DE19859916A1 - Surgical screw for replacing area of skull temporarily removed for brain operation, comprising specifically cut thread fitting to surface of cut and tool insertion space - Google Patents

Surgical screw for replacing area of skull temporarily removed for brain operation, comprising specifically cut thread fitting to surface of cut and tool insertion space

Info

Publication number
DE19859916A1
DE19859916A1 DE1998159916 DE19859916A DE19859916A1 DE 19859916 A1 DE19859916 A1 DE 19859916A1 DE 1998159916 DE1998159916 DE 1998159916 DE 19859916 A DE19859916 A DE 19859916A DE 19859916 A1 DE19859916 A1 DE 19859916A1
Authority
DE
Germany
Prior art keywords
dome
screw
bone
bone plate
cut
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
DE1998159916
Other languages
German (de)
Inventor
Dieter Von Zeppelin
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Priority to DE1998159916 priority Critical patent/DE19859916A1/en
Publication of DE19859916A1 publication Critical patent/DE19859916A1/en
Withdrawn legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/688—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin for reattaching pieces of the skull
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8605—Heads, i.e. proximal ends projecting from bone
    • A61B17/861—Heads, i.e. proximal ends projecting from bone specially shaped for gripping driver
    • A61B17/8615—Heads, i.e. proximal ends projecting from bone specially shaped for gripping driver at the central region of the screw head
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8645—Headless screws, e.g. ligament interference screws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8875—Screwdrivers, spanners or wrenches
    • A61B17/8877—Screwdrivers, spanners or wrenches characterised by the cross-section of the driver bit
    • A61B17/888—Screwdrivers, spanners or wrenches characterised by the cross-section of the driver bit the driver bit acting on the central region of the screw head

Landscapes

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

Abstract

The thread, cut into the shaft of the calotte screw is specifically shaped in order to match the profile created by the drill during the removal process. The headless screw is equipped with an insertion area at the top facilitating the use of an Allen key. A circular spacer can be used for the adjustment of the gap between the skull and the replaced segment.

Description

Die Erfindung betrifft ein Repositionierimplantat für die chirurgische Anwendung, mit welchem nach einer Kraniotomie die zur Durchführung der Operation herausgetrennte Knochenplatte wieder mit der Kalotte verbunden wird.The invention relates to a repositioning implant for surgical Application with which after a craniotomy to carry out the Operation separated bone plate is reconnected to the calotte.

Implantate zur Fixierung von Knochenplatten an Kalotten sind in unterschiedlichen Ausführungen bekannt. Dem Stand der Technik entsprechen das zum Patent angemeldete Craniofix (. . .) mit zwei tellerförmigen Scheiben, welche mittels einer zentral angeordneten Schraubenstange verbunden sind und die Knochenplatte mit der Kalotte verbindet sowie die sogenannten Miniplattensysteme (siehe Anlage A), welche mit kleinen Löchern versehen sind und mittels darin verankerten Knochenschrauben die Knochenplatte mit der Kalotte verbinden. Eine andere Möglichkeit der Fixierung bietet auch das Durchbohren von Knochenplatte und Kalotte und deren anschließendes Verbinden mit chirurgischem Nahtmaterial.Implants for fixing bone plates to calottes are in different versions known. State of the art the patent-pending Craniofix (...) with two plate-shaped Disks, which are connected by means of a centrally arranged screw rod are and connects the bone plate with the calotte and the so-called Mini plate systems (see Appendix A), which are provided with small holes and the bone plate with the Connect the calotte. This also offers another possibility of fixation Drilling through the bone plate and dome and their subsequent Connect with surgical sutures.

Den beiden Implantaten bzw. den bekannten Methoden zur Fixierung von Knochenplatten mit der Kalotte haftet der Nachteil des hohen Zeitaufwandes an. Außerdem lassen sich die Implantate nach Verwachsung der Knochenteile gar nicht oder nur sehr schwer entfernen. Vorteilhaft ist den bekannten Methoden, daß die Knochenplatten genau in der vorbestimmten Lage mit der Kalotte verwachsen.The two implants or the known methods for fixing Bone plates with the calotte have the disadvantage of the high expenditure of time. The implants can also be removed after the bone parts have grown together not or only very difficult to remove. The known methods have the advantage that the bone plates are precisely in the predetermined position overgrown with the calotte.

Aufgabe der Erfindung ist es, eine Kalottenfixierung als Kalottenschraube so auszubilden, daß diese schnell bei einfachster Handhabung die Knochenplatte mit der Kalotte wenigstens ebenso sicher verbindet und nach erfolgter Verwachsung der Knochen problemlos wieder entfernbar ist.The object of the invention is a dome fixation as a dome screw train that the bone plate quickly and easily connects with the calotte at least as securely and after it has been completed Adhesion of the bones can easily be removed again.

