JP7546897B2 - Medical Threading Device - Google Patents

Description

The present invention relates to a medical threading device.

In neurosurgery craniotomy, a portion of the skull may be cut out to make a window in the skull. The dura mater is originally attached to the inner surface of the skull, so it must be peeled off when cutting out the portion of the skull. Therefore, when closing the skull, the cut portion of the skull (hereinafter sometimes referred to as the "bone fragment") must be returned to its original position and the dura mater must be attached to the bone fragment. Tenting is known as a method for attaching the dura mater to the bone fragment. In tenting, a hole is formed in the bone fragment, a suture thread that has been tied to the dura mater is passed through the hole, and the suture thread is pulled to the outside of the bone fragment, thereby lifting the dura mater toward the bone fragment. This allows the dura mater to be attached to the bone fragment.

In relation to threading a suture through a perforation formed in the skull, Patent Document 1 describes a threading tool that can easily thread a suture through a perforation by passing the suture through the perforation while holding it with a thread gripper.

Japanese Patent Application Publication No. 10-309283

With the threading tool described in Patent Document 1, when the suture is held in the threading tool, the threading tool cannot be fixed to the bone fragment. This makes it difficult to stably hold the suture in the threading tool and insert and remove the threading tool (and the held suture) into and from the hole in the bone fragment while holding the bone fragment.

The present invention was made to solve the above problems, and aims to stably perform the operation of holding a suture in a threading tool and the operation of inserting and removing the threading tool into a hole in a bone fragment while holding the bone fragment.

Some embodiments of the present invention are medical threading devices that have a gripping portion that is held by the surgeon and a suture guide portion that has a thread holding portion that holds a suture, the suture guide portion being insertable into and removable from a perforation formed in the skull, and a fixing portion that is provided so as to protrude from the gripping portion in the direction in which the suture guide portion is inserted into the perforation and that can be fixed to the skull.

Other features of the present invention will become clear from the following description and drawings.

According to some embodiments of the present invention, the operation of holding the suture in the threading tool and the operation of inserting and removing the threading tool into the hole in the bone fragment can be performed stably while holding the bone fragment.

FIG. 1 is a perspective view of a threading tool 10 according to the present embodiment. 2A and 2B are plan and side views of the threading tool 10 of the present embodiment. FIG. 3 is an explanatory diagram showing the state of the thread guide part 13 fixed to the fastener 17 of the grip part 11. As shown in FIG. 4A to 4D are explanatory diagrams showing an outline of the procedure of craniotomy. 5A to 5D are explanatory diagrams showing examples of how the threading tool 10 of the present embodiment is used. FIG. 6 is an explanatory diagram showing a modified example of the fixing portion 12. In FIG.

At least the following points become clear from the description in the specification and drawings described below.

A medical threading tool is disclosed that has a gripping portion that is held by the surgeon, a thread guide portion having a thread holding portion that holds a suture, the thread guide portion being insertable into and removable from a perforation formed in the skull, and a fixing portion that is provided so as to protrude from the gripping portion in the direction in which the thread guide portion is inserted into the perforation and that can be fixed to the skull. With such a medical threading tool, the operation of holding a suture in the threading tool and the operation of inserting and removing the threading tool into and from a perforation in a bone fragment can be performed stably while holding the bone fragment.

The fixing part is located between the thread guide part, which is inserted into the perforation, and the grip part, and it is desirable that the size of the fixing part in the direction perpendicular to the direction in which the thread guide part is inserted into the perforation increases from the thread guide part side toward the grip part side. This allows the medical threading tool to be fixed to the skull by fitting the fixing part into a perforation formed in the skull.

It is desirable that the size of the fixing portion is smaller than the diameter of the perforation at the end of the fixing portion on the thread guide portion side and is larger than the diameter of the perforation at the end of the fixing portion on the grip portion side. This allows the medical threading tool to be fixed to the skull by fitting the fixing portion into a perforation formed in the skull.

