WO2024201539A1 - Device for fixing a cranial flap to the cranial vault to be positioned in the craniotomy hole - Google Patents
Device for fixing a cranial flap to the cranial vault to be positioned in the craniotomy hole Download PDFInfo
- Publication number
- WO2024201539A1 WO2024201539A1 PCT/IT2024/050057 IT2024050057W WO2024201539A1 WO 2024201539 A1 WO2024201539 A1 WO 2024201539A1 IT 2024050057 W IT2024050057 W IT 2024050057W WO 2024201539 A1 WO2024201539 A1 WO 2024201539A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- upright
- cortical
- closing means
- arms
- fixing
- 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.)
- Pending
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- 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 or setting implements
- 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
Definitions
- the present invention refers to a device for fixing a cranial flap to the cranial vault to be positioned in the craniotomy hole.
- a dedicated applicator for this device and a process for using this device are also described.
- the present invention constitutes an improvement of the devices described in documents WO-A1-2009/044421 and EP-A1-2 988 687 in the name of the same Applicant.
- craniotomy i.e. the incision and cutting of a bony flap of the cranial vault, is the mandatory neurosurgical procedure for the treatment of any intracranial lesion.
- a bone flap is carved by making one or more drill holes, according to two preferred procedures.
- the first involves using a cutting blade or a perforator applied to a pneumatic drill, which, freehand, detaches the underlying dura mater from the key hole and simultaneously cuts into the bone.
- the second procedure involves dissecting the dura mater from the bone between one drill hole and another with a curved periosteal detacher and subsequently, using a guide, passing a saw wire, which, pulled wide by the two ends upward with hands, carves the bone one segment at a time .
- the flap is placed back into the opening and fixed with detached metal or wire stitches passed through small drill holes paired on the free edge of the cranial bone.
- Object of the present invention is, therefore, solving the aforementioned prior art problems, creating a device for fixing a cranial flap to the cranial vault which allows the correct ossification of the bone flap at the edge of the cranial vault and at the same time closes the holes made for craniotomy .
- Another object of the invention is creating a device that allows for less tension on the brain itself, even in the event that a cerebral edema occurs during the postoperative course.
- the present invention can be inserted indiscriminately into the craniotomy hole or into the cut craniotomy, thus allowing the flap to be fixed in multiple points even when only one hole has been made, or the latter has an irregular shape. Furthermore, the special shape of the transverse arms allows for a better grip on the cranial bone and therefore better fixation of the flap.
- a further object of the present invention is creating a lower base to be assembled on the device indicated above to improve its functionality in the following ways:
- the base can be equipped with a centring device whereby, when the device is positioned inside a drill hole, a better centring of the operculum in the craniotomy is achieved.
- FIG. 1 shows a perspective view from above of a first example of the device for fixing a cranial flap to the cranial vault to be positioned in the craniotomy hole or in the craniotomy cut;
- FIG. 2 shows a perspective view from above of a second example of the device for fixing a cranial flap to the cranial vault to be positioned in the craniotomy hole or in the craniotomy cut;
- Figure 3 is a perspective view from below of the device of Figure 1;
- Figure 4 is a perspective view from below of the device of Figure 2;
- FIG. 5 shows a view of the device of Figure 1 or 2 in a first step of its use in the craniotomy hole
- FIG. 6 shows a view of the device of Figure 1 or 2 in a first step of its use in the craniotomy cutting
- FIG. 7 shows a view of the device of Figure 1 or 2 in a second step of its use in the craniotomy cutting
- FIG. 8 shows a view of the device of Figure 1 or 2 in a second step of its use in the craniotomy cutting
- FIGS. 9 and 10 show views of the device in Figure 1 or 2 in the final stages of its use in the craniotomy cutting
- FIG. 11 and 13 show a view from above and one from below (the latter which better highlights the fixing system of the elastic arms of the device m Figure 1) respectively, of a first embodiment of the base to be used with the device of Figure 1;
- FIG. 12 and 14 show a view from above and one from below (the latter which better highlights the fixing system of the elastic arms of the device in Figure 1) , respectively, of a second embodiment of the base to be used with the device of Figure 2;
- Figures 15 and 17 show a top and bottom view, respectively, of a third example of the fixing device
- FIG. 16 and 18 represent a top and bottom view, respectively, of a fourth example of the fixing device
- Figure 19 represents a perspective view of an embodiment of the device of the present invention.
