JP3217266U - Barhole plate - Google Patents

Abstract

Provided is a bar hole plate which is provided with a drain tube and which can easily protect a non-circular bar hole.
A bar hole plate 30 for protecting a skull is formed in a substantially U shape having two projecting portions 32a and 32b and an intermediate portion 36 connecting between the two projecting portions 32a and 32b. In the vicinity of the outer periphery of the intermediate portion 36, screw holes 40a, 40b, 40c, and 40d that are screwed to the skull around the bar hole are provided on the auxiliary circle 54. In the vicinity of the projecting ends of the two projecting portions 32 a and 32 b, screw holes to be screwed to the skull are provided outside the auxiliary circle 54. A drain tube penetrating the bar hole is passed through the substantially U-shaped cutout 37.
[Selection] Figure 3

Description

  The present invention relates to a bar hole plate for protecting a bar hole provided in a skull.

  In head surgery, a skull may be opened by using a medical drill or the like to make a plurality of holes (referred to as “barholes”) and then cutting the skull between the barholes. At the end of the surgery, the barhole is covered and protected by a cover called a barhole plate.

  The following Patent Document 1 discloses a bar hole plate having a drain tube hole at the center. The drain tube is installed for the purpose of removing drainage or monitoring after surgery. The bar hole plate is formed in a substantially circular shape, and a plurality of screw holes provided near the outer periphery are also arranged on the same circle.

  Patent Document 2 listed below discloses an artificial bone filling material having a cutout portion through which a drain tube passes.

  For example, as described in Non-Patent Document 1 and Non-Patent Document 2 below, a bar hole plate having a notch through which a drain tube passes is currently sold by a plurality of companies. Since the bar hole is circular, these bar hole plates are formed in a circular shape, and a plurality of screw holes for fixing the bar hole plate to the skull are also arranged in the same circular shape.

Special Table 2002-510992 Japanese Utility Model Publication No. 5-21914

Catalog of "BEAR PLATE SYSTEM", Bear Medic Co., Ltd. Product No .: NS-50012B-DC, [online], date not posted, [April 27, 2018 search], Internet URL: http://www.bearmedic.co.jp/library/55066c20daa60f3c4a000e39/552c62ed8fa251906a000053.pdf

  When the bar hole to be protected is formed in a flat shape instead of a circular shape for some reason, it may be difficult to use a circular bar hole plate.

  An object of the present invention is to realize a bar hole plate which is provided with a drain tube and which can easily protect a non-circular bar hole.

  The bar hole plate according to the invention of claim 1 is a bar hole plate that protects a bar hole provided in the skull, and is formed in a substantially U shape having two projecting parts and an intermediate part connecting the two projecting parts, Near the outer periphery of the intermediate portion, a screw hole to be screwed to the skull around the bar hole is provided on a substantially arc, and in the vicinity of the protruding ends of the two protruding portions, A screw hole to be screwed to the skull is provided outside a circle on which the arc rides, and a drain tube penetrating the bar hole is passed through the substantially U-shaped inner notch, It is characterized by that.

  The radius of the circle on which the screw hole provided in the protruding portion rides can be variously set according to the size and shape of the bar hole. For example, a circle on which a screw hole provided in the middle portion rides (center position is C1 and a radius is r1), and a circle on which a screw hole provided in the protrusion portion rides (the center position is the center position C1 of the previous circle). The ratio of R1 to r1 (that is, the value of R1 / r1) is 1.02 times or more, 1.03 times or more, 1.04 times or more, 1.05 times. As mentioned above, it can be 1.07 times or more, 1.1 times or more, 1.15 times or more, 1.2 times or more, 1.3 times or more, and further 1.5 times or more. Moreover, you may set the upper limit of this ratio.

  From another point of view, it is conceivable that R1 is longer than the half width of a typical osteotomy line, or longer than r1. Specifically, assuming that the width of a typical osteotomy line is about 1 mm to 3 mm, the length of R1 is 0.5 mm or more, 1 mm or more, 2 mm or more, 2.5 mm or more, 3 mm compared to r1. For example, a mode in which the length is increased by 4 mm or more can be given. Moreover, you may define the upper limit of this length.