Gemäß der Erfindung ist diese Aufgabe dadurch gelöst, daß eigens für diesen Zweck vorgegebene Kalottenschrauben von außen in den Knochenspalt zwischen Knochenplatte und Kalotte eingeschraubt werden. Die Kalottenschraube soll vorzugsweise das Querschnittprofil des Knochenspaltes aufweisen. Dieser entspricht in der Regel wenigstens dem Querschnittprofil des Kraniotomiefräsers oder verläuft weitgehend parallel zum Knochenspalt. According to the invention, this object is achieved in that specifically for this Purpose-specified dome screws from outside into the bone gap between Bone plate and calotte are screwed in. The dome screw should preferably have the cross-sectional profile of the bone gap. This usually corresponds at least to the cross-sectional profile of the craniotomy cutter or runs largely parallel to the bone gap.  

Mit der erfindungsgemäßen Ausführung der Kalottenschraube ist nunmehr erstmalig eine Möglichkeit geschaffen, mit der eine Knochenplatte in der Aussparung der Kalotte repositioniert werden kann, ohne zusätzliche Bohrungen anbringen zu müssen und mit der Möglichkeit, das Implantat wieder komplett entfernen zu können. Ein das Operationsrisiko erhöhendes Hantieren unmittelbar an der Dura entfällt.With the embodiment of the dome screw according to the invention is now for the first time created a possibility with which a bone plate in the Recess of the calotte can be repositioned without additional Have to drill holes and with the possibility of the implant again to be able to remove completely. Fiddling with the operational risk directly on the dura does not apply.

Die Kalottenschraube ist vorteilhaft ohne Schraubenkopf ausgebildet, wodurch jeglicher Volumenauftrag auf der Oberfläche der Kalotte vermieden ist.The dome screw is advantageously designed without a screw head, whereby any volume application on the surface of the spherical cap is avoided.

Das Einbringen der erfindungsgemaßen Kalottenschraube zur Repositionierung bzw. Fixierung der Knochenplatte mit der Kalotte wird vorteilhaft unterstützt durch einen oder mehrere Distanzhalter mit am Arbeitsende ähnlichen Abmessungen wie die Kalottenschrauben und vorzugsweise ohne Schraubenprofil.The introduction of the dome screw according to the invention for repositioning or fixation of the bone plate with the calotte is advantageously supported by one or more spacers with similar ones at the end of work Dimensions like the dome screws and preferably without Screw profile.

Die Repositionierung der Knochenplatte erfolgt mittig in der Kalottenausparung mittels zwei oder mehr Kalottenschrauben mit einem Kerndurchmesser in etwa der Knochenspaltabmessung. Die Fixierung kann aber auch seitlich angelagert sein mittels einer oder mehrerer Kalottenschrauben mit einem Kerndurchmesser in etwa der doppelten Abmessung wie vor.The bone plate is repositioned in the center of the dome recess using two or more dome screws with a core diameter of approx the bone gap dimension. The fixation can also be attached laterally be by means of one or more dome screws with a core diameter roughly twice the size as before.

Es ist darüber hinaus aber auch denkbar, die Abmessungen der erfindungsgemäßen Kalottenschraube dem bei fast allen Kopfoperationen üblichen Bohrloch anzugleichen und die Knochenplatte mit der Kalotte in einem oder mehreren Bohrlöchern zu fixieren. Diese Ausführung ist von besonderem Vorteil bei Vorhandensein von zwei oder mehr Bohrlöchern. Man kann aber auch eine oder mehrere Bohrlochfixierschrauben mit einer oder mehreren Kalottenschrauben kombinieren.It is also conceivable, however, the dimensions of the dome screw according to the invention in almost all head operations align the usual borehole and the bone plate with the calotte in one or several drill holes to fix. This version is special Advantage if there are two or more drill holes. But you can also one or more borehole fixing screws with one or more Combine dome screws.

Die Verwendung der Bohrlochfixierschraube hat den zusätzlichen Vorteil, die besonders große Knochenlücke eines Bohrloches zu verschließen. Der Bohrlochdurchmesser beträgt meist zwischen 7 und 14 mm.The use of the downhole fixation screw has the additional advantage that to close a particularly large bone gap in a borehole. The Borehole diameter is usually between 7 and 14 mm.

Nachfolgend wird die Erfindung anhand von bevorzugten Ausführungsformen unter Bezugnahme auf die anliegende Zeichnung im Einzelnen erläutert. Es zeigen:The invention is described below on the basis of preferred embodiments explained in detail with reference to the accompanying drawing. It demonstrate:

Fig. 1 eine schematische Seitenansicht einer Kalottenschraube zur mittigen Repositionierung der Knochenplatte (1a) in der Kalottenaussparung (1b); Figure 1 is a schematic side view of a dome screw for central repositioning of the bone plate ( 1 a) in the dome recess ( 1 b).

