JP4188858B2 - Bone flap holding plate - Google Patents

Description

  The present invention relates to a bone flap holding plate for holding a bone flap excised by craniotomy back to the head and holding it.

  In neurosurgery, craniotomy may be performed for the treatment of, for example, cerebral aneurysms. In this craniotomy, for example, an incision is made in the scalp of the temporal region, three holes called barholes are made in the temporal region of the skull, and the bone is cut out based on the hole, and the cut bone is cut. Remove the valve to open the skull, treat the root of the aneurysm from this opening with a titanium clip so that blood flow does not flow into the aneurysm, then fix the bone flap back to the opening, The procedure is to sew the wounds on the scalp.

  And as a fixing tool for returning the bone flap to the opening and fixing it, an elongated plate having screw holes formed at both ends, or a quadrilateral frame body having screw holes formed at four corners Plates and the like were used, and these plates were placed between the skull main body and the bone flap and fixed with screws through screw holes.

  On the other hand, Patent Document 1 below discloses a surgical connector in which a plurality of ring-shaped portions are connected by three curved ribs extending outward from each ring-shaped portion to form a grid-like plate. ing. And it is described that this surgical connector can be easily deformed to fit a bone structure having a compound curvature.

In addition, a bone grafting material made of hydroxyapatite that blocks a bar hole formed by craniotomy or the like is also commercially available. This bone prosthetic material has a shaft portion that is inserted into the bar hole and a flange portion that engages with the periphery of the bar hole.
Japanese Patent Laid-Open No. 10-277053

  However, the above-described elongated plate with screw holes formed at both ends, or a plate with a quadrilateral frame and screw holes formed at four corners, is used only to fix the bone flap to the skull. Therefore, it was not possible to close a large opening such as a bar hole, and the opening such as a bar hole was left as it was.

  For this reason, there was a problem that the barhole portion was depressed after treatment. In particular, the bar hole formed in the temple portion has a disadvantage that the temporal muscle arranged in that portion is displaced, so that it is easily depressed and the human phase after the operation is changed.

  In addition, the lattice-like plate described in Patent Document 1 can be easily deformed into a shape having a compound curve, but it is difficult to deform into a complicated shape such as a temple portion of a skull. It is believed that there is.

  Furthermore, since the bone grafting material made of hydroxyapatite has a porous tissue, body fluid may permeate into the interior during surgery and cause bacterial contamination. It is thought that attention is necessary.

  Therefore, an object of the present invention is a bone flap holding plate for holding a bone flap excised by craniotomy back to the head, and can hold the bone flap and cover the barhole. An object of the present invention is to provide a bone flap holding plate.

  In order to achieve the above object, a first aspect of the present invention is a bone flap holding plate for holding a bone flap excised by craniotomy back to the craniotomy and formed of a metal plate. It has a nail that can be inserted into the cancellous part or skull, covers a bar hole formed in the skull during craniotomy, and is molded into a three-dimensional shape that matches the shape of the skull in that part A bone flap holding plate characterized by the above is provided.

  According to the above invention, the bone valve holding plate covers the bar hole formed in the skull at the time of craniotomy and has a three-dimensional shape that matches the shape of the skull of that portion. When the plate (hereinafter referred to as a plate) is brought into contact, the plate fits and is disposed at the joint between the bone flap and the skull body. Further, the plate can be fixed and arranged easily by inserting the nail portion into the cancellous portion of the cut portion of the skull or the skull. As a result, the bar hole can be covered to the original skull shape, and the bone flap can be held without slipping. Moreover, since it is formed of a metal plate, problems such as bacterial contamination are less likely to occur.

  A second aspect of the present invention is the bone flap holding plate according to the first aspect, which covers the bar hole formed in the temple portion of the skull and is molded into a three-dimensional shape adapted to the shape of the skull of that portion. Is to provide.

  According to the above-described invention, it is possible to cover the bar hole formed in the temple portion of the skull having a particularly complicated shape in a fitted state, and to prevent the depression of the portion and the displacement of the bone flap.