  The bar hole plate according to the invention of claim 2 is a bar hole plate that protects a bar hole provided in the skull, and the outer peripheral shape of the bar hole plate is an arc portion formed in a substantially arc shape; A projecting part formed in a shape projecting outward from a circle on which the arc is placed on both ends of the arc part, and an inner side from the circle on which the arc is placed on the opposite side of the arc part between the projecting parts. And a screw that is screwed to the skull around the bar hole in the vicinity of the outer periphery of the arc portion. A hole is provided, and a screw hole to be screwed to the skull around the bar hole is provided in the vicinity of the outer periphery of both the projecting portions.

  The degree of protrusion of the protrusion can be variously set according to the size and shape of the bar hole. For example, a circle on which the arc portion rides (center position is C2 and radius is r2) and a circle on which the protruding end of the protrusion portion rides (the center position is the same as the center position C2 of the previous circle and the radius is R2) The ratio of R2 to r2 is 1.02 times or more, 1.03 times or more, 1.04 times or more, 1.05 times or more, 1.07 times or more, 1.1 times or more, 1.15 Double or more, 1.2 or more, 1.3 or more, or even 1.5 or more. Moreover, you may set the upper limit of this ratio.

  From another point of view, the R2 is equal to or more than the half width of a typical osteotomy line compared to the r2, that is, 0.5 mm or more, 1 mm or more, 2 mm or more, 2.5 mm or more, A mode in which the length is 3 mm or longer or 4 mm or longer is conceivable. You may define the upper limit of this length.

  According to the first aspect of the present invention, it is easy to fix around a bar hole having an elongated shape such as an ellipse.

  According to the invention of claim 2, it is easy to cover and protect the bar hole having an elongated shape such as an ellipse.

It is a figure which shows the position of the frontotemporal craniotomy in a skull. It is a figure which shows the bar hole in the frontotemporal craniotomy vicinity, an osteotomy line, and a bone fragment. It is a top view of the bar hole plate concerning Embodiment 1. FIG. It is a figure which shows the aspect which bone-fixes a bar hole using the bar hole plate concerning Embodiment 1. FIG. It is a top view of the barhole plate concerning Embodiment 2. It is a top view of the bar hole plate concerning a reference form. It is a figure which shows the aspect which bone-fixes a bar hole using the bar hole plate concerning a reference form.

  Hereinafter, embodiments will be described with reference to the drawings. In the description, specific aspects are shown for ease of understanding, but these are examples of the embodiments, and various other embodiments can be taken.

[Embodiment 1]
FIG. 1 is a side view showing a skeleton of a head including a human skull 10. FIG. 1 illustrates the position of frontotemporal craniotomy of the pterional approach, which is the most frequently performed approach in the field of neurosurgery. In the illustrated example, three circular bar holes 12, 14, 16 penetrating the skull 10 are opened by, for example, a medical drill. The osteotomy line 18 connecting the bar holes 12 and 14, the osteotomy line 20 connecting the bar holes 14 and 16, and the osteotomy line 22 connecting the bar holes 16 and 12 are lines that cut the skull 10 using a medical saw or the like. It is. In this way, the open head 24 surrounded by the bar holes 14, 16, 18 and the osteotomy lines 18, 20, 22 is formed. The osteotomy lines 18, 20, 22 are generally provided outside the center of the bar holes 12, 14, 16 so that the open head 24 is wide. The diameter of the bar holes 12, 14, 16 is, for example, about 18 mm, and the width of the osteotomy line 18 is, for example, about 1 mm to 3 mm.

  FIG. 2 is a view showing the vicinity of the open head 24 shown in FIG. Here, in the latter half of the operation, a state in which the cut bone fragment 26 of the skull 10 is returned to the open head 24 is shown. In this process, the bone piece 26 is generally fixed toward the front (face side) so that the osteotomy lines 20 and 22 near the face are not conspicuous in consideration of the adjustment surface. For this reason, in the vicinity of the bone cutting line 18 on the rear side, the gap is increased by the amount corresponding to the filling of the bone cutting lines 20 and 22. Further, the bar holes 12 and 14 in the vicinity also have an oval shape elongated from the original circular shape. In the case of the oval bar hole 14, the short axis is about 18 mm and the long axis is about 19 to 21 mm, and the long axis is about 1.05 to 1.15 times longer than the short axis. Yes.

