JP2016202468A - Prosthetic material for skull bone perforation - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide prosthetic material for skull bone perforation which is rigid, excellent in handleability during operation and prevents occurrence of postoperative biocompatibility or plastic problems.SOLUTION: A shaft part 10, which is inserted and arranged in a drill perforation 5 drilled for making an opening 4 in the skull bone 2, includes: a shaft part body 11 erected from the under surface of an engaging lid part 20; and a claw part 12 which is given elastic force in a shaft direction of the shaft part 10 by contacting the inner surface of the drill perforation 5 while the shaft part 10 is inserted/arranged in the drill perforation 5.SELECTED DRAWING: Figure 1

Description

  The present invention relates to a skull drilling filling material called a keyhole or a barhole for closing a drill drilled in a skull.

  When an opening having a size corresponding to the surgical site is formed on the skull exposed by incising the scalp in craniotomy, as shown in FIG. A plurality of drill holes are formed on the virtual outer periphery, and cuts are formed by a line saw along the virtual outer periphery of the opening so as to connect the drill holes. As shown in FIG. The cut bone piece (bone flap) is taken out to form the opening.

  And, as a skull drilling filling material used for closing the drill drilling, conventionally, a shaft part formed with a diameter of a size corresponding to the drill drilling and one end of the shaft part, the outer periphery of the shaft part Various skull perforation filling materials having a locking lid portion having a buttock protruding in the direction have been developed.

  For example, Patent Document 1 discloses a skull drilling filling material for drill drilling (keyhole) that is first formed in the vicinity of the temple during craniotomy, and is made of ceramic such as hydroxyapatite having biocompatibility. Thus, a skull drilling filling material formed so as to close the drilling hole by fitting the shaft part into the drilling hole is disclosed.

  Further, the bone flap cut off at the time of craniotomy is closed and closed on the dura mater after closing the dura mater in the opening at the end of the craniotomy (at the time of craniotomy). Here, since the drill hole is formed with a diameter of about 12 to 14 mm and the cut line of the wire saw is formed with a width of about 1.5 to 2 mm, the shape of the opening is slightly larger than that of the bone flap, In some places, a part of the drill hole is formed in a shape that remains as a circular cutout. Therefore, in order to fix the bone flap cut out in the slightly larger opening, a skull drilling filling material is disposed in the drill hole, and the bone valve is sandwiched and fixed between the shaft portions in the opening. Has been made. According to this method, it is possible to prevent the scalp from sinking into the drill hole after the operation by closing the drill hole with the skull drilling filling material.

  Patent Document 2 is a skull perforation filling material, which is also made of ceramics and has a male screw formed on the outer periphery of the shaft portion, and is screwed into a female screw formed on the inner peripheral portion of the opening of the skull. While locking the locking lid to the opening edge of the skull and the upper surface of the outer peripheral edge of the bone flap, the bone flap is sandwiched and fixed between the shafts in the opening, and the drill drill is closed. A disclosed skull perforation filling material is disclosed.

Japanese Patent Laid-Open No. 2001-112797 Japanese Utility Model Publication No. 5-84306

  Here, in consideration of the fact that the scalp is sutured so as to cover the upper surface of the skull perforation filling material and the bone flap when the skull is closed, the locking lid portion is as thin as possible and the scalp surface is uneven. It is desirable to be formed so as not to become. However, the skull perforation filling material in which the locking lid portion is thinly formed of ceramics has a problem that the buttocks and the like of the locking lid portion are easily damaged during handling.

  Further, like the skull drilling filling material described in Patent Document 1, the bone flap is fixed in the opening by the skull drilling filling material when the shaft portion is simply inserted into the drill drilling and arranged. In addition to the fact that this cannot be expected, there is also a concern that the skull drilling prosthetic material may be detached from the drill drilling due to some impact or the like.

  On the other hand, like the skull drilling filling material described in Patent Document 2, the skull drilling filling material configured to be screwed into the drill drilling can solve the problem of detachment of the skull drilling filling material from the drill drilling. When it is used, a surgical process is required in which a female screw is screwed on the inner peripheral surface of the drill drilling, resulting in a new problem in terms of technology and speeding up the operation (reducing the operation time). .

