WO2002026106A2 - Plaque de suspension destinee a fixer les sutures de support du muscle temporal et a porter le volet osseux dans sa position anatomique correcte - Google Patents

Plaque de suspension destinee a fixer les sutures de support du muscle temporal et a porter le volet osseux dans sa position anatomique correcte Download PDF

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Publication number
WO2002026106A2
WO2002026106A2 PCT/US2001/029469 US0129469W WO0226106A2 WO 2002026106 A2 WO2002026106 A2 WO 2002026106A2 US 0129469 W US0129469 W US 0129469W WO 0226106 A2 WO0226106 A2 WO 0226106A2
Authority
WO
WIPO (PCT)
Prior art keywords
holes
suspension plate
temporalis
plate according
eyelet
Prior art date
Application number
PCT/US2001/029469
Other languages
English (en)
Other versions
WO2002026106A3 (fr
Inventor
Jeffrey D. Gross
Robert A. Bruce
Original Assignee
Kinamed, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Kinamed, Inc. filed Critical Kinamed, Inc.
Priority to AU2001291153A priority Critical patent/AU2001291153A1/en
Publication of WO2002026106A2 publication Critical patent/WO2002026106A2/fr
Publication of WO2002026106A3 publication Critical patent/WO2002026106A3/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/688—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin for reattaching pieces of the skull
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8085—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with pliable or malleable elements or having a mesh-like structure, e.g. small strips
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/08—Muscles; Tendons; Ligaments
    • A61F2002/0894—Muscles

