Device for osteopathy of skull

FIELD: neurosurgery; traumatology.

SUBSTANCE: device intends for fixing bone or its substitute in cranium at cranioplasty. Device is made of shape memory effect alloy and it has support and top and lower rings. Lower ring is closed. Top ring is made separated. Support connects rings and its length 0,-3,5 mm exceeds minimal distance between rings. Bone or its substitute is fixed reliable in cranium despite of difference in thickness. Bone or its substitute as well as device itself is not able to migrate.

EFFECT: simplified surgical work.

3 cl, 6 dwg

 

The invention relates to medicine, namely to neurosurgery and traumatology, and is intended for fixation of bone or its substitute in the skull when cranioplastic.

Cranioplastic is a standard procedure during operations on the skull, accompanied by a craniotomy. Cut out part of the bone of the skull after surgery on the brain should be fixed in the skull or replace the allograft, a plate of metal, plastic and other Fixation of cranial bone or its substitute is usually performed with the help of a thread or wire through the drilled holes along the line of the craniotomy (KLUCHEVSKY CENTURIES "Surgery injury": a Guide for paramedics, surgeons and traumatologists district hospitals. Yaroslavl: DIA-press, 1999, s).

However, this method of fixation is not possible to prevent possible migration of cranial bone or its substitute in the postoperative period, which is associated with irreversible plastic deformation of the fixing members when changes cranial pressure and bone resorption in places of fastening.

To prevent possible migration of the bone and create optimal conditions for healing uses the device of a material with shape memory effect, including the lower and upper wire ring connected by a backbone. The upper ring C is releasable and cooling its branches can straighten up so that their ends pass through the support. In this state, the device can be installed on the cranial box on line craniotomy and not to interfere with placement of cranial bone at the desired location. While the cranial bone rests on the bottom ring of the device. After heating the branches of the upper ring occupy the initial position, navigati on the cranial bone, and prevent its displacement up (Application EP 1224911 A1, A, 61 B 17/08). This unit is adopted for the prototype.

However, the use of such devices in medical practice is accompanied by certain difficulties. Since the thickness of the cranial bones in different places varies, it is difficult to find a device with the desired size to ensure reliable fixation of bones in the skull. Too small size of the device (the distance between the rings is less than the thickness of the bone) will lead to curvature of the upper ring, creating a cosmetic defect, but too big (the distance between the rings is greater than the thickness of the bone will not provide reliable fixation of the bone will not exclude its possible migration, and migration of the device. In addition, such a device does not allow the use of bone substitutes, which usually differ in thickness from the skull. In this regard, for successful operation, the surgeon must have a large set device is in different sizes and to find a suitable depending on the specific conditions.

The present invention is to provide a reliable fixation of the bone or its substitute in the skull, including a difference in their thicknesses, and preventing migration of the bone or its substitute, migration of the device, as well as simplifying the work of the surgeon.

The problem is solved due to the fact that the device for bone grafting skull contains the upper and the lower ring and the lower ring is closed, and the upper releasable, and connecting the support ring, the length of which exceeds the minimum distance between the rings. Such excess may be 0.5 to 3.5 mm, Increasing the length of the support can be realized due to the fact that it is made with bends, or due to the fact that it is made in the form of a broken line from the top, outside the space bounded by the planes of the rings. The device is mainly made of an alloy with shape memory effect.

Figures 1 and 2 show a General view of the claimed device, where 1 is the bearing; 2, 3 - upper and lower rings; 4 - the connection ring support; 5, 6 - branch of the upper ring.

Installing devices in the skull is as follows (Fig.3-6).

After craniotomy and surgical interventions on the brain carry out the fixation of the cut bone is whether its substitute in the skull. For this device, made from an alloy based on Nickel-titanium (Ti-56%Ni) shape memory effect, made with the support as shown in figure 2 and having a support length greater than the minimum distance between the rings 2 mm, cooled in a physiological solution with a temperature of 5°and deform so as to increase the distance between the upper and lower rings (2, 3). To do this, using a needle holder or forceps unbend the connection ring support (4) so that the angle between them increased (figure 3). The branches of the upper ring (5, 6) straighten and brought back behind the base line. As such, the lock set on the edge of the bones of the cranium (7)to the ends of the branches of the upper ring does not extend beyond the line craniotomy, figure 4. Carved bone or its substitute (8) is placed in the defect of the skull so that its inner part relied on the lower ring device (3), figure 5. The device then irrigated with saline solution with a temperature of 40-45°C. When this branch of the upper ring (5, 6) looming on the fixed bone or its substitute, and bearing seeks to acquire its original shape, bringing together the top (2) and lower ring (3), resulting in a device attached to the skull and fixed to the bone or its substitute, 6.

Thus, due to the ongoing efforts obliguus the x ring, the device securely locks the bone or its substitute and eliminates the possibility of spontaneous migration, and migration of the device. In addition, it simplifies the work of the surgeon, as to the successful operation requires a much smaller set of clamps of different sizes, i.e. a certain versatility of the device.

1. Device for bone grafting skull, made of alloy with shape memory effect and comprising upper and lower ring and the lower ring is closed, and the upper releasable, and connecting ring bearing, characterized in that the leg length is 0.5-3.5 mm greater than the minimum distance between the rings.

2. The device according to claim 1, characterized in that the bearing is made with curves.

3. The device according to claim 1, characterized in that the support is executed in the form of a broken line from the top, outside the space bounded by the planes of the rings.



 

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