  Therefore, an object of the present invention is to provide a skull perforation filling material that is robust, has good handleability during surgery, and does not cause biocompatibility or shaping problems after surgery.

In order to solve the above problems, the skull perforation filling material of the present invention according to claim 1 is inserted and arranged in a drill perforation formed when an opening having a size corresponding to a surgical site is formed in the skull. A shaft portion and a collar portion formed at an axial upper end of the shaft portion and projecting in the outer peripheral direction of the shaft portion are engaged with the upper surface of the skull when the shaft portion is inserted and disposed in the drill hole. And a thin plate-like locking lid portion formed so as to cover the skull, and is a skull perforation filling material formed of a biocompatible resin material or metal material. An axial elastic force is applied to the shaft portion by contact between the shaft body standing up from the lower surface of the lid portion and the inner peripheral surface of the drill hole when the shaft part is inserted and arranged in the drill hole. And a claw portion to be provided.

  Further, in the skull perforation filling material of the present invention according to claim 2, the claw portion connects the proximal end portion to the axial lower end side at the axially symmetric position of the virtual central axis of the shaft body, and the proximal end portion A flexible locking piece which is formed so as to gradually move away from the shaft main body toward the upper end side in the axial direction from the shaft, and the shaft portion is drilled in the tip of the flexible locking piece. A sliding contact portion having a curved surface to be slidably contacted with the inner peripheral surface of the drill drill when being inserted and arranged in the drill is formed.

  The skull perforation filling material of the present invention according to claim 3 is characterized in that an instrument engaging hole is formed on the upper surface of the locking lid portion.

  The skull perforation filling material of the present invention according to claim 4 is characterized in that a drain through-hole capable of disposing a medical tube disposed inside and outside of the drill perforation is formed.

  The skull perforation filling material of the present invention having such a configuration inserts the shaft portion into the drill hole while bringing the nail portion into contact with the inner peripheral surface of the drill hole so as to apply an axial elastic force to the nail portion. To do. In this way, the skull perforation filling material inserted in the drill perforation formed on the outer periphery of the opening holds itself within the opening while holding the bone flap within the opening by the reaction force of the elastic force of the nail. Therefore, it is possible to prevent the skull drilling filling material from being detached from the drill drilling due to impact or the like.

  And the skull drilling filling material in which the shaft part is inserted and arranged in the drill drilling is such that the buttocks projecting the locking lid part in the outer peripheral direction of the shaft locks the upper surface of the skull and covers the drill drilling. In addition, there is no inconvenience that the scalp falls into the scalp and a dent is formed, and the locking lid portion formed of a resin material or metal material having biocompatibility can be formed thinly, so that there is no problem in shaping. In addition, it is easy to handle because it is robust without cracking or chipping. Moreover, since it consists of material which has biocompatibility, there is little irritation | stimulation and burden to a patient's body.

  In addition, the skull drilling filling material formed so that the curved surface of the sliding contact portion of the flexible locking piece comes into sliding contact with the inner peripheral surface of the drill drilling is slidable when inserted into or removed from the drill drilling. The dynamic friction can be reduced, and the surgical process can proceed smoothly.

  Furthermore, the skull perforation filling material in which the instrument engagement hole is formed is obtained by hooking or grasping the tip of a forceps or the like using the instrument engagement hole, thereby making the skull perforation filling material more effective against drilling. The skull perforation filling material in which the drain through-hole is formed can be securely attached and detached, and the medical tube for discharging unnecessary body fluid in the skull is arranged and fixed in the drain through-hole. Becomes simple, shortening the operation time and prompting the progress of the operation.

  As described above, according to the skull perforation filling material of the present invention, it is robust, has excellent handling properties at the time of operation, and exhibits excellent effects such as no biocompatibility and shaping problems after the operation. it can.