  According to a third aspect of the present invention, in the first or second aspect of the present invention, the plate provides a bone flap holding plate having holes for inserting fixing screws and fixing temporal muscles.

  According to the above invention, the screw can be inserted through the hole and fixed to the skull body or the bone flap, and the temporal muscle can be fixed by binding the temporal muscle using the hole. .

  According to a fourth aspect of the present invention, there is provided the bone flap holding plate according to any one of the first to third aspects, wherein the plate has a thickness of 0.1 to 0.6 mm.

  According to the above invention, since it is thin, it can be bent, and even if the shape of the skull changes slightly depending on the individual patient, the shape can be adapted to the skull of the individual patient by bending the plate slightly at the operation site. It can be corrected.

  According to a fifth aspect of the present invention, in any one of the first to fourth aspects of the present invention, a cut and raised portion is formed inside the rounded peripheral edge portion of the bone flap holding plate, and the tip of the cut and raised portion. A bone flap holding plate having a claw portion formed by bending a portion toward the outer side of the peripheral edge portion is provided.

  According to the said invention, while the nail | claw part is formed in the said plate, the peripheral part of the said plate is rounded and formed continuously, without notching in the middle by a slit etc. Therefore, the plate can be easily fixed and placed by inserting the nail part into the cancellous part of the cut part of the skull or the skull, and the plate can be covered firmly without denting the bar hole. Therefore, the depression of the bar hole can be surely prevented. In particular, the bar hole near the temple part can be used effectively because the change in the human phase after the operation is conspicuous even if a part of the bar hole is depressed.

  According to a sixth aspect of the present invention, in any one of the first to fourth aspects of the present invention, the bone flap holding plate covers the bar hole and is formed into a three-dimensional shape that matches the shape of the skull of the portion. A bone flap holding plate main body, and a claw member attached to the bone flap holding plate main body and inserted into the cancellous portion or skull of the skull cutting portion. A hole for inserting the claw part of the claw member is formed inside the rounded peripheral edge part, and an insertion part for fixing the claw member is formed further inside the hole for inserting the claw part. And the claw member has a claw portion inserted into the claw portion insertion hole and a mounting portion inserted into the insertion portion and fixed to the bone flap holding plate body. A holding plate is provided.

  According to the above invention, the claw member is not formed integrally with the plate but is formed separately, and is attached to the bone flap holding plate body (hereinafter referred to as plate body) later. Yes. Therefore, unlike the nail part integrally formed with the plate, the bending stress when bending is not applied, so the strength of the nail part can be secured and the nail part can be prevented from breaking during and after the operation. it can.

  In addition, when the attachment portion of the nail member is inserted into the insertion portion formed on the plate, a slight clearance is generated between the attachment portion and the insertion portion, so that the nail portion of the nail member is attached to the skull. Even after being inserted into the cancellous portion of the cut portion or a hole or the like provided separately in the skull, the plate body can be slid to finely adjust the arrangement position.

According to a seventh aspect of the present invention, in any one of the first to sixth aspects of the present invention, at least two slits are formed in parallel in the bone flap holding plate, and a belt-like portion sandwiched between the slits is disposed outside. A bone flap holding plate having a thread insertion hole for binding and fixing temporal muscles, which is formed by bending, is provided.

  According to the invention, the band-shaped portion sandwiched between the slits is curved outward, and a thread insertion hole (hereinafter referred to as a thread insertion hole) for binding and fixing the temporal muscle is formed. Even after fixing to the bone flap and skull with a set screw or the like, the medical thread in which the ends of the temporalis are bundled together is smoothly inserted into the thread insertion hole using a medical needle or the like. The temporal muscle can be firmly and easily tied to the thread insertion hole and fixed to the plate.

  Moreover, since the belt-like portion is gently curved, after the plate is fixed and the scalp is covered, the belt-like portion is difficult to bite into the scalp, and even when it hits a hard object or is subjected to an impact Since the belt-shaped portion is deformed, it is difficult to bite into the scalp and is safe.