It is preferable that a screw is formed on the outer periphery of the fixing part. This allows the fixing part to be screwed to the skull, thereby more firmly fixing the medical threading tool to the skull.

It is desirable that the fixing part be formed in a needle shape that protrudes from the grip part in the direction in which the thread guide part is inserted into the perforation. This allows the medical threading tool to be fixed to the skull by piercing the fixing part into the skull.

====Present Embodiment====
<Configuration>
Fig. 1 is a perspective view of the threading tool 10 of the present embodiment. Fig. 2A is a plan view of the threading tool 10 of the present embodiment. Fig. 2B is a side view of the threading tool 10 of the present embodiment. Fig. 3 is an explanatory diagram showing the state of the thread guide part 13 fixed to the fastener 17 of the grip part 11.

In the following, when describing the configuration and operation of the threading tool 10, the description may be made according to the directions shown in Figures 1 to 3. That is, the direction in which the left and right parts (right side part 13A and left side part 13B) of the ring-shaped part 19 (thread guide part 13) of the threading tool 10 are lined up is referred to as the "width direction". Also, the direction in which the surface including the ring-shaped part 19 faces (the direction perpendicular to the surface including the ring-shaped part 19, the normal direction to the surface including the ring-shaped part 19) is referred to as the "thickness direction". Also, of the directions perpendicular to the "width direction" and "thickness direction", the direction when the thread guide part 13 (or the fixed part 12) is viewed from the grip part 11 is referred to as the "insertion direction", and the direction when the grip part 11 is viewed from the thread guide part 13 (or the fixed part 12) is referred to as the "removal direction". As shown in Figures 5A to 5D, which will be described later, the "insertion direction" is the direction in which the suture guide portion 13 is inserted into the perforation 3 in the bone piece 2, and the "removal direction" is the direction in which the suture guide portion 13 is removed from the perforation 3 in the bone piece 2. The "insertion direction" and "removal direction" are sometimes collectively referred to as the "insertion/removal direction."

The threading tool 10 is a tool for threading a suture through a perforation formed in the skull. The threading tool 10 has a gripping portion 11, a fixing portion 12, and a suture guide portion 13.

The gripping portion 11 is a member that is gripped by the surgeon (here, a doctor) when using the threading tool 10. In the threading tool 10 of this embodiment, when using the threading tool 10, the thread guide portion 13 is inserted into a perforation formed in the bone piece (see Figures 5A and 5B described later). At this time, the surgeon grips the gripping portion 11 and moves the thread guide portion 13 toward the bone piece. As shown in Figures 1 to 2B, the gripping portion 11 is formed so that the size in the thickness direction is smaller than the size in the width direction. That is, the gripping portion 11 is formed in a plate shape that is thin in the thickness direction. However, the gripping portion 11 may be formed in a plate shape that is thin in the width direction, or in a rod shape (a shape in which the size in the width direction and the size in the thickness direction are the same). In addition, it may be in any other shape as long as it is a shape that the surgeon can grip. By forming the gripping portion 11 in a plate shape, it becomes easier to apply a rotational force (torque) to the threading tool 10 when screwing and fixing the fixing portion 12 having the male thread portion 15 into a drilled hole in a bone fragment, compared to when the gripping portion 11 is formed in a rod shape. The gripping portion 11 is provided with a gripping surface 11A for the surgeon to grip. The gripping surface 11A is a surface parallel to the width direction. The gripping surface 11A is also a surface perpendicular to the thickness direction.

The grip portion 11 has a flange portion 14 and a fastener 17.

The flange 14 is a member that is fitted to the outer surface of the bone fragment when the fixing part 12 is fixed to the bone fragment. As shown in Figs. 1 to 2B, the flange 14 is provided on the insertion direction side (thread guide part 13 side, fixing part 12 side) of the part of the gripping part 11 where the gripping surface 11A is formed. By providing the flange 14 on the gripping part 11, the thread guide part 13 can be inserted straight into the perforation of the bone fragment, and the fixing part 12 can be fixed to the bone fragment. As shown in Figs. 1 to 2B, the surface of the flange 14 on the insertion direction side is a surface perpendicular to the insertion/removal direction. The flange 14 does not have to be provided.