It is explanatory drawing which shows 1st Embodiment of the skull puncture filling material of this invention, (a) is a top view, (b) is a bottom view, (c) is a front view, (d) is a side view, (e) Is a perspective view seen from the upper surface direction, (f) is a perspective view seen from the lower surface direction, and (g) is a cross-sectional view taken along the line gg ′ of (e). Explanatory drawing which shows the state which hold | maintained the skull puncture filling material of FIG. 1 using forceps It is explanatory drawing which shows the state which has arrange | positioned the skull puncture filling material of FIG. 1 to drill puncture, (a) is sectional drawing, (b) is the perspective view seen from the upper surface side of (a). It is explanatory drawing which shows 2nd Embodiment of the skull puncture filling material of this invention, (a) is a top view, (b) is bb 'sectional drawing of (a), (c) was seen from the upper surface direction. A perspective view, (b) is a perspective view seen from the bottom surface direction. (A) shows the drill perforation and line saw cut formed in the skull in craniotomy, (b) is an explanatory view of the state in which the bone flap is removed from (a) and an opening is formed.

  Hereinafter, a first embodiment of a skull perforation filling material of the present invention will be described with reference to FIGS. 1 to 3.

  The skull perforation filling material 1 of the present embodiment includes a shaft portion 10 that is inserted into a drill hole 5 that is formed when the bone flap 3 is removed from the skull 2 to form the opening 4, and the shaft of the shaft portion 10. And a thin plate-like locking lid portion 20 integrally formed at the upper end in the direction.

  In the present embodiment, the locking lid portion 20 has a planar shape that is a circular shape having a diameter larger than the inner diameter of the drill hole 5, and as shown in FIGS. 1 (c), 1 (d), etc. The portion is formed so as to be slightly raised in the axial direction from the outer periphery and to have a thickness. The shaft portion 10 is suspended from the center portion of the lower surface of the locking lid portion 20. The outer peripheral region of the locking lid portion 20 that projects in the outer circumferential direction of the shaft portion 10 becomes a collar portion that locks to the upper surface of the skull 2 when the shaft portion 10 is inserted and arranged in the drill hole 5.

  Here, the shaft portion 10 is in contact with the shaft portion main body 11 suspended from the lower surface of the locking lid portion 20 and the inner peripheral surface of the drill drilling 5 when the shaft portion 10 is inserted and disposed in the drill drilling 5. Thus, the claw portion 12 to which the elastic force in the axial direction of the shaft portion 10 is applied is configured.

  In the present embodiment, as shown in FIGS. 1 (b), (f), (g), etc., the axial body 11 has an axial length equal to or slightly longer than the thickness of the skull 2, In order to position a pair of surfaces (flat wall portions 15 to be described later) on which the claw portion 12 is formed at an axially symmetric position (180 ° rotation position of the virtual central axis) of the shaft body 11, the locking lid portion The outer peripheral part located in the axially symmetric position of the cylinder suspended from the lower surface of 20 is cut into a flat shape in the axial direction to form a pair of flat wall portions 15, and is formed in a cross-sectional oval shape.

  And the nail | claw part 12 each protrudingly provided by the pair of flat wall part 15 is the axial direction lower end of the flat wall part 15, as shown in FIG.1 (b), (c), (f), (g) etc. The base end portion 13a is connected to the side, and the base end portion 13a is gradually expanded from the base end portion 13a toward the upper end in the axial direction so as to be separated from the shaft main body 11, and the base end portion 13a is used as a fulcrum. It has a small piece of flexible locking piece 13 formed so as to bend in the axial direction.

  Further, in the present embodiment, the shaft portion 10 is placed in the drill hole 5 at the distal end portion 13 b of the flexible locking piece 13, that is, the portion located on the outermost periphery of the shaft portion 10 in the flexible locking piece 13. A sliding contact portion 14 having a curved surface to be brought into sliding contact with the inner peripheral surface of the drill hole 5 when inserted and arranged is formed. Specifically, as shown in FIGS. 1C, 1F, 1G, etc., the slidable contact portion 14 has a longitudinal section in the axial direction at a portion connected to the distal end portion 13b of the flexible locking piece 13. The outer surface of the bent portion is formed as the curved surface.

  In the skull perforation filling material 1, the longest diameter of the shaft body 11 is smaller than the diameter of the drill hole 5, and the dimension between the sliding contact portions 14 located on the outermost periphery of the claw portions 12 arranged to face each other. Is formed larger than the inner diameter of the drill hole 5.

