JP6049473B2 - Skull plate - Google Patents

Description

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

  Conventionally, a cranioplasty for repairing a bone defect by fitting a skull plate (hereinafter sometimes referred to as “plate”) to the bone defect of the skull has been performed (for example, patents). Reference 1).

By the way, when repairing a large bone defect, it is necessary to increase the size of the plate.
However, since the plate used for cranioplasty corresponds to the complicated shape of the bone defect, the following problems arise when the size of the plate is increased.

  That is, if the size of the plate is increased, it becomes difficult to manufacture, and the load during manufacture increases, so that a defective portion is likely to occur, and the yield decreases. Therefore, in order to prepare plates by the day of surgery, it is necessary to manufacture a plurality of plates in consideration of yield. In addition, when a defective portion is generated on the plate, it is necessary to recreate the entire plate, which increases the manufacturing time and the manufacturing cost.

  Furthermore, in a clinical field etc., in order to match the manufactured plate with a bone defect part, the plate may be subjected to processing such as trimming. Since the plate is processed in a state where the plate is held, if the size of the plate is increased, it becomes difficult to hold the plate, and the workability deteriorates.

JP 2005-160646 A

  An object of the present invention is to provide a skull plate suitable for repairing a large bone defect of a skull.

As a result of intensive studies to solve the above-mentioned problems, the present inventors have found a solution means having the following constitution and have completed the present invention.
(1) A skull plate that includes a plurality of plate pieces that are separated from each other and has a curved boundary portion between the plate pieces that are adjacent to each other in the top view.
(2) The skull plate according to (1), wherein the skull plate is substantially quadrispherical or substantially hemispherical in top view.
(3) The skull plate according to (1) or (2), wherein the boundary portion has a substantially S-shaped or substantially inverted S-shaped curved shape in a top view.
(4) The plurality of plate pieces have a first plate piece and a second plate piece that are adjacent to each other, and are fitted to the bone defect portion including the median surface of the patient, and are fitted to the bone defect portion. When viewed from above, the boundary between the first plate piece and the second plate piece crosses the median plane, and extends forward from the intersection with the median plane to the front of the skull. A curved portion, a posterior curved portion connected to the anterior curved portion and extending from the intersecting portion to the back of the skull, and an end of the anterior curved portion on the side away from the intersecting portion and the The skull plate according to any one of (1) to (3), wherein an end portion on a side away from the intersecting portion of the rear curved portion is located away from the median plane.
(5) The skull plate according to any one of (1) to (4), further including at least one connecting member that connects the plate pieces adjacent to each other among the plurality of plate pieces. .
(6) The skull plate according to (5), wherein the at least one connecting member is a plate-like connecting member.
(7) The plurality of plate pieces include a first plate piece and a second plate piece which are adjacent to each other, the first plate piece has a first divided section, and the second plate piece is The apparatus further comprises at least one buffer member having a second buffer section facing the first split section and having a first buffer portion interposed between the first split section and the second split section. The skull plate according to any one of (1) to (4).
(8) The first plate piece further includes a first upper surface connected to the first divided surface, and the second plate piece further includes a second upper surface connected to the second divided surface. And the at least one buffer member further includes a second buffer portion positioned across the first upper surface from the first upper surface, and the first plate piece and the second buffer portion via the second buffer portion. The skull plate according to (7), further including at least one plate-like connection member connecting the second plate pieces.
(9) The skull plate according to (8), wherein the at least one buffer member is formed by integrally forming the first buffer and the second buffer.
(10) The first plate piece further includes a first lower surface, and a first chamfered portion formed by chamfering an intersection of the first divided cross section and the first lower surface, and the second plate piece includes: The skull plate according to any one of (7) to (9), further including a second lower surface, and a second chamfered portion formed by chamfering the second divided surface and the intersecting portion of the second lower surface.
(11) The skull plate according to any one of (7) to (10), wherein the constituent material of the first plate piece and the second plate piece is ceramics.
(12) The plurality of plate pieces include a first plate piece and a second plate piece which are adjacent to each other, and the first plate piece is connected to the first divided section and the first divided section. A first upper surface, and at least one first groove located on the first upper surface and reaching an intersection of the first divided cross section and the first upper surface, and the second plate piece includes: A second dividing surface facing the first dividing surface; a second upper surface connected to the second dividing surface; and the second dividing surface and the second upper surface located on the second upper surface. The first plate piece and the second plate in a state of being accommodated in each of the at least one first groove and the at least one second groove. At least one rod-like connecting member connecting the pieces Comprising the al, skull plate according to any one of (1) to (4).
(13) The length of the at least one rod-shaped connecting member is larger than the total length of each of the at least one first groove and the at least one second groove, and is for the skull according to (12). plate.
(14) Both end portions of the at least one rod-like connecting member are substantially spherical, and the end portion on the side away from the first divided section of the at least one first groove and the at least one second groove (12) or (13) wherein any one of the end portions of the at least one rod-shaped connecting member is substantially hemispherical and can accommodate one of the both end portions. The skull plate as described in).
(15) The plurality of plate pieces include a first plate piece and a second plate piece which are adjacent to each other, and the first plate piece is positioned on the first divided section and the first divided section. At least one convex portion or at least one concave portion, and the second plate piece is located at the second divided surface facing the first divided surface, and at the second divided surface, and In any one of (1) to (4), the first plate piece has at least one convex portion or at least one convex portion that can be concavo-convexly fitted into the at least one concave portion. Skull plate.
(16) In the above (15), the at least one convex portion has a top width larger than a base end width, and the at least one concave portion has a bottom width larger than an opening width. The skull plate as described.
(17) The width of the at least one convex portion increases from the base end portion toward the top portion, and the width of the at least one concave portion increases from the opening portion toward the bottom portion. The skull plate according to (16) above.
(18) The plurality of plate pieces include a first plate piece and a second plate piece that are adjacent to each other, and the first plate piece is positioned on the first divided section and the first divided section. And the second plate piece is positioned on the second divided surface and overlaps the first stepped portion. The skull plate according to any one of (1) to (4), further including a second stepped portion that can be matched.
(19) The first plate piece further includes at least one first through hole penetrating the first stepped portion in the thickness direction, and the second plate piece includes the at least one first through hole. Further including at least one second through hole penetrating the second stepped portion in the thickness direction, the at least one first through hole and the at least one second through hole. The skull plate according to (18), further comprising at least one fixing member inserted through each of the skull plate.