  According to the bone flap holding plate of the present invention, it covers a bar hole formed in the skull during craniotomy, and has a three-dimensional shape that matches the shape of the skull of that portion, so that the bar hole is covered. By bringing the plate into contact with each other, the plate is fitted and arranged at the joint between the bone flap and the skull main body, covers the bar hole to the original skull shape, and the bone flap can be held without being displaced. Moreover, since it is formed of a metal plate, problems such as bacterial contamination are less likely to occur.

  In the following, embodiments of the present invention will be described in detail with reference to the drawings. The present invention is not limited only to these embodiments.

  FIG. 1 shows a first embodiment of a bone flap holding plate according to the present invention. FIG. 4A is a perspective view seen from the convex side of the plate, and FIG. 4B is a perspective view seen from the concave side of the plate.

  The bone flap holding plate 10 is formed of a biocompatible metal such as titanium, a titanium alloy, or stainless steel.

  Although the thickness of this plate 10 is not specifically limited, Preferably it is 0.1-0.6 mm, More preferably, it is 0.2-0.4 mm. If the thickness is less than 0.1 mm, sufficient strength cannot be obtained, and if it exceeds 0.6 mm, it becomes difficult to modify the shape to fit an individual patient.

  And this plate 10 is shape | molded by the three-dimensional shape which fits the surrounding skull shape while covering the bar hole formed in the temple part of a skull in the case of craniotomy. The bar hole formed in the temple portion is sometimes called a key hole.

  The plate 10 has a relatively small hole 11 suitable for inserting a skull body and screws for fixing to the bone flap, and a relatively large rectangular hole 12 suitable for binding and fixing the temporal muscle. have.

  Further, a claw portion 14 protrudes from one point of intersection of the grid-like portion 13 surrounding the rectangular hole 12. The claw portion 14 is formed so as to protrude obliquely outward with respect to the convex curved surface of the plate 10 and has a slightly sharp tip.

  For example, the plate 10 is formed by punching a metal plate made of the above-described material having the above thickness into a planar shape having the above-described contour and holes, and then press-molding the plate into a three-dimensional shape. Can be manufactured by.

  The surface of the plate 10 may be coated with a biocompatible resin film such as a fluororesin, a silicon resin, or a polyurethane resin.

  FIG. 2 shows a second embodiment of a bone flap holding plate according to the present invention. FIG. 4A is a perspective view seen from the convex side of the plate, and FIG. 4B is a perspective view seen from the concave side of the plate.

  This bone flap holding plate 20 is also made of a metal plate of the same material and thickness as in the previous embodiment, covers the bar hole formed in the temple portion of the skull during craniotomy, and has a skull shape around it. It is molded into a three-dimensional shape that fits.

  However, in the plate 20, a plurality of holes 21 having the same inner diameter are formed from the peripheral part to the central part of the plate 20 at substantially equal intervals. In addition, a pair of parallel slits 22 and 23 are formed from one place on the periphery of the plate 20, and a claw portion 24 separated by these slits 22 and 23 is formed. The nail | claw part 24 is formed so that it may protrude a little from the periphery of the plate 20, and the front-end | tip part is bent a little diagonally.

  This bone flap holding plate 20 can insert a fixing screw through the hole 21 and can also bind a temporal muscle or the like. Moreover, since the nail | claw part 24 protrudes from the periphery of the plate 20, it is easy to pierce the spongy part of the cut part of a skull, the hole provided in the skull, etc. separately.

  3 to 6 show an example of a method for using the bone flap holding plate according to the present invention. FIG. 3 is an explanatory view showing a state in which the bone flap is removed from the skull main body, FIG. 4 is an explanatory view showing a state in which the bone flap is returned and fixed to the open head of the skull main body, and FIG. FIG. 6 is a partial cross-sectional view schematically showing the cross-sectional structure of the skull.