  Furthermore, in the present embodiment, an instrument engaging hole 22 into which the tip of an instrument such as the forceps 6 can be inserted is formed on the upper surface of the locking lid 20 as shown in FIG. Specifically, as shown in FIGS. 1A, 1E, 1G, etc., the instrument engaging hole 22 is symmetrical from the center point of the locking lid portion 20 in the opposing direction of the flat wall portion 15. Two holes are formed at positions. Each instrument engagement hole 22 is opened on the upper surface of the locking lid portion 20 with a substantially conical tip directed outward, and the inside thereof, as shown in FIG. It is formed as a space 22 that is inclined so as to gradually increase the depth from the upper surface of the locking lid portion 20 toward the virtual central axis. The instrument engaging hole 22 inserts the distal end of the forceps 6 or the like into the opening to grip the skull drilling filling material 1, or hooks the distal end of the forceps 6 or the like into the opening to pull out the skull drilling filling material 1 from the drill drilling 5. It is used when doing.

  The skull perforation filling material 1 of this embodiment is integrally formed of a resin material such as polyethylene or nylon 12 having biocompatibility and mechanical strength (fastness). Of course, the resin agent may further have contrast characteristics.

  The skull perforation filling material 1 of this embodiment formed in this way is inserted and held at the tip of the forceps 6 in a pair of instrument engagement holes 22 as shown in FIG. 2, for example, as shown in FIG. Then, the shaft portion 10 is inserted into the drill hole 5 formed in the skull 2, and the collar portion 21 is locked to the upper surface of the skull 2. Thus, by holding the skull perforation filling material 1 using the instrument engagement hole 22 with the forceps 6, attachment / detachment with respect to the drill perforation 5 is simplified.

  When the shaft portion 10 is inserted into the drill hole 5, first, the flexible locking piece 13 of the claw portion 12 contacts the outer periphery of the drill hole 5, but the shaft portion 10 is pushed into the drill hole 5 as it is. As a result, the flexible locking piece 13 is gradually bent in the axial direction of the shaft portion 10 so as to be rotated about the base end portion 13a. The buttocks 21 are placed on the upper surface of the skull 2 while being in sliding contact with the peripheral surface. At this time, by adopting a configuration in which the curved surface of the slidable contact portion 14 is slidably contacted with the inner peripheral surface of the drill hole 5, sliding friction during insertion and removal from the drill hole 5 can be reduced, and the operation is smoothly performed. It is possible to proceed with this process.

  Further, the skull drilling filling material 1 inserted into the drill hole 5 in this way is fixed by applying an elastic force in the axial direction of the shaft portion 10 by contact with the inner peripheral surface of the drill hole 5. Therefore, it is possible to prevent the skull drilling filling material 1 from being detached from the drill drilling 5 due to an impact or the like. Further, the skull drilling filling material 1 inserted into the drill drilling 5 formed on the outer periphery of the opening 4 is returned to the opening 4 of the skull 2 by the reaction force of the elastic locking piece 13. It is possible to sandwich the bone flap 3 that has been made.

  Moreover, since the locking lid part 20 covers the drill hole 5 when the collar part 21 is locked to the upper surface of the skull 2, the problem that the scalp falls into the drill hole 5 after the operation and a dent is eliminated. can do. In addition, the skull perforation filling material 1 made of a resin material having biocompatibility can form the locking lid portion 20 thinly, so that there is no problem in shaping, and there is strength. The thin and fine parts such as the part 21 and the claw part 12 are not easily damaged and are easy to handle. In addition, manufacturing is simple if the resin is integrally formed. Furthermore, since it is made of a biocompatible material, there is little irritation and burden on the patient's body.

  FIG. 4 is a view for explaining a second embodiment of the skull perforation filling material 1 of the present invention. The skull perforation filling material 1 of the present embodiment is the same as the skull perforation filling material 1 of the first embodiment described above. Further, a drain through-hole 30 for arranging a medical tube (not shown) arranged over the inside and outside of the drill hole 5 is formed.

  In the present embodiment, the drain through-hole 30 is formed in a cutout shape that penetrates the locking lid portion 20 and the shaft portion 10 in the axial direction. Specifically, the drain through hole 30 extends in a direction orthogonal to the opposing direction of the pair of flat wall portions 15 formed in the shaft portion 10 as shown in FIGS. As a letter-shaped notch, it is formed so as to open on the upper surface of the locking lid portion 20.