Fig. 2 eine schematische Seitenansicht einer Kalottenschraube zur seitlich angelagerten Repositionierung der Knochenplatte (1a) in der Kalottenaussparung (1b); Figure 2 is a schematic side view of a dome screw for laterally repositioning the bone plate ( 1 a) in the dome recess ( 1 b).

Fig. 3 eine schematische Seitenansicht einer Bohrlochkalottenschraube; Fig. 3 is a schematic side view of a dome screw;

Fig. 4 ein Anwendungsbeispiel unter Verwendung von Kalottenschrauben (Fig. 1) bei mittiger Knochenplattenfixierung; Fig. 4 shows an application example using dome screws ( Fig. 1) with central bone plate fixation;

Fig. 5 ein Anwendungsbeispiel unter Verwendung von Kalottenschrauben (Fig. 2) bei seitlich angelagerter Repositionierung der Knochenplatte; Figure 5 is an application example using Kalottenschrauben at the side of attached repositioning of the bone plate. (Fig. 2);

Fig. 6 ein Anwendungsbeispiel unter Verwendung von Bohrlochkalottenschrauben (Fig. 3); FIG. 6 shows an application example using borehole dome screws ( FIG. 3);

Fig. 7 ein Anwendungsbeispiel mit kombinierter Verwendung verschiedenartiger Kalottenschrauben (Fig. 1; 3). Fig. 7 shows an application example with the combined use of different types of cap screws ( Fig. 1; 3).

Fig. 8 ein Anwendungsbeispiel einer Kalottenschraube mit Flachkopf (8a). Fig. 8 shows an application example of a dome screw with flat head ( 8 a).

Fig. 9 ein erfindungsgemäßes Ausführungsbeispiel eines Distanzhalters mit einer Arretierhilfe (9a). Fig. 9 shows an embodiment of a spacer according to the invention with a locking aid ( 9 a).

Claims (6)

1. Kalottenschraube zur Repositionierung einer Knochenplatte (1a) in einer Kalottenaussparung, dadurch gekennzeichnet, daß die Kalottenschraube (Fig. 1; 2; 3) mit festem Sitz in den vorgegebenen Knochenspalt bzw. die Aussparung zwischen Knochenplatte und Kalotte einschraubbar ist.1. dome screw for repositioning a bone plate ( 1 a) in a dome recess, characterized in that the dome screw ( Fig. 1; 2; 3) with a tight fit in the predetermined bone gap or the recess between the bone plate and dome can be screwed. 2. Kalottenschraube nach Anspruch 1, dadurch gekennzeichnet, daß der Profilverlauf der Kalottenschraube (Fig. 1; 2; 3) dem Knochenspaltprofil zwischen Knochenplatte (1a) und Kalotte (1b) entspricht.2. dome screw according to claim 1, characterized in that the profile profile of the dome screw ( Fig. 1; 2; 3) corresponds to the bone gap profile between the bone plate ( 1 a) and dome ( 1 b). 3. Kalottenschraube nach einem oder mehreren der vorgenannten Ansprüche, dadurch gekennzeichnet, daß die Kalottenschraube (Fig. 1; 2; 3) an dem dem Patientenkopf abgewandten Ende ein drei- oder mehrkantiges Sackloch (1c; 2c; 3c) zum Einbringen eines Schraubendrehers (1d) und zur Richtungsstabilisierung aufweist.3. dome screw according to one or more of the preceding claims, characterized in that the dome screw ( Fig. 1; 2; 3) at the end facing away from the patient's head a triangular or polygonal blind hole ( 1 c; 2 c; 3 c) for insertion a screwdriver ( 1 d) and for directional stabilization. 4. Kalottenschraube nach einem oder mehreren der vorgenannten Ansprüche, dadurch gekennzeichnet, daß die Kalottenschraube an dem dem Patientenkopf abgewandten Ende einen flachen Kopf (8a) aufweisen, welcher im fixierten Zustand flach auf der Kalotte (1b) und der Knochenplatte (1a) zu liegen kommt.4. dome screw according to one or more of the preceding claims, characterized in that the dome screw at the end facing away from the patient's head have a flat head ( 8 a) which in the fixed state flat on the dome ( 1 b) and the bone plate ( 1 a ) comes to rest. 5. Kalottenschraube nach einem oder mehreren der vorgenannten Ansprüche, dadurch gekennzeichnet, daß der Kalottenschraube (Fig. 1; 2; 3) eine Distanzhalters (Fig. 9) beigegeben ist, mit welchem der gewünschte Fixierspalt zwischen Knochenplatte (1a) und Kalotte (1b) (zur Vereinfachung des Einschraubens der Kalottenschrauben) einstellbar ist, dadurch gekennzeichnet, daß der Durchinesser des Arbeitsendes des Distanzhalters (Fig. 9) der Abmessung des Knochenspaltes nachempfunden ist und sich vorzugsweise hinter dem Arbeitsende eine tellerförmige Arretierhilfe (9a) befindet.5. dome screw according to one or more of the preceding claims, characterized in that the dome screw ( Fig. 1; 2; 3) a spacer ( Fig. 9) is added with which the desired fixing gap between the bone plate ( 1 a) and dome ( 1 b) (to simplify screwing in the dome screws) is adjustable, characterized in that the diameter of the working end of the spacer ( FIG. 9) is modeled on the dimension of the bone gap and there is preferably a plate-shaped locking aid ( 9 a) behind the working end. 6. Kalottenschraube nach einem oder mehreren der vorgenannten Ansprüche, dadurch gekennzeichnet, daß die Länge der Kalottenschraube wenigstens 3 mm und höchstens 20 mm beträgt.6. dome screw according to one or more of the preceding claims, characterized in that the length of the cap screw at least 3 mm and at most 20 mm.
DE1998159916 1998-12-23 1998-12-23 Surgical screw for replacing area of skull temporarily removed for brain operation, comprising specifically cut thread fitting to surface of cut and tool insertion space Withdrawn DE19859916A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
DE1998159916 DE19859916A1 (en) 1998-12-23 1998-12-23 Surgical screw for replacing area of skull temporarily removed for brain operation, comprising specifically cut thread fitting to surface of cut and tool insertion space

