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An anatomical study of corona mortis and its clinical significance
Hua-xing Hong1, Zhi-jun Pan, Xin Chen
1Department of Orthopaedics, Second Affiliated Hospital, Medical College of Zhejiang University, Hangzhou 310009, China. honghuaxing@sohu.com
Insights
The corona mortis, a vascular connection near the superior pubic ramus, is frequently present and risks injury during anterior pelvic and acetabular surgery. Surgeons must carefully consider this anatomy during the ilioinguinal approach.
Area of Science:
- Anatomy
- Vascular Surgery
- Surgical Approaches
Background:
- The corona mortis is a critical vascular anastomosis.
- Understanding its anatomy is vital for pelvic and acetabular surgery.
Purpose of the Study:
- To detail the corona mortis anatomy relevant to the ilioinguinal approach.
- To assess the incidence and characteristics of vascular connections over the superior pubic ramus.
Main Methods:
- Dissection of 50 hemipelvises with intact soft tissues.
- Observation of the course, branches, and distribution of vascular connections.
Main Results:
- 72% of specimens showed communicating vessels between obturator and external iliac/inferior epigastric systems.
- Average vessel diameter was 2.6 mm.
- Vessels coursed over the superior pubic ramus or iliopubic eminence.
Conclusions:
- High incidence of corona mortis over the superior pubic ramus.
- These vessels are vulnerable during the ilioinguinal approach.
- Attention to corona mortis anatomy is crucial for surgical safety.
Objective:
To provide detailed information of corona mortis for ilioinguinal approach as an anterior approach to the acetabulum and pelvis.
Methods:
The course, branches and distribution of the vascular connection between the obturator system and the external iliac or inferior epigastric systems located over the superior pubic ramus were observed on 50 hemipelvises with intact soft tissues.
Results:
During the dissections, 72% of the cadaveric sides had at least one communicating vessel between the obturator system and the external iliac or inferior epigastric systems on the superior pubic ramus. The average diameter of the connecting vessel was 2.6 mm (range, 2.0-4.2 mm). It coursed over the superior pubic ramus or iliopubic eminence vertically to enter the obturator foramen and exit the pelvis. The average distance from pubic symphysis to the vascular connections between the obturator and external iliac systems was 52 mm (range, 38-68 mm).
Conclusions:
Vascular connections between the obturator system and the external iliac or inferior epigastric systems were found over the superior pubic ramus with a high incidence. They are prone to damage during the ilioinguinal approach as an anterior approach to the acetabulum and pelvis. Thus, corona mortis located over the superior pubic ramus deserves great attention during the ilioinguinal approach.
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