The fastener 17 is a member that fixes (holds) the end of the thread guide portion 13 in the removal direction to the grip portion 11. In other words, the fastener 17 is a member that holds the base of the thread guide portion 13. As shown in FIG. 3, the fastener 17 is formed to protrude from the flange portion 14 in the insertion direction. The end of the thread guide portion 13 in the removal direction is fixed to the outer circumferential surface of the fastener 17. Although not shown in FIG. 3, a hole may be formed in the width direction of the fastener 17, and the end of the thread guide portion 13 in the removal direction may be inserted and fixed in the hole. As a result, when the thread guide portion 13 is removed from the perforation 3 of the bone piece 2 (see FIG. 5D described later) and the thread guide portion 13 is subjected to a pulling force in the removal direction, the thread guide portion 13 is less likely to come off the fastener 17. The fastener 17 does not have to protrude from the flange 14, and the end of the thread guide part 13 on the removal direction side may be fixed directly to the flange 14 (grip part 11).

The fixing portion 12 is a portion that allows the threading tool 10 to be fixed to a bone fragment. As shown in FIGS. 1 to 3, the fixing portion 12 is provided so as to protrude from the flange portion 14 (the grip portion 11) in the insertion direction. Also, as shown in FIGS. 1 to 3, the fixing portion 12 is located between the thread guide portion 13 inserted into the perforation and the grip portion 11. Furthermore, in this embodiment, as shown in FIG. 3, the fixing portion 12 is provided on the outside of the fastener 17 of the grip portion 11 when viewed along the axis of the insertion and removal direction of the thread guide portion 13. When viewed from the fixing portion 12, the fastener 17 is provided on the inside of the fixing portion 12 when viewed along the axis of the insertion and removal direction of the thread guide portion 13. As shown in FIG. 3, the end of the thread guide portion 13 on the removal direction side is pressed from the outside by the fixing portion 12 and fixed to the fastener 17. This makes it more difficult for the thread guide portion 13 to come off from the fastener 17. However, the end of the thread guide part 13 on the removal direction side does not have to be held from the outside by the fixing part 12 and fixed to the fastener 17.

In this embodiment, as shown in FIG. 2A and FIG. 2B, the outer circumference of the fixing part 12 has a conical surface that is convex in the insertion direction, with the surface perpendicular to the insertion direction (the surface on the insertion direction side of the flange part 14 of the grip part 11) as the bottom surface. As a result, the size of the fixing part 12 in the direction perpendicular to the insertion direction increases from the thread guide part 13 side (insertion direction side) toward the grip part 11 side (removal direction side). The size (D1) of the fixing part 12 in the direction perpendicular to the insertion direction at the end of the thread guide part 13 side (insertion direction side) of the fixing part 12 is smaller than the diameter (D) of the hole in the bone piece into which the thread guide part 13 is inserted (D1<D). The size (D2) of the fixing part 12 in the direction perpendicular to the insertion direction at the end of the grip part 11 side (removal direction side) of the fixing part 12 is larger than the diameter (D) of the hole in the bone piece into which the thread guide part 13 is inserted (D2>D). As a result, when the threading tool 10 is moved further in the insertion direction after the thread guide portion 13 has been inserted into the hole in the bone piece, the fixed portion 12 fits (engages) in the hole in the bone piece at a predetermined position in the insertion/removal direction of the fixed portion 12 (a predetermined position between the end on the thread guide portion 13 side and the end on the grip portion 11 side). As a result, the threading tool 10 can be fixed to the bone piece by inserting the fixed portion 12 into the hole in the bone piece. Note that the outer peripheral surface of the fixed portion 12 does not have to be a conical surface, and may have another shape as long as the fixed portion 12 can fit (engage) in the hole in the bone piece at a predetermined position in the insertion/removal direction of the fixed portion 12.