  In the case of craniotomy for treatment of an intracerebral aneurysm or the like, after the scalp is cut open, three bar holes 31, 32, 33 are formed in the temporal region of the skull 30 as shown in FIG. Then, the bone flap 34 is cut by cutting the skull 30 based on these bar holes 31, 32, 33. An aneurysm or the like is clipped from the open head 35 formed by cutting the bone flap 34 in this way. Specifically, after the aneurysm is clamped with a clip made of titanium or the like, the bone flap 34 is fitted into the open head 35 and fixed as shown in FIG. 4, and as shown in FIG. After the temporal muscles 50 and the like are placed in their original positions, the scalp is stitched together to complete the operation.

  In this embodiment, after fitting the bone flap 34 into the open head 35, the bone flap 34 is fixed to the skull 30 with a titanium frame-shaped fixing plate 40 and a set screw 41, and formed in the temple portion. The bone flap holding plate 10 of the present invention is disposed so as to cover the bar hole 33.

  The frame-shaped fixing plate 40 has a quadrangular shape, and holes 42 are formed at four corners thereof. Then, the two holes 42 of the fixing plate 40 are fixed to the bone flap 34 with a set screw 41, and the remaining two holes 42 are fixed to the skull (skull body) 30 with the set screw 41, whereby the bone flap 34 is fixed. Is fixed to the skull 30. About two fixing plates 40 are preferably used.

  On the other hand, the bone flap holding plate 10 of the present invention is disposed so as to cover the bar hole 33 formed in the temple portion and the periphery thereof. At this time, the plate 10 can be easily fixed by piercing the nail portion 14 of the plate 10 into the cancellous portion 36 (see FIG. 6) of the cut portion of the skull 30. The cancellous portion 36 is a porous soft tissue formed in the middle of the bone thickness direction, and can easily pierce the nail portion 14. Since the nail | claw part 14 stabbed in this way is pinched | interposed into the dense part 37 formed in the front and back of the skull 30, it is fixed firmly.

  It is also possible to artificially make a small hole at an appropriate position of the skull 30 and insert the nail portion 14 into the hole for fixing. Further, by inserting a set screw through the hole 11 of the plate 10 and fixing the set screw to the skull 30 or the bone flap 34, the plate 10 can be fixed more firmly.

  Since the bone flap holding plate 10 of the present invention is formed in a three-dimensional shape that matches the shape of the temple portion of the skull 30, the bone flap 34 is shifted to the correct position by contacting the plate 10. It is possible to maintain the original shape of the skull while covering the bar hole 33.

  Further, the temporal muscle 50 shown in FIG. 5 is partly removed from the skull during craniotomy, but after the bone flap 34 is returned to the head and fixed, as shown in FIG. It can be repositioned and tied to the bone flap holding plate 10 of the present invention and fixed. At this time, the temporal muscles 50 can be bound using the holes 12 and the lattice-like portions 13 of the plate 10. As a result, the temporal muscle 50 can be prevented from shifting.

  As described above, by using the bone flap holding plate 10 of the present invention, the bar hole 33 formed in the temple portion of the skull 30 can be covered to the original skull shape, and the temporal muscle 50 is tied up. Since it can be fixed, there is no depression after the operation, and it is possible to prevent the human phase from changing.

  In this example, the bone valve holding plate 10 shown in FIG. 1 is used, but the bone valve holding plate 20 shown in FIG. 2 can also be used in the same manner.

  In the embodiment shown in FIGS. 1 and 2, the plate is formed with holes and claws. However, even if the plate does not have both holes and nails, the bar hole is covered. By bringing the plate into contact with each other in this way, the fine movement of the bone flap is suppressed, and it has an effect on the depression and bulge of the bone flap.

  7 to 11 show a third embodiment of a bone flap holding plate according to the present invention. Note that parts that are substantially the same as those of the above-described embodiment are given the same reference numerals, and descriptions thereof are omitted.