  According to the present invention, there is an effect that a skull plate suitable for repairing a large bone defect portion of a skull can be provided.

(A)-(c) is a schematic explanatory drawing which shows the use condition of the plate for skulls concerning 1st Embodiment of this invention. It is sectional drawing which expands and shows the boundary part vicinity of the plate for skulls shown in FIG. It is a top view which shows the plate-shaped connection member with which the plate for skulls shown in FIG. 1 is provided. It is a figure which expands and shows the boundary part vicinity of the skull plate which concerns on 2nd Embodiment of this invention, (a) is a disassembled perspective view, (b) is a top view (top view). It is a figure which shows the modification of the plate for skulls concerning 2nd Embodiment of this invention, and is an exploded perspective view which expands and shows the boundary part vicinity. It is a figure which expands and shows the boundary part vicinity of the skull plate which concerns on 3rd Embodiment of this invention, (a) is a disassembled perspective view, (b) is a disassembled perspective view which shows the modification of (a). . It is a disassembled perspective view which expands and shows the boundary part vicinity of the plate for skulls which concerns on 4th Embodiment of this invention. (A)-(c) is process drawing which shows a part of manufacturing method of the plate for skulls concerning 1st Embodiment of this invention.

<Skull plate>
(First embodiment)
Hereinafter, the skull plate according to the first embodiment of the present invention will be described in detail with reference to FIGS.

  As shown in FIG. 1, the plate 1 </ b> A of the present embodiment is for fitting the bone defect portion 101 of the skull 100 to repair the bone defect portion 101. Examples of the constituent material of the plate 1A include ceramics, metals, and synthetic resins. 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 plate 1A 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 employed as the constituent material of the plate 1A, the thickness of the plate 1A can be set to about 1 mm.

  Here, the plate 1A of the present embodiment includes a plurality of plate pieces 2 that are separated from each other. According to such a configuration, the following effects can be obtained. That is, the bone defect portion 101 of this embodiment is located across the frontal bone, parietal bone, sphenoid bone, and temporal bone of the skull 100 and occupies most of the frontal bone. In order to repair such a large bone defect 101 with a plate, it is necessary to increase the size of the plate as described above. Since the plate 1A of the present embodiment includes the plurality of plate pieces 2, it is possible to increase the overall size of the plate 1A while configuring each of the plurality of plate pieces 2 in a relatively small size. .

  Specifically, when viewed from above, the plate 1A can be formed into a substantially semispherical shape (substantially semi-dome shape) or a substantially hemispherical shape (substantially dome shape). The top view means a state in which the plate 1A is viewed from the upper surface side of the plate 1A. The upper surface of the plate 1A means a surface located on the scalp side of the patient of the plate 1A when the plate 1A is fitted to the bone defect portion 101. In the present embodiment, the state in which the plate 1A is viewed from the first upper surface 212 side of the first plate piece 21 and the second upper surface 222 side of the second plate piece 22, which will be described later, is a top view. And in this top view, plate 1A of this embodiment is comprised by the substantially quadrispherical shape in which the whole shape respond | corresponds to the bone defect part 101 mentioned above.