In this embodiment, as shown in Figs. 1 to 2B, a male thread portion 15 is formed on the outer periphery of the fixing portion 12. Hereinafter, the male thread portion 15 may be simply referred to as a "screw." When a rotational force is applied to the gripping portion 11 with the fixing portion 12 fitted (engaged) in the drilled hole of the bone piece at a predetermined position in the insertion/removal direction, the fixing portion 12 rotates around the axis of the insertion/removal direction, and the fixing portion 12 with the thread formed on the outer periphery is screwed into the drilled hole of the bone piece. This makes it possible to screw and fix the fixing portion 12 into the drilled hole of the bone piece. Therefore, the threading tool 10 can be fixed to the bone piece more firmly. However, the fixing portion 12 does not have to have a male thread portion 15 formed on the outer periphery.

The thread guide 13 is a member that guides the suture when passing the suture through the perforation of the bone fragment. When the thread guide 13 is inserted into the perforation 3 of the bone fragment 2 (see FIG. 5B described later), the suture 5 is inserted into the thread guide 13 (see FIG. 5C described later), and the thread guide 13 guides the suture 5 to the outside (removal direction side) of the bone fragment 2 while holding the suture 5 (see FIG. 5D described later). The thread guide 13 of this embodiment is formed by bending a single linear member. As shown in FIG. 3, both ends of the thread guide 13 are fixed to the fasteners 17 of the gripping portion 11. The thread guide 13 with both ends fixed is bent to make a circle while forming the intersection 18, and a ring-shaped portion 19 is formed on the insertion direction side of the intersection 18. The ring-shaped portion 19 is the portion into which the suture is inserted. By forming the intersection 18, the ring-shaped portion 19 can be kept open in the width direction.

A thread holding section 16 is formed at the end of the ring-shaped section 19 in the insertion direction. The thread holding section 16 is the first part to be inserted when the thread guide section 13 is inserted into the perforation of the bone fragment. The thread holding section 16 also holds the suture inserted into the ring-shaped section 19 when guiding the suture 5 to the outside (removal direction) of the bone fragment 2. As shown in Figures 1, 2A and 3, the thread holding section 16 is bent at an acute angle at the end of the ring-shaped section 19 in the insertion direction. This makes it easier to insert the thread guide section 13 into the perforation of the bone fragment. The suture 5 inserted into the ring-shaped section 19 and located at the thread holding section 16 is held by friction with the thread guide section 13 on both sides in the width direction. However, as long as the suture holder 16 can be inserted into the hole in the bone fragment and can hold the suture inserted into the ring-shaped portion 19, it does not have to be bent at an acute angle at the end of the ring-shaped portion 19 in the insertion direction.

The loop-shaped portion 19 is composed of a right side portion 13A on one side in the width direction (the right side when the loop-shaped portion 19 is viewed in the thickness direction) and a left side portion 13B on the other side (the left side when the loop-shaped portion 19 is viewed in the thickness direction) of the line connecting the thread holding portion 16 and the intersection portion 18. A right side bend portion 20A is provided in the middle of the right side portion 13A in the insertion/removal direction. A left side bend portion 20B is provided in the middle of the left side portion 13B in the insertion/removal direction. The right side bend portion 20A and the left side bend portion 20B are portions formed by folding the loop-shaped portion 19. As a result, the loop-shaped portion 19 is formed into a diamond shape in which the line connecting the thread holding portion 16 and the intersection portion 18 and the line connecting the right side bend portion 20A and the left side bend portion 20B are diagonal lines.