- FIG. 20 represents a side view of the device of Figure 19.
- the device for fixing a cranial flap to the cranial vault to be positioned in the craniotomy hole or in the craniotomy cut, according to the present invention is globally indicated with numeric reference 10.
- the device 10 has elongated elastic arms 11, linked to the cortical upright 12, and ending in elongated arms 13, 13' placed transversely with respect to the axis of the elongated elastic arms 11, and an upper plate 14, which must be inserted in the upper part of the cortical upright 12.
- the cortical upright 12 will be equipped with a handle 15 and a plurality of fixing elements 16 (which can be, for example, teeth as illustrated in Figures 1 to 9, or transversal protrusions as illustrated in Figures 15 to 18) placed at as many levels along the length of the upright 12, fixing elements 16 which will be used for the insertion of the upper plate 14.
- fixing elements 16 which can be, for example, teeth as illustrated in Figures 1 to 9, or transversal protrusions as illustrated in Figures 15 to 18
- the cortical upright 12, connecting the elastic arms 11 and the upper plate 14, due to the elasticity of the arms 11, allows a fine adaptation to the thickness of the bone.
- the conformation of the inventive device 10 therefore provides that the first closing means 11, 13, 13' are connected to the distal end of the cortical upright 12 and the second closing means 14 are suitable for being fixed to the cortical upright 12 in a nearby position of the distal end of the cortical upright 12, such that, when the device 10 is in its operative fixing position, the first closing means 11, 13, 13' are placed against the internal distal surface of the skull and the second closing means 14 are placed against the near outer surface of the skull.
- the device 10 of the invention serves for fixing a cranial flap to the cranial vault 17 capable of being positioned in a craniotomy hole, and includes:
- first closing means 11, 13, 13' are connected to the distal end of the cortical upright 12 and the second closing means 14 are adapted to be fixed to the cortical upright 12 in a position close to the distal end of the cortical upright 12, such that, when the device 10 is in its operative fixing position, the first closing means 11, 13, 13' are placed against the internal distal surface of the skull and the second closing means 14 are placed against the near external surface of the skull, the first closing means 11, 13, 13' being composed of at least two elongated elastic arms 11 operatively connected to the cortical upright 12, each of the elongated elastic arms 11 ending in an elongated arm 13, 13' placed transversely with respect to the elongated elastic arms 11, wherein the device 10 is also equipped with at least one lower base 5 to
- the first feature of the present invention is that the transverse elongated arms 13' are substantially semi- circular in shape with greater transverse thickness in their central part 13' ' compared to their two ends 13' ' ' , each of the transverse elongated arms 13' having their ends 13' ' ' oriented towards the respective ends 13' ' ' of the other of the elongated transverse arms 13' so as to leave a space between the ends 13' ' ' , as can be clearly seen in Figure 19.
- the second closing means 14 is equipped with a cylindrical collar 100 designed to centre the second closing means 14 in the craniotomy hole of the skull during installation.
- the instrumentalist prepares the quantity of devices 10 suitable for fixing the craniotomy.
- an applicator suitable for operating with the device 10 described above is provided, preferably but not exclusively; this applicator includes a seat designed to support the upper plate 14 and to allow the operational coupling between this plate 14 and the cortical upright 12 at the end of the closing of the craniotomy hole or the craniotomy cut.
- the surgeon inserts the device 10 into the craniotomy hole ( Figure 5) with the cortical upright 12 placed in the centre of the hole and perpendicular to the cranial surface, and so that part of the transverse arms 13, 13' is positioned in the space between the cranial vault 17 and the dura mater 18.
- the bony operculum 19 is repositioned as indicated in Figure 7. In this way the cortical upright 12 will protrude from the craniotomy hole.
- the surgeon checks the good position of the operculum 19 and relaxes, using the handle 15, the cortical upright 12 and the elastic arms 11 to be able to insert the upper plate 14 in correspondence with one of the fixing elements 16, as shown in the Figure 9.
- the surgeon uses the applicator described above. In this way, the craniotomy hole will be closed.
- the surgeon removes the handle 15 with nippers ( Figure 10) .