  FIG. 3 is a plan view of the bar hole plate 30 according to the first embodiment. The bar hole plate 30 is a member used to protect the bar hole 14 and is formed in a substantially U shape (a shape that can be regarded as a U shape when viewed roughly), including a shape close to a C shape or a V shape. ing. Specifically, it comprises two projecting portions 32a and 32b extending upward and an intermediate portion 36 connecting these. While being sandwiched between the protrusions 32a and 32b, a notch 37 is formed which is recessed inward. In addition, the notch part 37 is a name based on a shape characteristic, and includes not only a part made by cutting a member in a manufacturing process but also a part made by other manufacturing methods (for example, molding).

  In FIG. 3, for convenience of explanation, a center 50 and three auxiliary circles 52, 54, 56 centered on the center 50 are drawn as auxiliary lines. In the example of FIG. 3, the most concave portion of the notch portion 37 is recessed with a size that reaches the center 50. The rough outer peripheral shape of the intermediate portion 36 is an arc portion riding on the auxiliary circle 52 (for convenience, the auxiliary circle 52 is drawn slightly outward so that the lines do not overlap). Then, four semicircular protrusions 38a, 38b, 38c, and 38d are provided at substantially equal intervals on the outer side of the arc portion. The outermost sides of the protrusions 38a, 38b, 38c, and 38d are formed so as to ride on the auxiliary circle 56. For this reason, it can be said that the projections 38a, 38b, 38c, and 38d also form an arc portion on the auxiliary circle 56. In addition, screw holes 40a, 40b, 40c, and 40d, which are through holes, are provided inside the protrusions 38a, 38b, 38c, and 38d, respectively. These screw holes 40a, 40b, 40c, and 40d are holes through which screws for fixing to the skull 10 are passed, and are formed to have a slight taper around the screw according to the size and shape of the screw. Yes. The screw holes 40 a, 40 b, 40 c, and 40 d are arranged such that their centers are on the arc that rides on the auxiliary circle 54.

  Inside the screw holes 40a, 40b, 40c, and 40d, through-holes 42a, 42b, 42c, and 42d having substantially triangular shapes are provided in consideration of material mobility, design, and processability, respectively. Further, inward cuts 44a, 44b, and 44c are provided between the screw holes 40a, 40b, 40c, and 40d. By using these cuts 44a, 44b, 44c to slightly bend the intermediate portion 36, it is possible to adjust the three-dimensional shape to match the skull 10 of the patient.

  The leading ends (protruding ends) of the projecting portions 32 a and 32 b have a shape projecting not only to the auxiliary circles 52 and 54 but also to the outside of the auxiliary circle 56. And screw hole 46a, 46b is provided in the protrusion end vicinity of protrusion part 32a, 32b, respectively. The centers of the screw holes 46a, 46b are located outside the auxiliary circle 54 on which the centers of the screw holes 40a, 40b, 40c, 40d of the intermediate portion 36 ride, and are arranged at positions so as to ride on the auxiliary circle 56. Has been.

  For example, the bar hole plate 30 can be formed by punching a metal plate such as titanium or a titanium alloy and then processing it so as to have a predetermined curvature. Further, for example, a resin having good biocompatibility can be formed by molding.

  Next, a usage mode of the bar hole plate 30 will be described with reference to FIG. FIG. 4 is a view corresponding to FIG. 2 and shows a state in which the bone fragment 26 is fixed using three plates. The plates used for fixing are the bar hole plate 30 shown in FIG. 3, another type of bar hole plate 60, and a mesh-like plate 70.

  The bar hole plate 30 is disposed so as to cover the bar hole 14. Specifically, the middle part 36 is located on the bone piece 26 side, and the protrusions 32a and 32b are located on the surrounding skull 10 side. At this time, the barhole plate 30 is fixed to the bone fragment 26 by inserting screws into the screw holes 40b, 40c, and 40d and screwing the bone fragment 26. Then, a drain tube (not shown) protruding from the bar hole 14 is set in the notch 37, and then the bone fragment 26 is installed at the position shown in FIG. The bar hole plate 30 is fixed to the surrounding skull 10 by inserting screws into the screw holes 46a and 46b and fastening them. However, in the illustrated example, one screw hole 40 a of the intermediate portion 36 is located on the outer periphery of the bone fragment 26, and a part thereof is engaged with the osteotomy line 18. In such a state, a screw may not be inserted into the screw hole 40a.

  As described above, the bar hole 14 protected by the bar hole plate 30 is an oval hole having a larger area than when opened by a medical drill. For this reason, when a circular plate is used instead of the bar hole plate 30, it is necessary to prepare a large-sized plate based on the major axis of the ellipse. On the other hand, the bar hole plate 30 is formed long in the direction in which the protrusions 32a and 32b extend. By aligning this direction with the major axis direction of the bar hole 14, it is possible to protect the bar hole 14 while having a relatively small size.