Therefore, when the loop-shaped portion 19 is viewed in the removal direction from the thread holding portion 16, the right side portion 13A and the left side portion 13B are oriented to move away from each other toward the right side bending portion 20A (or the left side bending portion 20B). Also, when the loop-shaped portion 19 is viewed in the removal direction from the right side bending portion 20A (or the left side bending portion 20B), the right side portion 13A and the left side portion 13B are oriented to move closer to each other toward the intersection portion 18. In other words, when the loop-shaped portion 19 is viewed in the insertion direction from the intersection portion 18, the right side portion 13A and the left side portion 13B are oriented to move away from each other toward the right side bending portion 20A (or the left side bending portion 20B). Also, when the loop-shaped portion 19 is viewed in the insertion direction from the right side bending portion 20A (or the left side bending portion 20B), the right side portion 13A and the left side portion 13B are oriented to move closer to each other toward the thread holding portion 16.

In this embodiment, the ring-shaped portion 19 (thread guide portion 13) can be elastically deformed so that the right bending portion 20A and the left bending portion 20B approach and separate in the width direction. The threading tool 10 in the state shown in Figures 1 to 3 is in a state in which the right bending portion 20A and the left bending portion 20B are separated in the width direction, and this state is sometimes called a "state in which the ring-shaped portion 19 is open in the width direction." When the ring-shaped portion 19 is open in the width direction, it is easy to insert a suture into the ring-shaped portion 19. Also, when the right bending portion 20A and the left bending portion 20B are close in the width direction (see the dashed line in Figure 5A described later), this state is sometimes called a "state in which the ring-shaped portion 19 is closed in the width direction." When the ring-shaped portion 19 is closed in the width direction, the ring-shaped portion 19 has a shape close to a line extending in the insertion/removal direction, and can be inserted into and removed from the perforation of the bone fragment.

<Overview of craniotomy>
4A to 4D are explanatory diagrams showing an outline of the procedure of craniotomy.

Before describing the operation of the threading tool 10 of this embodiment, an overview of craniotomy will be given below. In the human head, the brain is surrounded from the outside by skin, fascia (tendon), skull, dura mater, arachnoid membrane, etc. Craniotomy is a procedure for opening these to expose the brain. In the skull opening operation, a dedicated drill is used to make multiple holes in the skull 1, and a bone fragment 2, which is part of the skull 1, is cut out with a tool such as an electric saw in a manner that connects the holes (see FIG. 4A). This opens a window (bone window) in the skull 1. The bone fragment 2 is sometimes called a bone flap. In the following, the bone fragment 2 may be simply called the "skull." When the bone fragment 2 is removed, the dura mater 4 covering the brain is revealed, and by cutting this with scissors, the surface of the brain covered with the arachnoid membrane is revealed.

Figures 4B to 4D show the procedure for closing the skull after treatment is completed. When treatment is completed, the surgeon sutures the dura 4. Since the dura 4 is originally attached to the inner surface of the skull (the inner surface of the bone fragment 2 before it was cut), the cut bone fragment 2 is returned to its original position, and the dura 4 is attached to the bone fragment 2 using tenting as shown in Figures 4B to 4D.

In tenting, the surgeon first forms multiple (four in this case) perforations 3 in the bone fragment 2 as shown in FIG. 4B. However, the number of perforations 3 formed in the bone fragment 2 may be one. The diameter of the perforations 3 is about 1.0 mm to 1.5 mm. The same number of sutures 5 (four in this case) as the number of perforations 3 are hooked on the dura 4 and extend outward. Then, the surgeon passes the sutures 5 through each of the perforations 3 as shown in FIG. 4C. Also, as shown in FIG. 4D, the bone fragment 2 is returned to its original position (the position where it was cut out). Here, the sutures 5 are pulled outward from the bone fragment 2, lifting the dura 4 toward the bone fragment 2 and adhering it to the bone fragment 2. Finally, the surgeon ties the sutures 5. In addition, in Figures 4B to 4D, one suture 5 extends from one location on the dura 4, but two or more sutures 5 may extend from one location on the dura 4. In this case, two or more sutures 5 are passed through the perforation 3.

<Operation>
5A to 5D are explanatory diagrams showing an example of use of the threading tool 10 of this embodiment. The threading tool 10 of this embodiment is used when threading the suture 5 shown in FIG. 4C described above through the perforation 3.