Definitions

  • the present invention relates generally to a suspension plate and, more particularly, to a temporalis suspension plate for easily attaching the sutures to attach the temporalis muscle and to hold the bone flap in its correct anatomical position.
  • the bar or bars bridge across the craniotomy cut and the screws are placed in the bone through the receptacle holes on each side of the cut to provide fixation.
  • Three or more bone plates spaced roughly in equal distance around the bone flap provide stable fixation of the flap to the adjacent skull.
  • the elevated temporalis muscle needs to be repositioned in its correct anatomical location as well.
  • Various approaches are typically used to deal with the repositioned temporalis muscle at this point in the surgical procedure.
  • One method is to simply reposition the temporalis muscle in its correct anatomical position and close the scalp over the top of the temporalis muscle to complete the surgery.
  • One of the drawbacks to this approach is that the upper or "superior" aspect of the temporalis muscle may easily migrate to an "inferior" or lower position as the muscles contract after the patient returns to consciousness or particularly as the patient chews food or simply swallows as both actions result in contraction of these muscles.
  • This malpositioning of the superior part of this muscle has significant consequences as it can adversely effect the patients ability to chew with full effectiveness or in a balanced way as these are paired muscles working in concert on both sides of the head.
  • a cosmetic deformity may also result in the form of an unnatural appearing hollow where the superior aspect of the muscles would normally be positioned and/or an unnatural bulkiness in the region of the more inferior part of the muscle.
  • the muscle may become non-functional or marginally functional resulting in atrophy and pain of the muscle and increased cosmetic deformity.
  • One aspect of the present invention is to provide a device that allows for easy attachment for the temporalis muscle supporting sutures while at the same time functioning as a bone fixation device to hold the bone flap in its correct anatomical position. This may be accomplished through a specially configured bone plate device that includes a suture eyelet hole, ring, and/or bar that allows for passage and fixation of a suture.
  • fixation of the bone flap is facilitated by providing a bone plate device that includes an array of screw-receiving holes connected in series by bone plate connecting bar members with each connecting bar attachment angled relative to the screw-receiving holes such that the holes are offset from their adjacent holes by an amount suitable for bridging alternate sides of the craniotomy cut thereby providing for fixation of the bone flap.
  • the temporalis suspension plate may also be used for reconnection of the temporalis bone to the cranium, while not serving to affix the craniotomy bone flap to the skull.
  • it would be applied directly to the bone flap, or the intact skull with screws as described to allow temporalis muscle reconstruction to its anatomic position.
  • the connecting bar attachment points are angled such that any three or more alternate holes have a common centerline that forms an arc approximating the arc that typically defines the edge of a craniotomy cut.
  • the device may offer a close fit with the typical craniotomy cut with minimal re-shaping. If the subject device is supplied in some malleable material, such as titanium for example, the operating surgeon can easily accomplish re-shaping to fit the exact curve of the craniotomy cut.
  • the muscle suspension plate may also be used elsewhere on the cranium, to reattach the occipitalis muscle, or other muscles with attach or insert upon the skull.
  • FIG. 1 is an exemplary view of a temporalis suspension plate according to one embodiment of the present invention holding a bone flap in its correct anatomical position within a craniotomy cut in a skull;
  • FIG. 2A is a top view of the exemplary temporalis suspension plate according to FIG. 1;
  • FIG. 2B is an bottom view of the exemplary temporalis suspension plate according to FIG. 1;
  • FIG. 2C is a cross-sectional view of the exemplary temporalis suspension plate along the line 2C-2C in FIG.2A;
  • FIG. 2D is a cross-sectional view of the exemplary temporalis suspension plate along the line 2D-2D in FIG.2A;
  • FIG. 2E is a cross-sectional view of an another embodiment of a temporalis suspension plate
  • FIG. 2F is a cross-sectional view of an another embodiment of a temporalis suspension plate
  • FIG. 3 is a top view of yet another embodiment of a temporalis suspension plate
  • FIG. 4 is a top view of still another embodiment of a temporalis suspension plate.
  • FIG. 5 is a top view of yet another embodiment of a temporalis suspension plate.
  • FIG. 1 illustrates by way of example a suspension plate 10 in accordance with one embodiment of the present invention used to reattach the temporalis muscle and to hold the bone flap 12 in its correct anatomical position.
  • FIG. 1 shows the top view of the suspension plate 10.
  • the suspension plate 10 is laid across the bone flap 12 and the skull 16.
  • screws are inserted into a predetermined number of outer holes 18 and a predetermined number of inner holes 18' that are diagonal to each other.
  • a predetermined number of eyelet holes 20 are provided adjacent to the inner holes 18' so that sutures may be tied through the eyelet holes 20 that ties to the temporalis muscle.
  • FIGS. 2A-2D illustrate by way of example more detail views of the suspension plate 10.
  • the outer holes 18 and the inner holes 18' are coupled in series by arm members 22 that are diagonal to each other.
  • the angel between the two adjacent arm member 22 is about 90.
  • the inner holes 18' form an arc 24' in reference to a focal point 24; likewise, the outer holes 18 form an arc 24" in reference to the same focal point 24; and, the eyelet holes 20 form an arc 24'" in reference to the focal point 24 as well.
  • the suspension plate 10 may be arced to approximate the arc cut out portion 14' (FIG. 1) that typically define the edge of the craniotomy cut 14. That is, as illustrated in FIG.
  • the arc cut out portion 14' generally run between the two arcs 24' and 24". This way, when a bone screw is inserted in to a predetermined number of outer holes 18 and inner holes 18' the bone flap 12 is securely held within the craniotomy cut 14.
  • the suspension plate 10 Besides holding the bone flap 12 in its correct anatomical position, the suspension plate 10 also has the eyelet holes 20 adjacent to the inner holes 18' so that the sutures that reattach the temporalis muscle can be attached to the eyelet holes 20.
  • the suspension plate 10 is generally positioned so that the inner holes 18' are facing the temporalis muscle as shown in FIG. 1.
  • the sutures 26 are used to attach the temporalis muscle to the eyelet holes 20.
  • the temporalis muscle is held in its correct anatomical position until the biological reattachment of muscle to the skull occurs as a result of normal healing.
  • the outer edges of the temporalis muscle is arced as well so that the arc of the suspension plate 10 helps to attach the sutures between the eyelet holes 20 and the edges of the temporalis muscle.
  • the suspension plate 10 may be made of malleable material so that an operating surgeon can easily re-shape the suspension plate 10 to fit the outline of the craniotomy cut portion 14' and the curvature of the skull 16. That is, the angel between the two arm members 22 may be varied by the surgeon so that the craniotomy cut portion 14' is between the outer holes 18 and inner holes 18' of the suspension plate 10.