  This bone flap holding plate 60 is also made of a metal plate of the same material and thickness as in the previous embodiment, covers the bar hole formed in the temple portion of the skull during craniotomy, and has a skull shape around it. It is molded into a three-dimensional shape that fits.

  The plate 60 is different from the above embodiment in the shape of the claw portion 64 and the forming method thereof. As shown in FIG. 7, the plate 60 has a cut and raised portion 63 separated by a U-shaped notch 62 inside a rounded peripheral edge portion 61. The cut and raised portion 63 is bent toward the outer side of the peripheral edge portion 61 to form a claw portion 64. Note that the cutting and raising means, for example, that a predetermined shape is cut into a plate-shaped member, and a portion separated from the plate-shaped member by bending is bent to form a predetermined shape.

  In the case of the third embodiment, the cut-and-raised part 63 is formed by a U-shaped notch 62, but the notch 62 may have a V-shape, an arc shape, or the like. It suffices if a portion that can be cut and raised is formed.

  Furthermore, at least two or more slits 65, 65 are formed in parallel at a predetermined portion of the plate 60. And the thread | yarn insertion hole 67 is formed by curving the strip | belt-shaped part 66 pinched | interposed by the slits 65 and 65 outside. Since the belt-like portion 66 is gently curved, even after the plate 60 is fixed and covered with the scalp, the belt-like portion 66 hardly bites into the scalp, and even when it hits a hard object or is subjected to an impact. Since the belt-like portion 66 is deformed, it is difficult to bite into the scalp, which is safe.

  In the case of the third embodiment, the slits 65 and 65 are formed substantially in parallel. However, the slits 65 and 65 may be formed obliquely, for example, like a letter C, and are sandwiched between the slits. It is only necessary to form Further, in the first and second embodiments described above and the fourth embodiment described later, the slits 65 and 65 may be formed, and the belt-like portion 66 and the thread insertion hole 67 may be formed.

  This plate 60 is used in the same manner as the first plate 10 and the plate 20 of the second embodiment, and after the scalp is cut open, as shown in FIG. Bar holes 31, 32 and 33 are formed, the bone flap 34 is cut out, and an aneurysm and the like are clipped from the open head 35. Thereafter, as shown in FIG. 9, the bone valve 34 is fitted and fixed to the open head 35, and the bone plate 34 is fixed to the skull 30 with the fixing plate 40 and the set screw 41, and the bar formed in the temple portion. The plate 60 is disposed so as to cover the hole 33.

  At this time, the claw portion 64 is formed on the plate 60, and the peripheral portion 61 of the plate 60 is continuously formed in a rounded shape without being cut out in the middle by a slit or the like. By piercing the nail 64 into the cancellous portion 36 of the cut portion of the skull 30, the plate 60 can be easily fixed and disposed, and the bar hole 33 can be covered firmly without being recessed by the plate 60. . Therefore, the depression of the bar hole 33 can be reliably prevented. In particular, the bar hole 33 in the vicinity of the temple portion can be effectively applied because the change of the human phase after the operation is conspicuous even if a part of the bar hole 33 is depressed.

  Further, the thread insertion hole 67 is formed in the plate 60 as described above, and a medical thread in which the temporal muscles 50 are bundled can be inserted, and the temporal muscles 50 can be tied to the plate 60 and fixed. It has become. The procedure at this time is shown in FIGS. 10A, 10B, and 11. FIG.

  That is, as shown in FIG. 10 (A), when the bone flap 34 is cut off, the ends of the temporal muscles 50 that have been peeled off from the skull 30 and separated into pieces are gathered together with a medical thread 81. Bundle it up. Next, the distal end portion of the medical thread 81 is inserted into a hole provided at the proximal end of the medical needle 80 and pulled out.

  Then, as shown in FIG. 10B, the medical needle 81 is inserted from one end of the thread insertion hole 67 of the plate 60 from the tip, and the medical needle 80 is pulled as it is, so that the medical thread 81 is pulled. The thread is inserted through the thread insertion hole 67 and extracted to the opposite side of the thread insertion hole 67.

