Corona Mortise- anatomical variants and implications in pelvic-acetabular surgery: An evidence based review
1Department Of Orthopaedics, All India Institute Of Medical Sciences, Jodhpur, Rajasthan, 342005, India.
Insights
The Corona Mortise, a vascular connection in the pelvis, is typically venous, posing bleeding risks during acetabular surgery. Understanding its anatomy is crucial for surgical safety and managing potential hemorrhage.
Area of Science:
- Vascular anatomy
- Pelvic surgery
- Surgical risk assessment
Background:
- The Corona Mortise comprises anastomotic vessels connecting the external and internal iliac vascular systems.
- These vessels present a significant risk of uncontrollable bleeding when injured, particularly during anterior acetabular approaches.
- There is ongoing debate regarding the precise nature and location of the Corona Mortise, complicating its identification.
Purpose of the Study:
- To conduct a comprehensive literature review on the Corona Mortise.
- To discuss the anatomy and clinical implications of accurately identifying the Corona Mortise in pelvic-acetabular surgery.
Main Methods:
- Comprehensive literature review of existing studies on the Corona Mortise.
- Analysis of anatomical descriptions and surgical case reports.
Main Results:
- The Corona Mortise is predominantly venous rather than arterial.
- Its venous nature complicates hemorrhage control and limits the utility of pre-operative angiography.
- Current surgical approaches are generally maintained despite the risks.
Conclusions:
- Accurate identification of the Corona Mortise is vital for pelvic-acetabular surgery.
- The venous predominance of the Corona Mortise presents unique challenges for surgeons.
- Despite risks, surgical approach modifications are not widely recommended.
Background:
Corona Mortise is the name given to the anastomotic vessels forming a communication between external and internal iliac vascular systems. These channels have a high tendency to cause uncontrollable bleeding if injured and are particularly at risk during the anterior approach to acetabulum. While previous studies have described them as arterial or venous connections or both, there is still a lack of consensus regarding exact nature and location of these vessels, which make their timely identification all the more challenging.
Objective:
The present review is aimed at performing a comprehensive review of existing literature and discuss the anatomy and implications of correct identification of Corona Mortise in pelvic-acetabular surgery.
Conclusion:
Corona Mortise is more commonly venous than arterial. This not only makes haemorrhage control more challenging but also precludes the use of pre-operative angiography. However, most authors do not recommend a change in surgical approach for fear of damaging these vessels.
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