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
DE1998159916 DE19859916A1 (en) 1998-12-23 1998-12-23 Surgical screw for replacing area of skull temporarily removed for brain operation, comprising specifically cut thread fitting to surface of cut and tool insertion space

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DE19859916A1 true DE19859916A1 (en) 2000-06-29

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DE1998159916 Withdrawn DE19859916A1 (en) 1998-12-23 1998-12-23 Surgical screw for replacing area of skull temporarily removed for brain operation, comprising specifically cut thread fitting to surface of cut and tool insertion space

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE10360852A1 (en) * 2003-12-21 2005-07-21 Christoph Miethke Device for joining bone cover to remaining skull bone, engages in cut surface on bone cover and/or skull bone, with pre-attached device having stop for abutment with skull bone
WO2005096965A1 (en) * 2004-04-08 2005-10-20 Emmebi S.R.L. Shaver handpiece and terminal accessories, particularly for use in arthroscopy

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19603887A1 (en) * 1996-02-03 1997-08-14 Lerch Karl Dieter Means for fixing a piece of bone removed from the skull capsule for the purpose of the surgical intervention after the operation relative to the remaining skull bone
US5707373A (en) * 1996-04-26 1998-01-13 Ikonos Corporation Bone fastener and instrument for insertion thereof
DE19634697C1 (en) * 1996-08-28 1998-04-23 Aesculap Ag & Co Kg Connecting component used in surgery for fixing cap segment removed from skull capsule to remaining skull cap
DE19634698C1 (en) * 1996-08-28 1998-04-23 Aesculap Ag & Co Kg Surgical closure for closing trepanned hole in skull capsule

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19603887A1 (en) * 1996-02-03 1997-08-14 Lerch Karl Dieter Means for fixing a piece of bone removed from the skull capsule for the purpose of the surgical intervention after the operation relative to the remaining skull bone
US5707373A (en) * 1996-04-26 1998-01-13 Ikonos Corporation Bone fastener and instrument for insertion thereof
DE19634697C1 (en) * 1996-08-28 1998-04-23 Aesculap Ag & Co Kg Connecting component used in surgery for fixing cap segment removed from skull capsule to remaining skull cap
DE19634698C1 (en) * 1996-08-28 1998-04-23 Aesculap Ag & Co Kg Surgical closure for closing trepanned hole in skull capsule

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE10360852A1 (en) * 2003-12-21 2005-07-21 Christoph Miethke Device for joining bone cover to remaining skull bone, engages in cut surface on bone cover and/or skull bone, with pre-attached device having stop for abutment with skull bone
DE20321716U1 (en) 2003-12-21 2009-07-02 Christoph Miethke Gmbh & Co Kg Device for connecting a bone cover to a skull bone
WO2005096965A1 (en) * 2004-04-08 2005-10-20 Emmebi S.R.L. Shaver handpiece and terminal accessories, particularly for use in arthroscopy

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