 3 is configured to have a pair of slope portions 351 and 351, but instead, the lower portion 35 can be configured to have a curved region. . Even with such a configuration, it is possible to disperse the external force applied to the lower portion 35 at the time of fitting or during fitting, thereby suppressing the loss of the lower portion 35. Moreover, it can replace with the structure of the above-mentioned embodiment, and can also be set as the structure in which the lower part 35 of the projection part 3 has a level | step difference.

DESCRIPTION OF SYMBOLS 1 Skull plate 2 Main body part 21 Upper surface 22 Lower surface 23 Side surface 24 Chamfering part 25 Through-hole 3 Protrusion part 31 Outer edge 32 Base end part 33 Front end part 34 Upper part 35 Lower part 351 Slope part 351a vertex 351b vertex 351c vertex 351d Intersecting line part 36 Part 100 Skull 101 Bone defect 102 Bottomed recess 102a Bottom 103 Surface

Claims (13)

A plate-like main body having an upper surface, a lower surface, and a side surface connected to each of the upper surface and the lower surface;
At least two protrusions located on the side surface;
A skull plate comprising:   The skull plate according to claim 1, wherein when viewed from above, at least one of the at least two protrusions has a curved shape with an outer edge convex outward.   The skull plate according to claim 1 or 2, wherein each of the at least two protrusions is located away from each other.   The skull plate according to any one of claims 1 to 3, wherein at least one of the at least two protrusions is formed integrally with the main body.   When viewed from above, at least one of the at least two protrusions has a width of the base end portion W, and a distance from the base end portion to the tip end portion L, W and L are W ≧ The skull plate according to any one of claims 1 to 4, which has a relationship of L.   6. The skull plate according to claim 1, wherein at least one of the at least two protrusions is continuous with the main body in a side view.   The skull plate according to any one of claims 1 to 6, wherein at least one of the at least two protrusions has a thickness that decreases toward the distal end. At least one of the at least two protrusions has an upper portion and a lower portion;
The skull plate according to any one of claims 1 to 7, wherein the lower portion approaches the upper portion toward the distal end portion.   9. The skull according to claim 8, wherein at least one of the at least two protrusions further includes a side portion connected to each of the upper portion and the lower portion and located from the distal end portion to the proximal end portion. Plate. At least one of the at least two protrusions has a lower portion;
The lower portion has a pair of slope portions intersecting each other,
In the bottom view, each shape of the pair of slope portions is a triangle, and one of the three vertices of the triangle is located on the distal end side, and the other two are located on the proximal end side. The skull plate according to any one of claims 1 to 9.   The skull plate according to claim 10, wherein an angle formed by the pair of slope portions is an obtuse angle. At least one of the at least two protrusions has a lower portion;
The skull plate according to claim 1, wherein the lower portion has a curved region.   When the thickness of each of the at least two protrusions is D1, and the thickness of a portion of the skull located near the bone defect is D2, the D1 and the D2 have a relationship of D1 <D2. The skull plate according to any one of claims 1 to 12.

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