  Further, in the present embodiment, each of the plurality of plate pieces 2 can be separately manufactured while being configured in a relatively small size, and therefore, compared to the case of manufacturing one large plate that is not divided into the plurality of plate pieces 2. It becomes easy to manufacture, and it is possible to reduce the load applied to each plate piece 2 during manufacturing and to prevent the occurrence of defective parts. Moreover, even if a defective portion occurs in the plate piece 2, it is only necessary to recreate the plate piece 2 in which the defective portion has occurred among the plurality of plate pieces 2, so that the manufacturing time can be shortened compared to the case of remaking the entire plate, Manufacturing costs can also be reduced.

  In the present embodiment, as described above, each of the plurality of plate pieces 2 can be separately manufactured while being configured in a relatively small size, and thus a small manufacturing apparatus can be employed. As a specific example, a ceramic green compact manufacturing apparatus, a CAM (computer aided manufacturing) apparatus, a firing furnace, a cleaning apparatus, and the like can be employed in a small size.

  Furthermore, when performing processing such as trimming on the plate 1A at a clinical site or the like, in the present embodiment, it is excellent because only the plate piece 2 including a portion that needs to be processed among the plurality of plate pieces 2 needs to be held. It becomes possible to exhibit workability.

  In particular, in the present embodiment, when ceramics is adopted as the constituent material of the plate 1A, its usefulness is improved. That is, when manufacturing a plate from ceramics, the plate-shaped green compact is usually processed and fired, but the green compact before firing is brittle. There is a risk of cracking. In addition, it is difficult to process a large size green compact with uniform pressure. In the present embodiment, as described above, each of the plurality of plate pieces 2 can be manufactured separately while being configured in a relatively small size, so that the green compact can be broken by reducing the load applied to the green compact during processing. The green compact can be processed with a uniform pressure while suppressing the above, and as a result, a high-quality ceramic plate 1A can be obtained with a high yield.

  Here, the several plate piece 2 of this embodiment has the 1st plate piece 21 and the 2nd plate piece 22 which are mutually adjacent | abutted. And in this embodiment, in the top view, between the plate pieces 2 and 2 adjacent to each other among the plurality of plate pieces 2, that is, the boundary portion 23 between the first plate piece 21 and the second plate piece 22 is curved. Is. According to such a configuration, when the plate 1A is fitted to the bone defect portion 101, the plate 1A can be prevented from bending outward or inward from the boundary portion 23. The reason for this is presumed as follows.

  That is, when the boundary portion 23 is configured with one straight line over the entire length, when the plate 1A is fitted to the bone defect portion 101, the plate 1A tends to be bent outward or inward from the boundary portion 23. . This is presumably due to the fact that when the plate 1A is fitted to the bone defect portion 101, stress generated by an error in the shape or size of the both is applied to the boundary portion 23. In the present embodiment, since the boundary portion 23 is curved when viewed from above, the above-described error is absorbed by the curved boundary portion 23 and stress applied to the boundary portion 23 is reduced, and as a result, the plate 1A is bounded. It is presumed that it is possible to suppress bending outward or inward from the part 23. In addition, the boundary part 23 of this embodiment may include the linear part in the top view as long as the effect mentioned above is acquired. That is, the boundary part 23 of this embodiment should just be substantially curvilinear over the full length.

  Moreover, it is preferable that the boundary portion 23 has a substantially S-shaped or substantially inverted S-shaped curved shape in a top view. In the present embodiment, the boundary portion 23 has a gentle, generally inverted S-curve shape when viewed from above. According to such a configuration, since the boundary portion 23 has a relatively simple configuration, manufacturing is facilitated, and the above-described effects due to the boundary portion 23 being curved can be efficiently obtained. Become.

  Moreover, the bone defect part 101 of this embodiment contains the median surface S of a patient, as shown in FIG.1 (c). The median plane S means a plane that equally divides the patient's body to the left and right. In the present embodiment, since the bone defect portion 101 includes the median plane S, the plate 1A, that is, the plurality of plate pieces 2 are fitted to the bone defect portion 101 including the median plane S. In the present embodiment, in order to suppress contact between the boundary portion 23 and the head blood vessel existing along the median plane S, the following configuration is provided.

  That is, the boundary portion 23 of the present embodiment crosses the median plane S in a top view when fitted to the bone defect portion 101. In addition, the boundary portion 23 of the present embodiment is connected to the anterior curve portion 232 extending from the intersection portion 231 with the median plane S to the front of the skull and the anterior curve portion 232 and extends from the intersection portion 231 to the rear of the skull. And a rear curve portion 233. In the present embodiment, the end portion 232a on the side away from the intersecting portion 231 in the front curved portion 232 and the end portion 233a on the side away from the intersecting portion 231 in the rear curved portion 233 are both median. Located away from the surface S. According to these structures, it becomes difficult for the boundary part 23 to contact the head blood vessel which exists along the median plane S, and damage to the head blood vessel can be suppressed. In FIG. 1, the X, Y and Z arrows indicate the directions as viewed from the patient. X1 is forward, X2 is backward, Y1 is left, Y2 is right, and Z is upward. ing. This also applies to FIG. 8 described later.