  Thereafter, the medical thread 81 is pulled to draw the portion where the ends of the temporal muscle 50 are bundled up to the vicinity of the thread insertion hole 67, and is tied to the belt-shaped portion 66 by the medical thread 81. (See FIG. 11).

  As described above, according to the thread insertion hole 67 formed in the plate 60, even after the plate 60 is fixed to the bone flap 34 and the skull 10 with a set screw or the like, the ends of the temporal muscles 50 are gathered together. The medical thread 81 bundled in the thread is smoothly inserted into the thread insertion hole 67 using the medical needle 80 or the like, and the temporal muscle 50 is firmly and easily bound to the belt-shaped portion 66 and fixed to the plate 60. It becomes possible.

  FIG. 12 shows a fourth embodiment of a bone flap holding plate according to the present invention. Note that parts that are substantially the same as those of the above-described embodiment are given the same reference numerals, and descriptions thereof are omitted.

  This bone flap holding plate 70 is also made of a metal plate of the same material and thickness as in the previous embodiment, covers the bar hole formed in the temple portion of the skull during craniotomy, and has a skull shape around it. It is molded into a three-dimensional shape that fits.

  The plate 70 is different from the above embodiment in that the claw portion is formed separately. As shown in FIG. 12, the plate 70 covers the bar holes 31, 32, 33, and has a three-dimensional shape conforming to the shape of the skull 10 of that portion, and a bone flap holding plate body 71, and the plate The claw member 74 is attached to the main body 71.

  The plate main body 71 is formed with a claw portion insertion hole 72 for inserting the claw portion 74a of the claw member 74 inside the rounded peripheral edge portion 61. Further, a pair of insertion portions 73 and 73 for fixing the claw member 74 are formed inside and on both sides of the claw portion insertion hole 72.

  In this embodiment, the claw member 74 has a substantially T-shape, and is inserted into the claw portion 74a inserted into the claw portion insertion hole 72 and the insertion portions 73 and 73 and fixed to the plate body 71. Mounting portions 74b and 74b. The claw member 74 may be Y-shaped or L-shaped, and is appropriately selected according to the shape of the hole 72 for inserting the claw portion and the insertion portion 73 formed in the plate body 71. It is determined.

  The claw member 74 can be attached to the plate body 71 by inserting the claw portion 74 a into the claw portion insertion hole 72 and then inserting the attachment portions 74 b and 74 b into the insertion portions 73 and 73. The attachment portions 74b and 74b of the claw member 74 are inserted into the insertion portions 73 and 73 of the plate body 71, and then the claw portion 74a of the claw member 74 is inserted into the hole 72 for inserting the claw portion of the plate body 71. Can also be installed.

  According to this plate 70, the claw member 74 is not formed integrally with the plate as in the other embodiments, and since no bending stress is applied when the claw portion is bent, the strength of the claw portion 74a. Can be secured, and the nail 74a can be prevented from being broken during or after the operation.

  Further, when the attachment portions 74 b and 74 b of the claw member 74 are inserted into the insertion portions 73 and 73 formed in the plate body 71, there is a slight clearance between the attachment portions 74 b and 74 b and the insertion portions 73 and 73. Arise. Therefore, even after inserting the claw portion 74a of the claw member 74 into the spongy portion 36 of the cut portion of the skull 10 or the hole provided in the skull separately, the plate body 71 is slid to finely adjust the arrangement position. be able to.

  When the bone flap excised by the craniotomy is held back to the craniotomy, the present invention fits the joint between the bone flap and the skull body and makes the original skull shape to displace the bone flap. It can be used as a bone flap holding plate that can be held in such a way as not to exist.

