Coronary Ligament

2020 ◽  
Author(s):  
Keyword(s):  
Coronary Ligament

An In Vitro Osteotomy Method to Expose the Medial Compartment of the Human Knee

1997 ◽  
Vol 119 (4) ◽  
pp. 379-385 ◽  
Author(s):  
T. A. Martens ◽  
M. L. Hull ◽  
S. M. Howell
Keyword(s):  
Contact Pressure ◽  
Pressure Measurement ◽  
Femoral Condyle ◽  
Compressive Load ◽  
Medial Femoral Condyle ◽  
Medial Compartment ◽  
New Method ◽  
Load Bearing ◽  
Coronary Ligament

This study was conducted to validate a new in vitro method to expose the medial compartment of the knee to be used in subsequent studies aimed at examining the load bearing capabilities of medial meniscal allografts. The new method involves an osteotomy and reattachment of the medial femoral condyle. The primary hypothesis was that the new method does not alter tibio-femoral contact pressure and area. To validate this method, the baseline contact pressure of the intact medial compartment was measured using a new nondestructive procedure for inserting pressure measurement film into the intact medial hemijoint. A secondary and related hypothesis was that incising the coronary ligament, a destructive method used by previous investigators to position pressure measurement film, alters the normal tibio-femoral contact pressure. To test these hypotheses, Fuji Prescale pressure-sensitive film was used to measure both tibio-femoral contact pressure and area within the medial compartment of the (1) intact knee, (2) the knee after osteotomizing and reattaching the medial femoral condyle, and (3) the osteotomized knee with an incised coronary ligament, using seven cadaver specimens. Measurements were taken at a compressive load of approximately two times body weight with the knee in 0, 15, 30, 45 deg of flexion. No significant differences between the intact and osteotomized knee were detected. Likewise, no significant differences were observed between the osteotomized knee and the osteotomized knee with an incised coronary ligament. These results confirm the utility of the new method in exposing the medial compartment for manipulation and placement of medial meniscal allografts in future studies examining the load-bearing characteristics of meniscal allografts.

scholarly journals VP010 INTRA-ABDOMINAL HERNIA AS A CAUSE OF ACUTE SMALL INTESTINE OBSTRUCTION. LAPAROSCOPIC EMERGENCY TREATMENT - SMALL INTESTINE OBSTRUCTION DUE TO INTERNAL HERNIA WITH CONCOMITANT ACALCULOUS CHOLECYSTITIS

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Janusz Świątkiewicz ◽  
Przemysław Kabala ◽  
Dariusz Tomaszewski ◽  
Szymon Jasiński
Keyword(s):  
Small Intestine ◽  
Internal Hernia ◽  
Anatomical Variation ◽  
Acalculous Cholecystitis ◽  
Abdominal Hernia ◽  
Falciform Ligament ◽  
Anatomical Variant ◽  
Oral Nutrition ◽  
Gastrointestinal Obstruction ◽  
Coronary Ligament

Abstract Aim Nowadays, in vast majority of emergency patients with gastrointestinal obstruction laparoscopy is not the treatment of choice. In our department laparoscopy is routinely used in emergency admitted patients, also those with abovementioned condition, sometimes yielding unexpected and thrilling results. The aim of this work is to present a laparoscopic internal hernia repair with simultaneous “Phrygian-cap-type” gallbladder excision, performed on a patient with small intestine obstruction and chronic acalculous cholecystitis. Material and Methods A 57-year-old patient was admitted to our department as an emergency, with a one week history of symptomatic cholecystitis accompanied by gastrointestinal obstruction. CT revealed atypical suprahepatic displacement of the small intestine. An attempt of conservative treatment failed after the re-initiation of oral nutrition. The patient was qualified for laparoscopy. Results An anatomical variant of the liver ligaments was visualized with two defects in the anteriorly displaced coronary ligament and shortening of the falciform ligament. Those defects formed the hernia ring entrapping a small intestine of a total length of about 1.5 m. The falciform ligament was dissected. To avoid re-entrapment of the intestine, most of the coronary ligament was severed. Consecutively the inflamed gallbladder was removed. The unusual anatomical variation of its structure, the so-called “Phrygian cap”, was an additional difficulty. The postoperative course was uneventful. Conclusions The presented material demonstrates the possibility of immediate treatment of intestinal obstruction, even in a complicated cases, with laparoscopic manner, without the need of conversion to the open method.