  On the other hand, as shown in FIG. 2, the first plate piece 21 of the present embodiment has a first dividing surface 211 and a first upper surface 212 connected to the first dividing surface 211. In addition, the second plate piece 22 of the present embodiment has a second divided surface 221 that faces the first divided surface 211, and a second upper surface 222 that is connected to the second divided surface 221. Both the first upper surface 212 and the second upper surface 222 are surfaces located on the scalp side of the patient when fitted to the bone defect portion 101.

  Further, the first plate piece 21 of the present embodiment further has a first lower surface 213. Similarly, the second plate piece 22 of the present embodiment further has a second lower surface 223. Both the first lower surface 213 and the second lower surface 223 are surfaces located on the patient's brain side when fitted to the bone defect portion 101.

  The first plate piece 21 of the present embodiment further includes a first chamfered portion 214 formed by chamfering an intersection between the first divided surface 211 and the first lower surface 213. Similarly, the second plate piece 22 of the present embodiment further includes a second chamfered portion 224 formed by chamfering the intersection of the second divided surface 221 and the second lower surface 223. According to these structures, when fitting the bone defect part 101, it can suppress that the cross | intersection part mentioned above of the 1st plate piece 21 and the 2nd plate piece 22 contacts and lose | deletes.

  Here, the plate 1 </ b> A of the present embodiment includes at least one plate piece 2, 2 adjacent to each other among the plurality of plate pieces 2, that is, at least one connecting the first plate piece 21 and the second plate piece 22. A connecting member is further provided. The connection member of this embodiment is a plate-like connection member 3 as shown in FIGS. The number of the plate-like connecting members 3 is not particularly limited as long as it is at least one, and a desired number can be adopted according to the shape, size, etc. of the plate piece 2. In the first plate piece 21 and the second plate piece 22, the number of the plate-like connection members 3 is suitably about 1 to 3, and preferably 2 to 3 from the viewpoint of connection stability. Examples of the constituent material of the plate-like connecting member 3 include the same ceramics, metals, and synthetic resins as exemplified in the plate 1A described above.

  Further, the plate 1A of the present embodiment further includes at least one buffer member 4 as shown in FIG. The buffer member 4 of the present embodiment has a first buffer part 41 and a second buffer part 42. The first buffer portion 41 of the present embodiment is interposed between the first divided surface 211 and the second divided surface 221 described above. The second buffer portion 42 of the present embodiment is located across the first upper surface 212 and the second upper surface 222. And the plate-shaped connection member 3 of this embodiment mentioned above has connected the 1st plate piece 21 and the 2nd plate piece 22 via the 2nd buffer part 42. FIG. According to these structures, it can suppress that the 1st dividing surface 211 and the 2nd dividing surface 221 contact mutually, and are missing | missed by the 1st buffer part 41. FIG. Further, the second buffer portion 42 can suppress the plate-like connecting member 3 and the first upper surface 212 and the second upper surface 222 from coming into contact with each other and being lost. The configuration described above is suitable when ceramics is used as the constituent material of the plate 1A. In addition, when a metal, a synthetic resin, etc. are employ | adopted for the constituent material of plate 1A, use of the buffer member 4 can be abbreviate | omitted.

  The number of the buffer members 4 is not particularly limited as long as it is at least one, and a desired number can be adopted according to the shape, size, and the like of the plate piece 2. In the first plate piece 21 and the second plate piece 22, the number of the buffer members 4 is the same as the number of the plate-like connecting members 3 described above. As a constituent material of the buffer member 4, for example, the same synthetic resin as exemplified in the plate 1A described above can be used.

  In the buffer member 4 of the present embodiment, the first buffer portion 41 and the second buffer portion 42 are integrally formed. According to such a configuration, the mounting of the buffer member 4 becomes relatively simple and the number of parts can be reduced, so that the operation time can be shortened.

  The 2nd buffer part 42 which buffer member 4 of this embodiment has is a part which functions as a washer. From the viewpoint of improving this function, in the present embodiment, the area of the second buffer portion 42 is larger than the area of the plate-like connecting member 3.

  Moreover, in this embodiment, when attaching the plate-shaped connection member 3 mentioned above to the 1st plate piece 21 and the 2nd plate piece 22, respectively, it has the following structures. That is, the plate-like connection member 3 of the present embodiment has a pair of through holes 31 and 31 located at both ends thereof. In addition, the buffer member 4 of the present embodiment further includes a pair of through holes 43 and 43 located at both ends of the second buffer portion 42. And plate 1A of this embodiment is further provided with a pair of screws 5 and 5 which are fixing members. According to these configurations, each of the pair of screws 5, 5 is inserted in the order of the through holes 31, 43, and further on the first lower surface 213 of the first plate piece 21 or the second lower surface 223 of the second plate piece 22. It is possible to attach the plate-like connecting member 3 to the first plate piece 21 and the second plate piece 22, respectively.