  When the skull perforation filling material 1 of the present embodiment formed in this way is inserted and arranged in the drill perforation 5, a medical tube for discharging unnecessary body fluid in the skull 2 is provided in the drain through hole 30. It can be arranged and fixed easily.

  In addition, this invention is not limited to embodiment mentioned above, A various change is possible as needed. For example, the shaft portion main body 11 is not necessarily formed in a substantially cylindrical shape as in the above-described embodiment, and a surface (flat wall portion) on which the claw portion 12 is formed at an axially symmetric position of the virtual central axis. Any shape that can position 15) may be used. For example, it may be composed of two straight plate-like wall members arranged opposite to each other. In that case, the opposite surfaces of the two opposing straight plate-like wall members are the flat wall portions 15. Similarly, the shaft portion main body 11 may have a polygonal shape such as a quadrangular prism (quadratic frame shape) or a hexagonal prism (hexagonal frame shape). Moreover, the shaft part main body 11 may be formed in the cross-sectional shape frame shape in which the space was formed in the center part.

  Further, the claw portion 12 also has a configuration in which an elastic force in the axial direction of the shaft portion can be applied by contact with the inner peripheral surface of the drill hole when the shaft portion is inserted and arranged in the drill hole. The configuration is not limited to the above-described embodiment. The sliding contact portion 14 does not necessarily have to be a curved surface of a bent portion as in the above-described embodiment. For example, the sliding contact portion 14 is a spherical portion formed at the distal end portion 13b of the flexible locking piece 13. A spherical surface (curved surface) may be used as the sliding contact portion 14.

  Further, the locking lid portion 20 may have any shape as long as the hook portion 21 can be locked to the upper surface of the skull 2 and the drill hole 5 can be covered even if the planar shape is not circular. And as a raw material of the skull puncture filling material 1, it is desirable to have biocompatibility, and it is not restricted to a resin material like the above-mentioned embodiment, For example, metal materials, such as titanium, may be sufficient.

DESCRIPTION OF SYMBOLS 1 Skull drilling filling material 2 Skull 3 Bone flap 4 Opening part 5 Drill drilling 6 Forceps 10 Shaft part 11 Shaft body 12 Claw part 13 Flexible locking piece 13a Base end part 13b Tip part 14 Sliding part 15 Flat wall part 20 Locking lid portion 21 collar portion 22 instrument engaging hole 30 drain through hole

Claims (4)

A shaft portion that is inserted and arranged in a drill hole that is drilled when an opening having a size corresponding to the surgical site is formed in the skull;
A collar portion formed at the upper end in the axial direction of the shaft portion and projecting in the outer peripheral direction of the shaft portion is locked to the upper surface of the skull when the shaft portion is inserted and arranged in the drill hole so as to cover the drill hole. A formed thin plate-like locking lid,
With
A skull perforation filling material formed of a resin material or a metal material having biocompatibility,
The shaft portion is
A shaft main body erected from the lower surface of the locking lid,
A claw part to which an axial elastic force of the shaft part is applied by contact with an inner peripheral surface of the drill hole when the shaft part is inserted and arranged in the drill hole;
A skull perforation filling material comprising:   The claw portion connects the base end portion to the lower end side in the axial direction at the axially symmetric position of the virtual central axis of the main portion of the shaft portion, and gradually moves away from the shaft main body from the base end portion toward the upper end side in the axial direction. A flexible locking piece that is formed so as to expand, and the distal end portion of the flexible locking piece slides on the inner peripheral surface of the drill hole when the shaft portion is inserted and arranged in the drill hole. 2. The skull perforation filling material according to claim 1, wherein a sliding contact portion having a curved surface to be contacted is formed.   The skull perforation filling material according to claim 1 or 2, wherein an instrument engagement hole is formed on an upper surface of the locking lid portion.   The skull perforation according to any one of claims 1 to 3, wherein a drain through-hole capable of disposing a medical tube disposed inside and outside the drill perforation is formed. Supplementary material.

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