1A and 1B show a first embodiment of a bone flap holding plate according to the present invention, in which FIG. 1A is a perspective view seen from the convex side of the plate, and FIG. 1B is a perspective view seen from the concave side of the plate. The 2nd Embodiment of the bone flap holding plate by this invention is shown, (A) is the perspective view seen from the convex surface side of the plate, (B) is the perspective view seen from the concave surface side of the plate. It is explanatory drawing which shows the state which removed the bone flap from the skull main body. It is explanatory drawing which shows the state which returned and fixed the bone flap to the open head of the skull main body. It is explanatory drawing which shows the state which fixed the temporal muscle to the plate. It is a fragmentary sectional view which shows typically the cross-sectional structure of a skull. 3A and 3B show a third embodiment of a bone flap holding plate according to the present invention, in which FIG. 3A is a perspective view seen from the concave side of the plate, and FIG. 4B is a perspective view seen from the convex side of the plate. It is explanatory drawing which shows the state which removed the bone valve from the skull main body in the case of using the plate for valve retention. It is explanatory drawing which shows the state which returned and fixed the bone flap to the open head of the skull main body using the bone flap holding plate. The procedure at the time of fixing temporal muscle to the bone flap holding plate is shown, (A) is a perspective view showing a state in which a medical thread is inserted through a hole of a medical needle, and (B) is a medical treatment. It is the perspective view which showed the state which penetrated the thread | yarn through the thread | yarn insertion hole for temporal muscle ligation. It is a perspective view which shows the state which finished fixing the temporal muscle to the plate for same bone flap holding. It is a perspective view which shows 4th Embodiment of the plate for bone flap holding | maintenance by this invention.

Explanation of symbols

10, 20, 60, 70 Bone flap holding plate 11, 12, 21 Holes 14, 24, 64, 74a Claw part 30 Skull 31, 32, 33 Bar hole 34 Bone flap 35 Open head 36 Spongy part 40 Fixing plate 50 Temporal muscle 61 Peripheral part 63 Cut and raised part 65 Slit 66 Band-like part 67 Thread insertion hole 71 Bone flap holding plate body 72 Claw part insertion hole 73 Insertion part 74 Claw member 74b Attachment part

Claims (7)

  A bone flap holding plate for holding the bone flap excised by craniotomy back to the craniotomy, which is made of a metal plate and has a nail portion that can be inserted into the cancellous portion of the cut portion of the skull or the skull. The bone flap holding plate is characterized in that it covers a bar hole formed in the skull during craniotomy and is formed into a three-dimensional shape that matches the shape of the skull of that portion.   2. The bone flap holding plate according to claim 1, wherein said plate is covered with a three-dimensional shape that covers a bar hole formed in the temple portion of the skull and conforms to the shape of the skull of that portion.   The bone flap holding plate according to claim 1 or 2, wherein the plate has holes for inserting fixing screws and fixing temporal muscles.   The bone flap holding plate according to any one of claims 1 to 3, wherein the plate has a thickness of 0.1 to 0.6 mm.   A cut-and-raised portion is formed inside the rounded peripheral edge portion of the bone flap holding plate, and a claw portion is formed by bending the tip of the cut-raised portion toward the outside of the peripheral edge portion. Item 5. The bone flap holding plate according to any one of Items 1 to 4. The bone flap holding plate covers the bar hole and is formed into a three-dimensional shape that fits the shape of the skull of the portion, and is attached to the bone flap holding plate body. A nail member inserted into the cancellous part or skull of the cut portion of the skull,
A hole for inserting the nail portion of the nail member is formed inside the rounded peripheral edge of the bone flap holding plate, and the nail member is fixed further inside the hole for inserting the nail portion. Insertion part is formed,
The said claw member has a claw part inserted in the hole for said claw part insertion, and the attaching part inserted in the said insertion part, and being fixed to the said bone flap holding plate main body. 4. The bone flap holding plate according to any one of 4 above.   The bone flap holding plate has at least two slits formed in parallel, and has a thread insertion hole for binding and fixing the temporal muscle formed by bending the band-like portion sandwiched by the slits outward. The bone flap holding plate according to any one of claims 1 to 6.

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