scholarly journals THE DISTANCE BETWEEN TIBIAL PHYSIS AND CORONARY LIGAMENT: A PEDIATRIC CADAVERIC STUDY

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0014
Author(s):  
Aleksei Dingel ◽  
Alexander Karius ◽  
Laura C. Boucher ◽  
Yi-Meng Yen ◽  
Theodore J. Ganley ◽  
...  
Keyword(s):  
Average Distance ◽  
Posterior Root ◽  
Skeletally Immature ◽  
Tibial Insertion ◽  
Anatomic Repair ◽  
Group 2 ◽  
Coronary Ligament ◽  
Anterior Root ◽  
Repair Techniques ◽  
Group 1

Background: Meniscal injuries in the skeletally immature have been increasingly reported. Many meniscal repair surgeries involve the approximation of the meniscus tissue to the peripheral meniscus capsule. This peripheral fixation may not be ideal for some meniscus tear patterns, and may contribute to ‘peripheralization’ of the meniscus during the healing process, which may alter the weight bearing distribution function of the meniscus/articular cartilage complex. Surgical procedures that do not periperalize the meniscus are being developed, which may better replicate the normal meniscus anatomy. Purpose: The primary purpose of this study was to evaluate the coronary ligament attachments of the meniscus, and how this may influence further development of anatomic repair techniques and implants to address meniscus injury. The secondary purpose of this study was to determine the distance between the tibial insertion of the coronary ligament and the proximal tibial physis. Methods: 10 skeletally immature knee cadaver specimens between the ages of 3 months and 11 years (3 female, 7 male) were included in this study. Prior to CT, pins were placed in the tibias marking the coronary ligament insertion at designated points surrounding both the medial and lateral menisci (Figure 1). Using OsiriX, a medical imaging software, the distances between the proximal tibial physis and the coronary ligament insertion sites were measured at 10 points (5 lateral: anterior root, 12 o’clock, 3/9 o’clock, 6 o’clock, and posterior root, and 5 medial: anterior root, 12 o’clock, 3/9 o’clock, 6 o’clock, and posterior root). Axial view was used confirm proper pin measurement and the measurements were gathered in either the sagittal and coronal view depending on the pin’s placement. The specimen were divided into two groups for analysis- Group 1: ages 3 months- 2 years, Group 2: ages 10-11 years. Results: Medial Meniscus The average distance from the proximal tibial physis to the posterior medial root of the coronary ligament was 0.48 ± 0.08 cm and 1.02 ± 0.10 cm for Group 1 and Group 2, respectively. The average distance from the physis and the 6 o’clock pin was 0.37 ± 0.19 cm and 0.78 ± 0.23 cm. The average distance from the physis and the 3/9 o’clock pin was 0.32 ± 0.13 cm and 0.73 ± 0.22 cm. The average distance from the physis to the 12 o’clock pin was 0.14 ± 0.22 cm and 0.65 ± 0.45 cm. The average distance from the physis to the anterior pin was 0.21 ± 0.30 cm and 1.01 ± 0.62 cm. Lateral Meniscus The average distance from the proximal tibial physis to the posterior lateral root of the coronary ligament was 0.48 ± 0.11 cm and 1.62 ± 0.29 cm for Group 1 and Group 2, respectively. The average distance from the physis and the 6 o’clock pin was 0.38 ± 0.16 cm and 1.72 ± 0.25 cm. The average distance from the physis and the 3/9 o’clock pin was 0.17 ± 0.15 cm and 0.1.41 ± 0.19 cm. The average distance from the physis to the 12 o’clock pin was -0.04 ± 0.20 cm and 0.60 ± 0.14 cm. The average distance from the physis to the anterior pin was 0.16 ± 0.07 cm and 0.31 ± 0.16 cm. Conclusions: Our results show an increase in the distance between the proximal tibial physis and the insertion points of the coronary ligament as age increases. For all measurements, medial and lateral, Group 1 (the younger specimen’s) tibial insertion of the coronary ligament was less than 1 cm away from the physis. Group 2’s coronary ligament insertion points were further away from the physeal line, however still less than 2 cm away, and sometimes even as close as <0.5 cm (anterolateral root). As this data shows the close proximity of the physis and coronary ligament attachements on the meniscus, they confirm the need for the development of anatomic repair techniques and implants that are mindful of the growth plate and avoid physeal injury. Clinical Significance: This study of pediatric cadaveric specimens allowed for direct visualization of the coronary ligament anatomy on the tibia. This information is clinically significant as it detailed the developmental pattern of coronary ligament anatomy in pediatrics and can be used by surgeons performing meniscal injury reconstructions and repairs in patients with open physes. [Figure: see text]

Lateral meniscal variant with absence of the posterior coronary ligament.