As shown in FIG. 5A, the surgeon first holds the gripping portion 11 of the threading tool 10 in his/her hand and moves the threading tool 10 in the insertion direction shown in FIG. 5A to insert the thread guide portion 13 into the perforation 3 of the bone fragment 2. Before the thread guide portion 13 is inserted into the perforation 3, the ring-shaped portion 19 is in a state of being opened in the width direction (the right bent portion 20A and the left bent portion 20B are spaced apart in the width direction). When the surgeon moves the threading tool 10 in the insertion direction, the thread holding portion 16 is inserted first into the perforation 3 of the bone fragment 2. The thread holding portion 16 is formed by bending at an acute angle at the end of the ring-shaped portion 19 in the insertion direction, so that it is easy to insert it into the perforation 3 of the bone fragment 2. When the surgeon further moves the threading tool 10 in the insertion direction, the ring-shaped portion 19 is elastically deformed in a direction in which the right bent portion 20A and the left bent portion 20B approach each other so as to follow the size of the perforation 3 in the width direction. That is, as shown by the dashed line in FIG. 5A, the ring-shaped portion 19 elastically deforms to close in the width direction along the width of the perforation 3. When the ring-shaped portion 19 is closed in the width direction, the ring-shaped portion 19 has a shape close to a line extending in the insertion/removal direction, making it possible to insert the ring-shaped portion 19 further into the perforation 3 of the bone fragment 2.

When the surgeon further moves the threading tool 10 in the insertion direction and the position of the perforation 3 in the ring-shaped portion 19 reaches the right bend 20A (or the left bend 20B), the ring-shaped portion 19 elastically deforms (restores) so that the right bend 20A and the left bend 20B move away from each other again. When the threading tool 10 is inserted until the intersection 18 of the ring-shaped portion 19 is positioned at the perforation 3, the ring-shaped portion 19 opens in the width direction again.

When the operator further moves the threading tool 10 in the insertion direction, as shown in FIG. 5B, the fixed part 12 fits (fits) into the perforation of the bone fragment at a predetermined position in the insertion/removal direction of the fixed part 12 (a predetermined position between the end on the thread guide part 13 side and the end on the grip part 11 side). This allows the threading tool 10 to be fixed to the bone fragment by inserting the fixed part 12 into the perforation 3 of the bone fragment 2. In addition, in this embodiment, since the male thread part 15 is formed on the outer periphery of the fixed part 12, when the fixed part 12 fits (fits) into the perforation of the bone fragment at a predetermined position in the insertion/removal direction, if the operator applies a rotational force to the grip part 11, the fixed part 12 rotates around the axis of the insertion/removal direction, and the fixed part 12 is screwed into the perforation 3 of the bone fragment 2. This allows the threading tool 10 to be more firmly fixed to the skull.

In this embodiment, the threading tool 10 and the bone fragment 2 are fixed together, so even if the surgeon releases the gripping portion 11 of the threading tool 10 while still holding the bone fragment 2, the threading tool 10 is prevented from falling off the bone fragment 2.

Next, the surgeon passes the suture 5 between the ring-shaped portions 19 of the suture guide portion 13, as shown in FIG. 5C. Then, as shown in FIG. 5D, the surgeon removes the male thread portion 15 of the fixing portion 12 from the perforation 3, and removes the suture guide portion 13 from the perforation 3 in the removal direction. Since the thread guide portion 13 is provided with a thread holding portion 16, it holds the suture inserted in the ring-shaped portion 19 when guiding the suture 5 to the outside of the bone fragment 2 (the removal direction side). The suture 5 is guided to the outside of the bone fragment 2 (the removal direction side) while holding the suture 5. This allows the suture 5 to be passed through the perforation 3.