  • suspension plate 10 may be made of titanium, which is malleable. Other materials such as stainless steel, other metals, biologic materials such as bone or coral, and resorbable or non- resorbable plastic or acrylic may be used as well.
  • the suspension plate 10 may be made of any material known to one skilled in the art.
  • FIG. 2B illustrates by way of example a bottom view of the suspension plate 10 that is substantially flat.
  • FIG. 2C illustrates by way of example a cross-sectional view an exemplary inner hole 18' and eyelet hole 20, along the line 2C-2C in FIG 2A.
  • FIG. 2C shows the combination of holes 18' and 20 having a top surface 28 and a bottom surface 30. That is, the bottom surface 30 is placed over the skull so that the top surface 28 is facing up when implanting the suspension plate 10.
  • the inner hole 18' has a countersink 32 so that the head of a bone screw is more flushed with the top surface 28 once the bone screw is inserted into the inner hole 18'.
  • the diameter of the inner holes 18 ' generally depends the diameter of the bone screw that is used.
  • An exemplary diameter along the top surface 28 of the inner hole 18' may be about 1.5 mm to about 3.5 mm; and exemplary diameter along the bottom surface 30 of the inner hole 18' may be about 1.0 mm to about 2.5 mm.
  • the thickness t of the suspension plate 10 may be about 0.2 mm to about 1.0 mm.
  • the thickness t of the suspension plate 10 may depend on the material that is used for the suspension plate 10, so that the suspension plate 10 is sufficiently flexible to be reshaped to match the craniotomy cut portion 14' and the curvature of the skull 16.
  • an exemplary radius Rl that defines the arc 24'" of the eyelet holes from the focal point 24 may be about 4.0 cm to about 5.5 cm; an exemplary radius R2 that defines the arc 24' of the inner holes 18' from the focal point 24 may be about 4.5 cm to about 6.0 cm; and an exemplary radius R3 (see FIG. 2B) that defines the arc 24" may be about 5.0 cm to about 6.5 cm.
  • one embodiment of the suspension plate 10 may have the following radius dimensions: Rl at about 4.8 cm; R2 at about 5.0cm; and R3 at about 5.72 cm.
  • FIG. 1 an exemplary radius that defines the arc 24'" of the eyelet holes from the focal point 24
  • an exemplary radius R2 that defines the arc 24' of the inner holes 18' from the focal point 24 may be about 4.5 cm to about 6.0 cm
  • an exemplary radius R3 that defines the arc 24" may be about 5.0 cm to about 6.5 cm.
  • one embodiment of the suspension plate 10 may have the following radius dimensions:
  • FIG. 2D illustrates by way of example the cross-sectional view of the outer hole 18, along the line 2D-2D in FIG. 2A.
  • the diameter and thickness of the outer hole 18 may be similar to the inner hole 18; however, they may be different.
  • the thickness of the outer hole 18 may be thinner than the thickness t of the inner hole 18', as further discussed below.
  • a suspension plate 10' in this embodiment is symmetrical along the centerline C-C. That is, the top surface 28' and the bottom surface 30' are substantially similar to the top surface 28 shown in FIGS. 2C and 2D.
  • One of the advantages with this embodiment is that the surgeon can place either surfaces 28' or 30' adjacent to the skull and still install a bone screw through the holes 18' and 18 and have the head of the bone screw be flushed within the countersink 32'. This way, a surgeon can not make a mistake of placing the wrong surface of the suspension plate 10 along the skull.
  • FIGS. 2G illustrate by way of example a cross-sectional view of the suspension plate 10 along the line 2G-2G in FIG. 2A, where thickness of the arm member 22 is substantially similar to thickness of the two holes 18 and 18'.
  • FIG. 2H illustrates by way of example that the thickness t" of the arm member 22' may be different from the two holes 18 andl8'. That is, the thickness t" may be thicker or thinner than the thickness t of the hole 18.
  • the holes 18 and 18' may be configured as in FIGS. 2E and 2F so that the thickness t of the holes is relatively thicker than the thickness t of the holes in FIG. 2C and 2D, but to maintain the flexibility or malleability of the suspension plate 10, the thickness of the arm member 22' may be thick as t in FIG. 2C and 2D.
  • FIG. 3 illustrates by way of example eyelet holes 20' and 20" located in alternative positions.
  • the eyelet hole 20' is located along the interior side of the outer hole 18. That is, the eyelet hole 20' is further away from the temporalis muscle than the eyelet hole 20.
  • a surgeon may use the eyelet hole 20' to attach a suture to have more tension in the suture.
  • an eyelet 20' ' may be placed along the arm member 22, which is between the eyelet holes 20 and 20'.
  • the combination of holes 20, 20', and 20" allows the surgeon to select the proper eyelet hole so that there is proper amount of tension in the suture.
  • FIG. 3 is an eyelet hook 34 that may be located in the interior side of the inner hole 18', arm member 22, and outer hole 18.
  • eyelet hook 34 One of the advantage with the eyelet hook 34 is that the suture does not have to be passed through the eyelet hole 20; rather the suture may be simply "hooked” onto the hook 34, which saves time in reattaching the temporalis muscle.
  • FIG. 3 also shows an elongated hole 36 where the inner hole 18' is combined with the eyelet hole 20. The elongated hole 36 may be placed along the arm member 22 and outer hole 18, as well.
  • FIG. 4 illustrate by way of example yet another embodiment of the present invention showing a suspension plate 10" with the outer holes 18 and inner holes 18' but without the eyelet holes 20.
  • the outer holes 18 and the inner holes 18' may be used to attach the sutures. That is, in some instances, not every holes 18 and 18' may be used so that the holes 18 and 18' that are not used may be used to attach the sutures. Such holes might also be used for temporalis muscle reattachment and cranial fixation, simultaneously.
  • FIG. 5 illustrate by way of example still another embodiment of a suspension plate 10'" including the outer holes 18, inner holes 18', and the eyelet holes 20, as discussed above.
  • each of the outer holes 18 is coupled to its respective inner holes 18' via a tangential arm 38; and each of the tangential arm 38 are coupled by an arm member 22'.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Neurology (AREA)
  • Engineering & Computer Science (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Neurosurgery (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention concerne une plaque de suspension temporale utilisée à la suite d'une intervention chirurgicale du cerveau, de façon à repositionner un fragment du crâne retiré à l'occasion d'une craniotomie avant l'opération du cerveau. Ce fragment est repositionné et maintenu par cette plaque de suspension dans une position déterminée dans l'ouverture du crâne générée par cette craniotomie. Cette plaque de suspension comprend une pluralité de trous intérieurs mélangés en diagonale, et couplés en souplesse à une pluralité de trous extérieurs. Ces couplages peuvent être réalisés par des tiges connectant ces trous. Ces trous peuvent être couplés à des oeillets permettant de recevoir les sutures.
PCT/US2001/029469 2000-09-25 2001-09-20 Plaque de suspension destinee a fixer les sutures de support du muscle temporal et a porter le volet osseux dans sa position anatomique correcte WO2002026106A2 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU2001291153A AU2001291153A1 (en) 2000-09-25 2001-09-20 Suspension plate for attaching the temporalis muscle supporting sutures