1992 ◽  
Vol 74 (8) ◽  
pp. 1186-1190 ◽  
Author(s):  
D C Neuschwander ◽  
D Drez ◽  
T P Finney
Keyword(s):  
Coronary Ligament

Location of liver lacerations resulting from deceleration injuries and a proposal for their classification

2021 ◽  
Vol 93 (SUPLEMENT) ◽  
pp. 1-5
Author(s):  
Piotr Arkuszewski
Keyword(s):  
Left Lobe ◽  
Falciform Ligament ◽  
Professional Literature ◽  
Liver Rupture ◽  
Right Lobe ◽  
Coronary Ligament ◽  
The Right ◽  
Inference Methods ◽  
Medical University ◽  
Deceleration Trauma

Purpose: The aim of the study was to verify during forensic autopsies the occurrence of liver lacerations resulting from deceleration traumas in the locations reported in professional literature, and also to check whether they are located near the left coronary ligament and its extension, i.e. the left triangular liver ligament. Methods: The liver injuries were assessed on the base of cases of forensic autopsies, performed at the Department of Forensic Medicine of the Medical University of Lodz from 1 of September 2011 to 15 of April 2014. In order to analyze the collected data, descriptive methods and statistical inference methods were used. Results: Three types of liver rupture turned out to be characteristic and statistically significant: 1 – on the diaphragmatic surface of the right lobe between its two sectors; 2 – within the left lobe to the right (in segment IV) or to the left (in segment III) of the falciform ligament; 3 – located near the left coronary ligament (in segment II). Conclusions: Typical location of liver lacerations after deceleration trauma, i. e. the right triangular ligament and falciform ligament, are confirmed in the analysed autopsy material. The place not previously described in the literature, which should be regarded as a characteristic location of a liver rupture after deceleration trauma is the diaphragmatic surface of segment II of the left lobe.

scholarly journals Comparative Study of the Liver Anatomy in the Rat, Rabbit, Guinea Pig and Chinchilla

2018 ◽  
Vol 75 (1) ◽  
pp. 33
Author(s):  
Florin Gheorghe STAN
Keyword(s):  
Guinea Pig ◽  
Lateral Lobe ◽  
Caudate Lobe ◽  
Falciform Ligament ◽  
Small Rodents ◽  
Macroscopic Anatomy ◽  
Medial Lobe ◽  
Right Lobe ◽  
Coronary Ligament ◽  
Left Lateral Lobe

In liver surgical and histological research, small rodents are the most used experimental models. Although the small animals liver is typically lobulated and its macroscopic appearance do not resemble that of the compact human liver, a high degree of lobulation equivalence, allow the use of small rodents in biomedical research. The macroscopic anatomy of the liver of the rat, rabbit, guinea pig and chinchilla was studied from a comparative standpoint. The topography, lobulation and the connection elements of the liver were examined by detailed in situ observation and explanted liver of forty specimens.The rat liver (Hepar) consists of four distinct lobes of different size: the left lateral lobe - LLL (Lobus hepatis sinister lateralis), the median lobe - ML, the right lobe – RL (Lobus hepatis dexter) and the caudate lobe CL (Lobus caudatus). The largest lobe was the median lobe. The rabbit liver consists of five lobes: left lateral lobe - LLL, left medial lobe - LML (Lobus hepatis sinister medialis), right lobe - RL, quadrate lobe – QL (Lobus quadratus) and caudate lobe - CL. The most developed lobe was the left lateral lobe. The caudate lobe had a very narrow attachment on the hilar region. The guinea pig liver show six lobes: left lateral lobe - LLL, left medial lobe - LML, right lateral lobe – RLL (Lobus hepatis dexter lateralis), right medial lobe – RML (Lobus hepatis dexter medialis), quadrate lobe - QL and caudate lobe - CL. The largest lobe of this specie was the left lateral lobe. In chinchilla liver showed four lobes like in the rat. In the rats the most developed hepatic ligament was the falciform ligament (Lig. Falciforme hepatis) which spans from xyphoid process of the sternum and diaphragm to the liver, beginning at the interlobular fissure. The coronary ligament (Lig. Coronarium hepatis) was well developed in all rats. Interlobular ligaments connect the left lateral lobe with the upper caudate lobe. In rabbits, guinea pigs and chinchillas the connection elements were represented by the falciform ligament, coronary ligament, right (Lig.triangulare dextrum) and left triangular ligaments (Lig. Triangulare sinistrum), hepatorenal ligament (Lig.hepatorenale) and hepatoduodenal ligament (Lig. hepatoduodenale) with varying degrees of development.Based on detailed study of the macroscopic anatomy of rat, rabbit, guinea pig and chinchilla a proper experimental model in liver research, could be assessed. In this regard, the vascular anatomy of the liver in the mentioned species is of a great importance and it is subject of another report.

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