  Examples of the constituent material of the screw 5 include the same ceramics, metals, and synthetic resins as exemplified in the plate 1A described above. When using ceramics as the constituent material of the plate 1A, that is, the first plate piece 21 and the second plate piece 22, it is preferable to use synthetic resin as the constituent material of the screw 5. Thereby, when attaching the plate-shaped connection member 3 to the 1st plate piece 21 and the 2nd plate piece 22, respectively, it can suppress that the ceramic 1st plate piece 21 and the 2nd plate piece 22 lose | delete. . In the present embodiment, the screw 5 is used as the fixing member of the plate-like connecting member 3. However, instead of the screw 5, other fixing members such as anchor bolts having a widened tip can be used.

(Second Embodiment)
Next, the plate which concerns on 2nd Embodiment of this invention is demonstrated in detail with reference to FIG. 4 and FIG. 4 and 5, the same components as those in FIGS. 1 to 3 described above may be denoted by the same reference numerals and description thereof may be omitted.

  In this embodiment, the connection structure of the 1st plate piece 21 and the 2nd plate piece 22 differs from 1st Embodiment mentioned above. Specifically, as shown in FIG. 4, in the plate 1 </ b> B of the present embodiment, the first plate piece 21 is located on the first upper surface 212, and the intersection of the first divided surface 211 and the first upper surface 212. It further has at least one first groove 216 leading to 215. Similarly, in the plate 1 </ b> B of the present embodiment, the second plate piece 22 is located on the second upper surface 222 and has at least one second groove reaching the intersection 225 of the second divided surface 221 and the second upper surface 222. 226 is further included. The plate 1B of the present embodiment connects the first plate piece 21 and the second plate piece 22 while being accommodated in each of the at least one first groove 216 and the at least one second groove 226. At least one rod-like connecting member 6 is further provided. Also with these configurations, the first plate piece 21 and the second plate piece 22 can be connected.

  In the first plate piece 21 and the second plate piece 22, the number of the first grooves 216 and the second grooves 226 is suitably about 1 to 3, and is 2 to 3 from the viewpoint of connection stability. Is preferred. This also applies to the number of rod-like connecting members 6. Examples of the constituent material of the rod-shaped connecting member 6 include the same ceramics, metals, and synthetic resins as exemplified in the plate 1A described above.

  In the present embodiment, as shown in FIG. 4B, the length L1 of the rod-like connecting member 6 is the sum of the length L2 of the first groove 216 and the length L3 of the second groove 226, that is, from the formula: L2 + L3 It is larger than the calculated value. According to such a configuration, an appropriate gap can be formed in the boundary portion 23, so that it becomes easy for the boundary portion 23 to absorb errors in the shape or size of both when the plate 1 B is fitted to the bone defect portion 101. The stress applied to the boundary portion 23 can be reduced. As a result, when the plate 1B is fitted to the bone defect portion 101, the plate 1B can be prevented from bending outward or inward from the boundary portion 23. In addition, it is preferable to set the length L1 of the rod-shaped connection member 6 so that the clearance gap formed in the boundary part 23 may become small within the range with which the effect mentioned above is acquired.

Moreover, in this embodiment, the structure as shown in FIG. 5 is employable as the modification. That is, in this modification, as shown in FIG. 5, both end portions 6a and 6a of the rod-like connecting member 6 are substantially spherical. Further, the end portion 216a on the side away from the first dividing surface 211 in the first groove 216 and the end portion 226a on the side away from the second dividing surface 221 in the second groove 226 are both rod-like connected. The member 6 has a substantially hemispherical shape that can accommodate one of the two end portions 6a and 6a. According to these structures, it can suppress that the rod-shaped connection member 6 slips out from the 1st groove | channel 216 and the 2nd groove | channel 226.
Since other configurations are the same as those of the plate 1A according to the first embodiment described above, the description thereof is omitted.

(Third embodiment)
Next, a plate according to a third embodiment of the present invention will be described in detail with reference to FIG. In FIG. 6, the same components as those in FIGS. 1 to 5 described above may be denoted by the same reference numerals and description thereof may be omitted.

  In this embodiment, the connection structure of the 1st plate piece 21 and the 2nd plate piece 22 differs from the 1st, 2nd embodiment mentioned above. Specifically, as shown in FIG. 6A, in the plate 1 </ b> C of the present embodiment, the first plate piece 21 further has at least one concave portion 217 located in the first dividing surface 211. Further, in the plate 1 </ b> C of the present embodiment, the second plate piece 22 is positioned on the second dividing surface 221, and at least one convex portion 227 that can be engaged with at least one concave portion 217 of the first plate piece 21. It has further. According to these configurations, the first plate piece 21 and the second plate piece 22 can be connected by fitting the convex portion 227 and the concave portion 217 to each other.