  For the bar hole 12, a substantially circular bar hole plate 60 having no hole through which the drain tube passes is used. The plate 70 is a member formed in a mesh and covers not only the bar hole 16 but also a part of the osteotomy line 22. In this way, it is possible to select an appropriate plate according to the part to be used and the purpose.

[Embodiment 2]
With reference to FIG. 5, the bar hole plate 80 concerning 2nd Embodiment is demonstrated. FIG. 5 is a plan view of the bar hole plate 80. In the drawing, the same center 50 as in FIG. 3 and auxiliary circles 52, 54, and 56 centering on the same are shown.

  The bar hole plate 80 is formed in a substantially U shape like the bar hole plate 30. Specifically, it consists of two projecting portions 82a and 82b extending upward and an intermediate portion 86 connecting them. A notch 84 that is recessed inward is formed between the protrusions 82a and 82b. The most concave portion of the notch 84 reaches the center 50. A rough outer peripheral shape of the intermediate portion 86 is an arc portion riding on the auxiliary circle 52. Three semicircular protrusions 88a, 88b, and 88c are provided at intervals of about 60 degrees on the outside of the arc portion. The outermost sides of the projections 88a, 88b, 88c are formed so as to ride on the auxiliary circle 56. For this reason, it can be said that the outer diameters of the protrusions 88 a, 88 b, 88 c form an arc portion riding on the auxiliary circle 56. In addition, screw holes 90a, 90b, and 90c, which are through holes, are provided inside the protrusions 88a, 88b, and 88c, respectively. The screw holes 90a, 90b, and 90c are arranged so that the centers thereof are on the arc that rides on the auxiliary circle 54.

  Inside the screw holes 90a, 90b, 90c, substantially triangular through holes 92a, 92b, 92c are provided. Further, on the outer peripheral surface of the intermediate portion 86, incisions 94a, 94b, 94c, and 94d are provided inward so as to sandwich the screw holes 90a, 90b, and 90c.

  The leading ends (protruding ends) of the protruding portions 82a and 82b have a shape protruding to the outside of any of the auxiliary circles 52, 54, and 56. And screw hole 96a, 96b is provided in the protrusion end vicinity of protrusion part 82a, 82b, respectively.

  The bar hole plate 80 includes three screw holes 90 a, 90 b, and 90 c that ride on the auxiliary circle 54 on the outer periphery of the intermediate portion 86. On the other hand, the bar hole plate 30 shown in FIG. 3 was provided with four screw holes 40 a, 40 b, 40 c, and 40 d on the auxiliary circle 54 on the outer periphery of the intermediate portion 36. Due to the difference in the number and position of the screw holes, the length and width of the bar hole plate 80 and the bar hole plate 30 are different. However, the three screw holes 90a, 90b, 90c of the bar hole plate 80 and the four screw holes 40a, 40b, 40c, 40d of the bar hole plate 30 are on the same auxiliary circle 54. Further, the screw holes 96a and 96b of the protrusions 82a and 82b of the bar hole plate 80 and the screw holes 46a and 46b of the protrusions 32a and 32b of the bar hole plate 30 are also on the same circle from the center 50. . As can be seen, the bar hole plate 80 can accommodate a bar hole of the same size as the bar hole plate 30. The bar hole plate 80 and the bar hole plate 30 may be selected in consideration of ease of attachment to the bone fragment 26.

[Reference form]
Subsequently, a reference embodiment will be described with reference to FIGS. 6 and 7. FIG. 6 is a plan view of the bar hole plate 110 according to the reference embodiment. Further, in the drawing, a center 120 and three auxiliary circles 122, 124, and 126 centering on the center 120 are shown as auxiliary.