- the surgeon inserts the device 10 into the craniotomy cut ( Figure 6) so that one end of the transverse arms 13, 13' is positioned in the space between the cranial vault 17 and the dura mater 18, with the elastic arms 11 aligned to the direction of the cut craniotomy and the cortical upright 12 perpendicular to the cranial surface.
- the bony operculum 19 is placed on the other ends of the transverse arms 13 of the device 10, as indicated in Figure 8. In this way, the upright 12 will protrude between the cranial vault 17 and the operculum 19. Subsequently, the surgeon checks the good position of the operculum 19 and relaxes, using the handle 15, the cortical upright 12 and the elastic arms 11 to be able to insert the upper plate 14 in correspondence with one of the fixing elements 16, as shown in the Figure 9. When inserting the upper plate 14, the surgeon uses the applicator described above. Finally, the surgeon removes the handle 15 with nippers ( Figure 10) .
- the fixing device 10 also includes, as illustrated in the various Figures and in detail in Figures 11 to 14 in two preferred, but not limiting, examples, a lower base 5, preferably made of biocompatible elastic plastic material, to be assembled to the device 10 for the fixing of a cranial flap and for the simultaneous closing of the holes made to perform the craniotomy.
- a lower base 5 preferably made of biocompatible elastic plastic material
- the lower base is indicated globally with numeric reference 5; the device for fixing a cranial flap to the cranial vault and the simultaneous closing of the craniotomy holes, as seen previously, is indicated globally with numeric reference 10.
- the lower base 5 has the cut 6 through which the device 10 can pass, and a seat 7 where the transverse arms 13, 13' linked to the elastic arms 11 are housed and slide. In this way, through the sliding of the transversal arms 13, 13' during the positioning step of the device 10, regardless of the presence of irregularities in the internal surface of the skull, a better application functionality of the device
- transverse arms 13, 13' are blocked, preventing them from opening in an excessive and unusable way, by the very shape of the seat 7 of the base 5, or by special coupling means 8 provided at two ends of the seat 7 (as seen in Figures 3, 4, 17 and 18) .
- a second version of the lower base 5, illustrated in Figures 1, 11 and 16 has a centring system 9, designed for the use of the device 10 in the holes made by the drill.
- the cranial fixing device 10 of the invention is indicated in all cases of craniotomy, as its shape and its adaptability to the bone thickness allow the bone flap to be kept adherent to the edge of the cranial vault, both on the internal margin and on the external margin, in order to allow the correct ossification.
- the elasticity of the biocompatible plastic material used guarantees less tension on the brain during the upright-operative period, when conditions of cerebral edema and therefore swelling of the brain itself may occur.
- the features of the device 10 for fixing a cranial flap to the cranial vault to be positioned in the craniotomy hole or in the craniotomy cut, which is the object of the present invention, are clear, just as the advantages are clear.
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)
- Neurosurgery (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)
- Prostheses (AREA)
Abstract
Description
Claims
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| IT102023000006270A IT202300006270A1 (en) | 2023-03-31 | 2023-03-31 | DEVICE FOR FIXING A CRANIAL FLAP TO THE CRANIAL VAULT TO BE POSITIONED IN THE CRANIOTOMY FORAMEN |
| IT102023000006270 | 2023-03-31 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| WO2024201539A1 true WO2024201539A1 (en) | 2024-10-03 |
Family
ID=86732868
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| PCT/IT2024/050057 Pending WO2024201539A1 (en) | 2023-03-31 | 2024-03-18 | Device for fixing a cranial flap to the cranial vault to be positioned in the craniotomy hole |
Country Status (2)
| Country | Link |
|---|---|
| IT (1) | IT202300006270A1 (en) |
| WO (1) | WO2024201539A1 (en) |
Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20080281339A1 (en) | 2007-05-11 | 2008-11-13 | X-Spine Systems, Inc. | Flexible cranial clamp and method of anchoring to cranium |
