The obturator artery is the primary supply to the adductor compartment muscles and provides the acetabular branch (via the ligamentum teres) to the femoral head. The corona mortis, an anomalous communication between the obturator and the inferior epigastric artery passing over the superior pubic ramus, is present in 20-30% of individuals and is a potentially fatal structure during pelvic fracture fixation.
| Origin | Anterior trunk of the internal iliac artery (or from the inferior epigastric, corona mortis variant in 20-30%) |
|---|---|
| Course | Passes along the lateral pelvic wall with the obturator nerve and vein through the obturator canal to supply the adductor compartment |
| Branches |
|
The corona mortis (crown of death) is the obturator-epigastric anastomosis passing over the superior pubic ramus at the 3-4 cm lateral to the pubic symphysis, present in 20-30% and up to 8 mm diameter. Division during lateral window of Stoppa approach for acetabular fracture or pubic ramus ORIF produces massive haemorrhage. It must be identified and ligated prophylactically before superior pubic ramus dissection.
Inadvertent division of the obturator-epigastric anastomosis during pelvic fracture surgery producing life-threatening haemorrhage managed with prophylactic ligation during exposure.
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