  In the first plate piece 21 and the second plate piece 22, the number of the convex portions 227 and the concave portions 217 is appropriately about 1 to 3, and preferably 2 to 3 from the viewpoint of connection stability. .

  In the present embodiment, in order to prevent the convex portion 227 and the concave portion 217 fitted to the concave and convex portions from being detached from each other in the lateral direction, the following configuration is provided. That is, as for the convex part 227 of this embodiment, the width | variety of the top part 227a is larger than the width | variety of the base end part 227b. Further, the recess 217 of the present embodiment has a bottom portion 217a having a width greater than that of the opening 217b.

  Further, in order to suppress the convex portion 227 and the concave portion 217 fitted to the concave and convex portions from coming off from each other in the lateral direction, in the present embodiment, a configuration as shown in FIG. Can do. That is, in this modification, as shown in FIG. 6B, the convex portion 227 has a width that increases from the base end portion 227b toward the top portion 227a, and the concave portion 217 extends from the opening 217b to the bottom portion 217a. The width increases as you go.

In the present embodiment, the first plate piece 21 has the concave portion 217, and the second plate piece 22 has the convex portion 227. However, an opposite configuration may be employed. In other words, the first plate piece 21 further has a convex portion located on the first dividing surface 211, and the second plate piece 22 is located on the second dividing surface 221, so that the first plate piece 21 is convex. It can be set as the structure which further has a recessed part which can be unevenly fitted to a part.
Other configurations are the same as those of the plates 1A and 1B according to the first and second embodiments described above, and thus the description thereof is omitted.

(Fourth embodiment)
Next, a plate according to a fourth embodiment of the present invention will be described in detail with reference to FIG. In FIG. 7, the same components as those in FIGS. 1 to 6 described above may be denoted by the same reference numerals and description thereof may be omitted.

  In this embodiment, the connection structure of the 1st plate piece 21 and the 2nd plate piece 22 differs from the 1st-3rd embodiment mentioned above. Specifically, as shown in FIG. 7, in the plate 1 </ b> D of the present embodiment, the first plate piece 21 further includes a first step portion 218 located in the first dividing surface 211. In the plate 1 </ b> D of the present embodiment, the second plate piece 22 further includes a second step portion 228 that is positioned on the second dividing surface 221 and can be superimposed on the first step portion 218. According to these configurations, the first plate piece 21 and the second plate piece 22 can be connected by overlapping the first step portion 218 and the second step portion 228 with each other.

  Moreover, in this embodiment, when connecting the 1st plate piece 21 and the 2nd plate piece 22 firmly, it has the following structures. That is, the first plate piece 21 of the present embodiment further includes at least one first through hole 219 that penetrates the first stepped portion 218 in the thickness direction of the first plate piece 21. In addition, the second plate piece 22 of the present embodiment is positioned corresponding to at least one first through hole 219 and passes through the second stepped portion 228 in the thickness direction of the second plate piece 22. Two second through holes 229 are further provided. The plate 1D of this embodiment further includes at least one fixing member (not shown) that is inserted into each of the at least one first through hole 219 and the at least one second through hole 229.

  In the first plate piece 21 and the second plate piece 22, the number of the first through holes 219 and the second through holes 229 is appropriately about 1 to 3, and 2 to 3 from the viewpoint of connection stability. Is preferred. This also applies to the number of fixing members. Examples of the fixing member include the above-described screw 5 and an anchor bolt with a distal end widened.

In addition, when the first stepped portion 218 and the second stepped portion 228 are overlapped with each other, the mutually facing surfaces of the first stepped portion 218 and the second stepped portion 228 may be configured with tapered surfaces that can be taper-fitted. it can.
Since other configurations are the same as those of the plates 1A to 1C according to the first to third embodiments described above, the description thereof is omitted.

<Manufacturing method of skull plate>
Next, a method for manufacturing a skull plate according to an embodiment of the present invention will be described in detail with reference to FIG. 8 taking the case of manufacturing the plate 1A described above as an example.

The manufacturing method of the plate 1A of the present embodiment includes the following steps (I) to (IV).
(I) A step of obtaining three-dimensional data 110 of the skull 100 based on a plurality of tomographic data of the skull 100 having the bone defect portion 101 as shown in FIG.
(II) As shown in FIG. 8 (b), bone shape data of the bone defect portion 101 is obtained based on the obtained three-dimensional data 110, and one undivided plate drawing is obtained based on the obtained bone shape data. The process of creating 1a.
(III) A step of setting a dividing line 23a corresponding to the boundary 23 to the created uncut plate drawing 1a to obtain a processed drawing 1A 'of the plate 1A as shown in FIG. 8C.
(IV) A step of obtaining the processing data of the plate 1A based on the obtained processing drawing 1A ′ and manufacturing the plate 1A based on the obtained processing data.

