Morphologic Study of the Corona Mortis Using the Simlife ® Technology

Abstract

Purpose Open book pelvic ring fractures are potentially life-threatening, due to their instability and major haemorrhage risk. If a pelvic belt could initially control the bleeding, the definitive management involves an open reduction and internal fixation. However, the pelvic approach remains a technical challenge, as the surgeon wants to prevent any iatrogenic damage of the vascular loop located in the retropubic area called corona mortis (CMOR). Recently, the cadaver perfused SIMLife® technology has been developed to improve the surgeon training, out of the operating room. This study aimed to compare two models of cadaveric dissection, to assess the interest of the perfused SIMLife® in the identification of the CMOR and its topography. Methods Twelve human cadaveric pelvises have been dissected, following two protocols. Twelve hemipelvises of the dissections were performed without perfusion (Model A), whereas the 12 other hemipelvises have been prepared with the SIMLife® pulsatile perfusion (Model B). The prevalence, length, and diameter of the CMOR have been reported, along with the distance between the CMOR and the pubic symphysis. Results The CMOR has been found in 66,67% of the cases. The length, the diameter and the distance between the CMOR and the pubic symphysis were significantly higher in model B (respectively p = 0.029, p = 0.01, and p = 0.022). Conclusion These results suggest that the CMOR is easier to identify and to dissect with the SIMLife® perfusion. As part of the surgical training of any trauma surgeon, this model could help him to keep in mind the topography of the CMOR, to improve the open book lesion management.