The incidence and clinical significance of corona mortis vessel

Objective To explore the incidence and clinical significance of corona mortis vessels. Methods From December 2015 to December 2017, 48 patients with pelvic acetabular fractures were treated with the Stoppa approach, including 36 males and 12 females, aged 30 to 67 years, with an average age of 47.2±8.2 years. There were 52 sides of hemipelvis in the all including 44 cases of unilateral pelvic acetabular fractures and 4 cases of bilateral pelvic acetabular fractures. In the 48 patients, there were 6 pelvic fractures, 40 acetabular fractures and 2 pelvic combined with acetabular fractures. According to Judet-Letournel classification: there were 6 cases of anterior column fracture, 4 cases of anterior column with anterior wall fracture, 2 cases of anterior column with posterior transverse fracture, 4 cases of transverse fracture, 6 cases of T shape fracture and 20 cases of double column fracture. According to Tile classification, there were 2 cases of B1 type, 2 cases of B3 type, 2 cases of C1 type, and 2 cases of C2 type. The time from injury to surgery was 5 to 16 days, with an average of 8.3±2.8 days. All patients were treated with the Stoppa approach for reduction and fixation. The incidence, number and type of corona mortis vessels across the superior pubic branch, and the diameter and the distance between the vessels and the pubic symphysiswere detected and recorded. Results In the 52 hemi pelvis, there were 46 sides with an anastomotic blood vessel, and no anastomotic blood vessel was found in 6 sides, with the incidence of corona mortis vessels of 88.5% (46/52). Among them, 36 cases were venous type, with the incidence of 78.3% (36/46); 8 cases were arterial type, with the incidence of 17.4% (8/46); 2 cases were mixed type, with the incidence of 4.3%(2/46); corona mortis venous blood vessel diameter was 1.8-3.7 mm, with an average of 2.9±0.5 mm; arterial blood vessel diameter was 2.4-3.0 mm, with an average of 2.7±0.3 mm; the distance between the vessels and the pubic symphysis was 48-71 mm, with an average of 56.9±5.8 mm. Conclusion The corona mortis vessels are common, with the incidence through Stoppa approach about 88.5%. In the clinical treatment of pelvic acetabular fractures, we should pay attention to careful separation of pubic branches exposed by the Stoppa approach, especially when using ilioinguinal approach to avoid corona mortis vessels injury and haemorrhage. Key words: Pelvis; Acetabulum; Fractures, bone; Blood vessels