  Here, the three-dimensional data 110 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 above-described step (III), it is preferable that the position of the dividing line 23a is set so that each of the plurality of plate pieces 2 in the obtained plate 1A has a relatively small size.

  In particular, in the step (III) described above, the position of the dividing line 23a is preferably set to a position where the patient's temporal muscle or hair is present. According to such a configuration, when the obtained plate 1A is fitted to the bone defect portion 101, soft tissue such as a patient's muscle or hair is present above the boundary portion 23. It can be difficult to see.

  On the other hand, when a metal, a synthetic resin, or the like is employed as the constituent material of the plate 1A, the plate 1A can be manufactured in the above-described step (IV) by cutting or the like. Moreover, when ceramics etc. are employ | adopted for the constituent material of plate 1A, manufacture of plate 1A in the process (IV) mentioned above usually includes a baking process. Therefore, in this case, it is preferable to obtain the plate 1A by processing the green compact in consideration of the shrinkage rate due to baking and baking the green compact.

  In particular, in the above-described step (IV), it is preferable to separately manufacture each of the plurality of plate pieces 2 to obtain the plate 1A. Thereby, it becomes possible to acquire the effect mentioned above by manufacturing each of the several plate piece 2 separately.

  In the above-described step (IV), if necessary, a plate 1A may be obtained by producing one undivided plate and then dividing the obtained undivided plate into a plurality of plate pieces 2. . In the present embodiment, the case where the plate 1A is manufactured has been described as an example, but the above-described plates 1B to 1D can also be manufactured in the same manner as the plate 1A.

<Cranioplasty>
Next, cranioplasty according to an embodiment of the present invention will be described taking as an example the case of using the plate 1A described above.

  In the cranioplasty of this embodiment, first, the plate 1A is sterilized and then brought into the surgical field. At this time, from the viewpoint of shortening the operation time, it is preferable that the plate 1A is brought into the surgical field in a state where the plurality of plate pieces 2 are combined in advance.

  Next, the plate 1 </ b> A is fitted to the bone defect portion 101. At this time, in order to align the plate 1A with the bone defect portion 101, when performing processing such as trimming on the plate 1A, only the plate piece 2 including a portion that needs to be processed among the plurality of plate pieces 2 is processed. do it.

  Through the above procedure, a cranioplasty using the plate 1A of the present embodiment can be performed. In the present embodiment, the case where the plate 1A is used has been described as an example. However, the cranioplasty can be performed on the above-described plates 1B to 1D in the same procedure as the plate 1A.

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

  For example, in the first embodiment described above, the configuration in which the plurality of plate pieces 2 includes the first plate piece 21 and the second plate piece 22 has been described. That is, in the first embodiment described above, the number of the plurality of plate pieces 2 is two, but the number of the plurality of plate pieces 2 is not limited to two, and the size of the bone defect portion 101 is not limited. Depending on the desired number, a desired number can be employed. The number of the plate pieces 2 is suitably about 2-3.

  Further, in the first embodiment described above, the boundary portion 23 is formed in a substantially inverted S-curve shape in a top view, but instead, the boundary portion 23 is replaced with another shape such as a wavy line, an arc shape, or the like. Can be curved.

  Moreover, it can replace with the structure of the above-mentioned 4th Embodiment, and can comprise the 1st dividing surface 211 and the 2nd dividing surface 221 in the taper shape which can mutually taper-fit.

1A to 1D Skull plate 2 Plate piece 21 First plate piece 211 First divided section 212 First upper surface 213 First lower surface 214 First chamfered portion 215 Intersection 216 First groove 216a End 217 Recess 217a Bottom 217b Opening 218 First step portion 219 First through hole 22 Second plate piece 221 Second divided section 222 Second upper surface 223 Second lower surface 224 Second chamfered portion 225 Crossing portion 226 Second groove 226a End portion 227 Protruding portion 227a Top portion 227b Base end Part 228 Second step part 229 Second through hole 23 Boundary part 231 Crossing part 232 Front curve part 232a End part 233 Back curve part 233a End part 3 Plate-like connecting member 31 Through hole 4 Buffer member 41 First buffer part 42 Second Buffer part 43 Through-hole 5 Screw 6 Rod-like connecting member 6a Both ends 100 Skull 101 Bone Missing part

Claims (19)