As described above, in this embodiment, since the threading tool 10 and the bone fragment 2 can be fixed by the fixing portion 12, the operation of holding the suture 5 in the thread guide portion 13 shown in FIG. 5C and the operation of removing the threading tool from the perforation 3 of the bone fragment 2 shown in FIG. 5D can be performed stably while holding the bone fragment 2. If the threading tool 10 does not have the fixing portion 12 (if the threading tool 10 and the bone fragment 2 cannot be fixed), for example, when the operator passes the suture 5 between the ring-shaped portion 19 of the thread guide portion 13, the threading tool 10 may fall off from the bone fragment 2. For this reason, two operators must work together, such as one operator holding the bone fragment 2 and the other operator passing the suture 5 between the ring-shaped portion 19 of the thread guide portion 13. However, in this embodiment, even a single surgeon can stably hold the suture 5 in the thread guide section 13 while holding the bone fragment 2, and can also stably remove the threading tool from the perforation 3 in the bone fragment 2.

<Modification>
FIG. 6 is an explanatory diagram showing a modified example of the fixing portion 12. In FIG.

In this modified example, the fixing portion 12 is formed in a needle shape that protrudes from the gripping portion 11 in the insertion direction. This allows the threading tool 10 to be fixed to the skull 1 by piercing the fixing portion 12 into the skull 1. In this modified example as well, the threading tool 10 and the bone fragment 2 can be fixed by the fixing portion 12, so that while holding the bone fragment 2, it is possible to stably perform the operation of holding the suture 5 in the thread guide portion 13 shown in FIG. 5C and the operation of removing the threading tool from the perforation 3 in the bone fragment 2 shown in FIG. 5D.

<Summary>
1 to 3 and 6, the suture guide unit 13 has a gripping portion 11 to be gripped by the surgeon, a thread holding portion 16 that holds a suture 5, the thread guide unit 13 being insertable into and retractable from a perforation 3 formed in the skull (bone fragment 2), and a fixing portion 12 that is provided so as to protrude from the gripping portion 11 in the direction in which the thread guide unit 13 is inserted into the perforation 3 and that can be fixed to the skull (bone fragment 2). This allows the operation of holding the suture 5 in the threading tool 10 and the operation of inserting and removing the thread guide unit 13 (threading tool 10) into and from the perforation 3 in the bone fragment 2 to be performed stably while holding the bone fragment.

===Other===
The above-described embodiment is for the purpose of facilitating understanding of the present invention, and is not intended to limit the present invention. The present invention can be modified or improved without departing from the spirit of the present invention, and it goes without saying that the present invention includes equivalents thereof.

1 skull, 2 bone fragment, 3 perforation, 4 dura mater, 5 suture,
10 Threading tool, 11 Grip part, 11A Grip surface, 12 Fixing part,
13 thread guide section, 13A right side section, 13B left side section, 14 flange section,
15 Male thread portion, 16 Thread holding portion, 17 Fastener, 18 Intersection portion,
19: ring-shaped portion, 20A: right-side bent portion, 20B: left-side bent portion

Claims (5)

A gripping portion that is gripped by a surgeon;
A suture guide portion having a suture holding portion for holding a suture, the suture guide portion being insertable into and removable from a perforation formed in the skull;
the thread guide portion is provided so as to protrude from the grip portion in a direction in which the thread guide portion is inserted into the perforation, and a fixing portion capable of being fixed to the skull. The medical threading instrument according to claim 1,
The fixing portion is located between the thread guide portion to be inserted into the hole and the grip portion,
A medical threading instrument, characterized in that a size of the fixing part in a direction perpendicular to a direction in which the thread guide part is inserted into the hole increases from the thread guide part side toward the grip part side. The medical threading instrument according to claim 2,
The size of the fixing portion is:
The diameter of the fixing portion at the end portion on the thread guide portion side is smaller than the diameter of the hole,
A medical threading tool, characterized in that the diameter of the end of the fixing part on the grip part side is larger than the diameter of the perforation. The medical threading instrument according to claim 2 or 3,
A medical threading tool, wherein a thread is formed on an outer periphery of the fixing part. The medical threading instrument according to claim 1,
The medical threading instrument, wherein the fixing portion is formed in a needle shape protruding from the grip portion in a direction in which the thread guide portion is inserted into the hole.

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