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US23526400P 2000-09-25 2000-09-25
US60/235,264 2000-09-25
US95456701A 2001-09-17 2001-09-17
US09/954,567 2001-09-17

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Publication Number Publication Date
WO2002026106A2 true WO2002026106A2 (fr) 2002-04-04
WO2002026106A3 WO2002026106A3 (fr) 2002-08-22

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PCT/US2001/029469 WO2002026106A2 (fr) 2000-09-25 2001-09-20 Plaque de suspension destinee a fixer les sutures de support du muscle temporal et a porter le volet osseux dans sa position anatomique correcte

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AU (1) AU2001291153A1 (fr)
WO (1) WO2002026106A2 (fr)

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2899094A1 (fr) * 2006-03-31 2007-10-05 Small Bone Innovations Interna Plaque osseuse de reparation de fractures de l'olecrane
DE102009026929A1 (de) * 2009-06-15 2010-12-23 Peter Lazic Gmbh Streifenförmiges Implantat zur Abdeckung eines Frässpalts
WO2017061007A1 (fr) * 2015-10-08 2017-04-13 プロスパー株式会社 Implant
JP2022034750A (ja) * 2020-08-19 2022-03-04 株式会社パイオラックスメディカルデバイス 骨固定プレート

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5468242A (en) * 1993-11-19 1995-11-21 Leibinger Gmbh Form-fitting mesh implant
US5752958A (en) * 1997-04-02 1998-05-19 Wellisz; Tadeusz Z. Bone fixation plate
US5766176A (en) * 1996-09-11 1998-06-16 Walter Lorenz Surgical, Inc. Formable mesh
US5961519A (en) * 1997-04-11 1999-10-05 Kinamed, Inc. Burr hole cover for cranial surgery
US6093201A (en) * 1999-01-19 2000-07-25 Ethicon, Inc. Biocompatible absorbable polymer plating system for tissue fixation

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5468242A (en) * 1993-11-19 1995-11-21 Leibinger Gmbh Form-fitting mesh implant
US5766176A (en) * 1996-09-11 1998-06-16 Walter Lorenz Surgical, Inc. Formable mesh
US5752958A (en) * 1997-04-02 1998-05-19 Wellisz; Tadeusz Z. Bone fixation plate
US5961519A (en) * 1997-04-11 1999-10-05 Kinamed, Inc. Burr hole cover for cranial surgery
US6093201A (en) * 1999-01-19 2000-07-25 Ethicon, Inc. Biocompatible absorbable polymer plating system for tissue fixation

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2899094A1 (fr) * 2006-03-31 2007-10-05 Small Bone Innovations Interna Plaque osseuse de reparation de fractures de l'olecrane
DE102009026929A1 (de) * 2009-06-15 2010-12-23 Peter Lazic Gmbh Streifenförmiges Implantat zur Abdeckung eines Frässpalts
DE102009026929B4 (de) * 2009-06-15 2013-03-07 Peter Lazic Gmbh Streifenförmiges Implantat
WO2017061007A1 (fr) * 2015-10-08 2017-04-13 プロスパー株式会社 Implant
CN108135700A (zh) * 2015-10-08 2018-06-08 普洛斯珀株式会社 植入体
JPWO2017061007A1 (ja) * 2015-10-08 2018-07-19 プロスパー株式会社 インプラント
CN108135700B (zh) * 2015-10-08 2020-02-14 普洛斯珀株式会社 植入体
JP2022034750A (ja) * 2020-08-19 2022-03-04 株式会社パイオラックスメディカルデバイス 骨固定プレート

Also Published As

Publication number Publication date
AU2001291153A1 (en) 2002-04-08
WO2002026106A3 (fr) 2002-08-22

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