It has a plurality of plate pieces that are separated from each other,
A skull plate in which a boundary portion between the plate pieces adjacent to each other among the plurality of plate pieces is curved in a top view.   The skull plate according to claim 1, wherein the skull plate is substantially quadrispherical or substantially hemispherical when viewed from above.   The skull plate according to claim 1 or 2, wherein the boundary portion has a substantially S-shaped or substantially inverted S-shaped curved shape in a top view. The plurality of plate pieces have a first plate piece and a second plate piece that are adjacent to each other, and fit into a bone defect including a median surface of a patient,
When viewed from above when fitted into the bone defect, the boundary between the first plate piece and the second plate piece crosses the median plane and the skull from the intersection with the median plane An anterior curve portion extending forward, and a posterior curve portion connected to the anterior curve portion and extending backward from the skull from the intersecting portion;
The end portion on the side away from the intersecting portion in the front curve portion and the end portion on the side away from the intersecting portion in the rear curve portion are both located away from the median plane. The skull plate according to any one of claims 1 to 3.   The skull plate according to any one of claims 1 to 4, further comprising at least one connecting member that connects the plate pieces adjacent to each other among the plurality of plate pieces.   The skull plate according to claim 5, wherein the at least one connecting member is a plate-like connecting member. The plurality of plate pieces have a first plate piece and a second plate piece adjacent to each other,
The first plate piece has a first dividing surface,
The second plate piece has a second divided section facing the first divided section,
The skull plate according to any one of claims 1 to 4, further comprising at least one buffer member having a first buffer portion interposed between the first and second divided sections. The first plate piece further includes a first upper surface connected to the first dividing surface,
The second plate piece further includes a second upper surface connected to the second dividing surface,
The at least one buffer member further includes a second buffer portion positioned from the first top surface to the second top surface,
The skull plate according to claim 7, further comprising at least one plate-like connecting member that connects the first plate piece and the second plate piece via the second buffer portion.   The skull plate according to claim 8, wherein the at least one buffer member is formed by integrally forming the first buffer portion and the second buffer portion. The first plate piece further includes a first lower surface, and a first chamfered portion formed by chamfering the intersecting portion of the first divided cross section and the first lower surface,
The said 2nd plate piece further has a 2nd lower surface and the 2nd chamfered part formed by chamfering the intersection of the said 2nd partial cross section and the said 2nd lower surface, The any one of Claims 7-9 Skull plate.   The skull plate according to any one of claims 7 to 10, wherein a constituent material of the first plate piece and the second plate piece is ceramics. The plurality of plate pieces have a first plate piece and a second plate piece adjacent to each other,
The first plate piece includes a first dividing surface, a first upper surface connected to the first dividing surface, and an intersection of the first dividing surface and the first upper surface located on the first upper surface. And at least one first groove leading to
The second plate piece is located on the second upper surface, the second upper surface connected to the second divided surface, the second divided surface facing the first divided surface, and the second upper surface. Having at least one second groove leading to a cross section and an intersection of the second upper surface,
And at least one rod-like connecting member that connects the first plate piece and the second plate piece in a state of being accommodated in each of the at least one first groove and the at least one second groove, The skull plate according to any one of claims 1 to 4.   The skull plate according to claim 12, wherein a length of the at least one rod-like connecting member is larger than a total length of each of the at least one first groove and the at least one second groove. Both ends of the at least one rod-like connecting member are substantially spherical,
The end on the side of the at least one first groove away from the first dividing surface and the end of the at least one second groove on the side away from the second dividing surface are both The skull plate according to claim 12 or 13, which has a substantially hemispherical shape capable of accommodating one of the both end portions of at least one rod-like connecting member. The plurality of plate pieces have a first plate piece and a second plate piece adjacent to each other,
The first plate piece has a first dividing surface and at least one convex portion or at least one concave portion located in the first dividing surface,
The second plate piece is positioned at the second divided surface facing the first divided surface, and the at least one convex portion of the first plate piece or the at least one The skull plate according to any one of claims 1 to 4, wherein the skull plate has at least one concave portion or at least one convex portion that can be fitted into the concave portion. The at least one convex portion has a top width larger than a base end width,
The skull plate according to claim 15, wherein the width of the bottom of the at least one recess is larger than the width of the opening. The at least one convex portion has a width that increases from the base end portion toward the top portion,
The skull plate according to claim 16, wherein the at least one recess has a width that increases from the opening toward the bottom. The plurality of plate pieces have a first plate piece and a second plate piece adjacent to each other,
The first plate piece has a first dividing surface and a first step portion located on the first dividing surface,
The second plate piece has a second divided surface that faces the first divided surface, and a second step portion that is located on the second divided surface and can be overlapped with the first step portion. The skull plate according to any one of claims 1 to 4. The first plate piece further includes at least one first through hole penetrating the first step portion in the thickness direction,
The second plate piece further includes at least one second through hole that is positioned corresponding to the at least one first through hole and penetrates the second stepped portion in the thickness direction,
The skull plate according to claim 18, further comprising at least one fixing member inserted into each of the at least one first through hole and the at least one second through hole.

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