| WO2009044421A1 (en) | 2007-10-01 | 2009-04-09 | Ntplast S.R.L. | Device for securing a cranial limb to the cranial top and for simultaneously closing craniotomy holes, and process for using it |
| EP2988687A1 (en) | 2013-04-24 | 2016-03-02 | Ntplast S.r.l. | Device for fixing a cranial limb to the cranial crown to be placed in the craniotomial hole or cutting |
| CN112087973A (en) * | 2018-03-02 | 2020-12-15 | 恩特蓬莱斯特公司 | Device for fixing a craniotomy eyelet to the cranial crown to be inserted in a craniotomy incision |
-
2023
- 2023-03-31 IT IT102023000006270A patent/IT202300006270A1/en unknown
-
2024
- 2024-03-18 WO PCT/IT2024/050057 patent/WO2024201539A1/en active Pending
Patent Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20080281339A1 (en) | 2007-05-11 | 2008-11-13 | X-Spine Systems, Inc. | Flexible cranial clamp and method of anchoring to cranium |
| WO2009044421A1 (en) | 2007-10-01 | 2009-04-09 | Ntplast S.R.L. | Device for securing a cranial limb to the cranial top and for simultaneously closing craniotomy holes, and process for using it |
| EP2988687A1 (en) | 2013-04-24 | 2016-03-02 | Ntplast S.r.l. | Device for fixing a cranial limb to the cranial crown to be placed in the craniotomial hole or cutting |
| US20160100947A1 (en) * | 2013-04-24 | 2016-04-14 | Ntplast S.R.L. | Device for fixing a cranial limb to the cranial crown to be placed in the craniotomial hole or cutting |
| CN112087973A (en) * | 2018-03-02 | 2020-12-15 | 恩特蓬莱斯特公司 | Device for fixing a craniotomy eyelet to the cranial crown to be inserted in a craniotomy incision |
Also Published As
| Publication number | Publication date |
|---|---|
| IT202300006270A1 (en) | 2023-07-01 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| EP2988687B1 (en) | Device for fixing a cranial limb to the cranial crown to be placed in the craniotomial hole or cutting | |
| US8287567B2 (en) | Device for securing a cranial limb to the cranial top and for simultaneously closing craniotomy holes, and process for using it | |
| US8679123B2 (en) | Surgical device, system and method of use thereof | |
| DE60112945T2 (en) | Skull cap fixation device and device for its use | |
| EP2341856B1 (en) | System for fracture reduction | |
| US5707373A (en) | Bone fastener and instrument for insertion thereof | |
| US4279248A (en) | Sternum closure device and procedure for using same | |
| US6197037B1 (en) | Surgical fastener for joining adjacent bone portions | |
| US5549620A (en) | Brain surgery with craniotomy pin | |
| CN101646394A (en) | Securing device to secure fixation devices to bone portions | |
| DE69922047T2 (en) | DEVICE FOR LOCALIZING AND RESEARING BONE | |
| EP1634540A1 (en) | Surgical clamp and cutting blade | |
| US20020169463A1 (en) | Surgical tool for tensioning a cranial-flap clamp | |
| CN112087973B (en) | Device for fixing a craniotomy aperture to a cranium roof to be inserted in a craniotomy incision | |
| EP2825118B1 (en) | Device for fixing a cranial limb to the cranial crown to be placed in the craniotomial hole or cutting and dedicated applying device | |
| US5836937A (en) | Rod cutter with depth gauge | |
| WO2024201539A1 (en) | Device for fixing a cranial flap to the cranial vault to be positioned in the craniotomy hole | |
| WO2024201111A1 (en) | Device for fixing a cranial limb to the cranial crown to be placed in the craniotomial hole or cutting | |
| JPH09290026A (en) | Brain surgery barhole cap | |
| KR102354017B1 (en) | Device of drill for dental implant procedure | |
| WO2024201540A1 (en) | Device for fixing a craniotomy operculum to the cranial vault to be inserted into the craniotomy cut | |
| WO2024201110A1 (en) | Device for fixing a craniotomy operculum to the cranial vault to be inserted in the craniotomy cut | |
| US20100211110A1 (en) | Craniofacial plating system and method |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| 121 | Ep: the epo has been informed by wipo that ep was designated in this application |
Ref document number: 24721775 Country of ref document: EP Kind code of ref document: A1 |
|
| REG | Reference to national code |
Ref country code: BR Ref legal event code: B01A Ref document number: 112025020552 Country of ref document: BR |
|
| WWE | Wipo information: entry into national phase |
Ref document number: 2024721775 Country of ref document: EP |
|
| NENP | Non-entry into the national phase |
Ref country code: DE |
|
| ENP | Entry into the national phase |
Ref document number: 2024721775 Country of ref document: EP Effective date: 20251031 |