  The bar hole plate 110 includes a main body part 112, an arcuate main body part 112 whose outer shape rides on the auxiliary circle 122, and four circular protrusions 113a, 113b, 113c, 113d provided around the main body part 112. Yes. The main body 112 has an arc shape whose outer shape is on the auxiliary circle 122. The arc shape is formed with an extent of about 280 degrees with respect to the center 120. The arc-shaped end is a notch 118 through which the drain tube passes. The notch 118 is wide on the outside (opening end side) and narrows toward the back, but is formed to have a certain width on the back side to some extent, and further, a circular shape is formed so as to surround the center 120 near the most concave portion. Has been. The protrusions 113a, 113b, 113c, 113d provided around the main body 112 are provided at equal intervals of about 72 degrees, and the outermost side is formed so as to ride on the auxiliary circle 126. Screw holes 114a, 114b, 114c, and 114d are provided inside the protrusions 113a, 113b, 113c, and 113d, respectively. These screw holes 114 a, 114 b, 114 c, 114 d are arranged so that their centers ride on the auxiliary circle 124. Further, in the body portion 112, incisions 116a, 116b, and 116c inward are formed at positions sandwiched between the protrusions 113a, 113b, 113c, and 113d. As described above, the bar hole plate 110 has a feature that the outer shape of the main body portion 112 is circular and the screw holes 114a, 114b, 114c, and 114d are also arranged on the same circle.

  FIG. 7 is a diagram corresponding to FIG. 4, and the same components are denoted by the same reference numerals and description thereof is omitted. In FIG. 7, the bar hole 14 is protected by using a bar hole plate 110 instead of the bar hole plate 30 of FIG. 4. The bar hole plate 110 is installed such that the main body 112 faces the bone piece 26 and the notch 118 faces the outer skull 10. Then, the screw holes 114b and 114c are screwed to the bone fragment 26, and the screw holes 114a and 114d are screwed to the surrounding skull 10. However, as described above, the bar hole 14 is oval, while the four screw holes 114a, 114b, 114c, and 114d are arranged concentrically. As a result, in the example of FIG. 7, the screw hole 114 a and the screw hole 114 d are located at the edge of the surrounding skull 10, and it is impossible or difficult to perform the screw fixation reliably.

  In such a case, instead of the bar hole plate 110, a bar hole plate 110 similar in shape but having a large size must be used.

[Other embodiment examples]
As described above, the bar hole plates 30 and 80 shown in the first and second embodiments have a shape suitable for fixing the oval bar hole 14. The bar hole plates 30 and 80 can be variously modified. For example, when the size and shape of the bar holes are different, the bar hole plates 30 and 80 are appropriately enlarged or reduced, or the lengths of the protrusions 32a, 32b, 82a, and 82b are changed as appropriate. It is possible to respond appropriately. It is also possible to change the number or position of the screw holes and further change the shape of the notch. Further, a part or the whole can be changed such as using a member having a mesh structure instead of a plate shape.

  10 skull, 12, 14, 16 bar hole, 18, 20, 22 osteotomy line, 24 craniotomy, 26 bone fragment, 30, 60, 80, 110 bar hole plate, 32a, 32b, 82a, 82b protrusion, 36 Intermediate part, 37, 84, 118 Notch part, 38a, 38b, 38c, 38d, 88a, 88b, 88c, 113a, 113b, 113c, 113d Protrusion, 40a, 40b, 40c, 40d, 46a, 46b, 90a, 90b, 90c, 96a, 96b, 114a, 114b, 114c, 114d Screw hole, 42a, 42b, 42c, 42d, 92a, 92b, 92c Through hole, 44a, 44b, 44c, 94a, 94b, 94c, 94d, 116a, 116b, 116c notch, 50, 120 center, 52, 54, 56, 122, 124 126 auxiliary circle, 112 body, 70 plates.

Claims (2)

A bar hole plate that protects the bar hole provided in the skull,
It is formed in a substantially U shape with two projecting parts and an intermediate part connecting them,
Near the outer periphery of the intermediate portion, a screw hole to be screwed to the skull around the bar hole is provided on a substantially arc,
Near the projecting ends of the two projecting portions, a screw hole to be screwed to the skull around the bar hole is provided outside the circle on which the arc rides,
A bar hole plate, wherein a drain tube penetrating the bar hole is passed through the substantially U-shaped notch. A bar hole plate that protects the bar hole provided in the skull,
The outer shape of the barhole plate is
An arc portion formed in a substantially arc shape;
A projecting portion formed in a shape projecting outward from a circle on which the arc rides on both ends of the arc portion;
A notch that is formed in a shape recessed inside the circle on which the arc rides on the opposite side of the arc between the two protrusions, and through which the drain tube penetrating the bar hole is passed,
Consists of
In the vicinity of the outer periphery of the arc portion, a screw hole to be screwed to the skull around the bar hole is provided,
In the vicinity of the outer periphery of both the projecting portions, a screw hole for screwing to the skull around the bar hole is provided.