What Is the Coronary Ligament?

A structure formed by the transition of the peritoneum below the chin and above the liver. The peritoneal folds of the liver and the iliac crest. It is very narrow, and the mesangial membrane is formed by turning the palatal surface of the liver directly behind the palate. It is coronal and consists of two layers of peritoneum. The upper layer continues forward from the right layer of the sickle ligament, and the lower layer starts from the posterior layer of the omentum. It is U-shaped, the upper end is continuous with the left and right triangular ligaments of the dorsal margin of the liver, and it runs down both sides of the posterior vena cava in the posterior vena cava sulcus. After the vena cava.

A structure formed by the transition of the peritoneum below the chin and above the liver. The peritoneal folds of the liver and the iliac crest. It is very narrow, and the mesangial membrane is formed by turning the palatal surface of the liver directly behind the palate. It is coronal and consists of two layers of peritoneum. The upper layer continues forward from the right layer of the sickle ligament, and the lower layer starts from the posterior layer of the omentum. It is U-shaped, the upper end is continuous with the left and right triangular ligaments of the dorsal margin of the liver, and it runs down both sides of the posterior vena cava in the posterior vena cava sulcus. After the vena cava.

Chinese name

Coronary ligament

Foreign name

coronary ligamen

Coronary ligament related anatomy

1. The peritoneum reverses from the liver to the right kidney and right adrenal gland, forming a hepatorenal ligament. The subcoronary ligament referred to in the literature and textbooks is actually the hepatorenal ligament in the subcoronary ligament.

2. Hepatorenal ligament moves to the right triangle of the right ligament of the liver and the upper layer of the coronary ligament. The hepatorenal ligament crosses the anterior border of the inferior vena cava to the left margin and then folds back to the palate, forming the left layer of the coronary ligament.

3. The left layer of the coronary ligament reaches the iliac crest upward along the left edge of the inferior vena cava, and then enters the venous ligament fissure and the posterior omentum.

4. The left layer of 100% coronary ligament and the upper layer of coronary ligament, sickle ligament and hepatic caudate lobe appear synchronously in the second hepatic hilar plane; but disappear asynchronously in the first hepatic hilar plane.

5. The left and right triangular ligaments of the coronary ligament appear or disappear adjacent to the first hilar plane. The "subcoronary ligament layer" observed on the cross-section between the second hilum and the first hilar plane is the left layer of the coronary ligament, and the bare liver region (extraperitoneal space) is between the upper layer of the coronary ligament and the left layer of the coronary ligament. ). In the fault that appears in the right triangular ligament, two components of the lower layer of the coronary ligament can be seen: the hepatorenal ligament and the left layer of the coronary ligament; between the right triangular ligament and the liver and kidney ligament, there is a liver and kidney crypt; Between the lower layers is the bare liver area.

Coronary ligament related diseases and treatment

1. Knee osteoarthritis is a common clinical disease with frequent occurrences, especially in women. The incidence of osteoarthritis in knees is particularly high. There is currently no special treatment in China and the treatment effect is poor. Through clinical studies, researchers believe that coronary ligament damage is closely related to osteoarthritis.

2. Applied Anatomy

The coronary ligament of the knee joint is located at the upper edge of the tibial condyle and surrounds both sides of the meniscus in a coronal position. Coronary ligaments are small fiber bundles that connect the meniscus to the tibial plateau. The outer side of the meniscus is loosely attached to the edge of the tibial condyle by a coronal ligament. The coronal ligament is tightly connected with the fibrous tissue of the joint capsule. The knee ligament is located at the upper edge of the tibial condyle and is wrapped around the front of the two menisci in a coronal position. It is often called a transverse knee ligament connected in a cord-like manner. When the knee joint is flexed, the meniscus moves backward, and the second half of the meniscus is pressed between the opposite joints of the femoral condyle and the tibial condyle. Conversely, when the knee joint is straightened, the meniscus will move forward in the surrounding of the coronary ligament. The front half of the meniscus is nestled between the opposing joints of the femoral condyle and the tibial condyle. Any over-straightening will put pressure on the front. The medial ligament is more commonly internalized, and the lesion can be found by turning the foot to the external rotation position when the knee is flexed at an appropriate angle. When doing this, the tibial plateau is convex, and the ligaments are squeezed onto the plateau, causing pain.

3.Etiology and pathology

The meniscus moves back and forth with the extension and flexion of the knee joint. Each movement must stimulate and corrode the ligaments of the coronary ligament. With the occurrence of knee osteoarthritis, the lateral space becomes narrower. The stimulus is gradually aggravated, so the damage to the coronary ligament is also aggravated, causing its swelling, congestion, mechanical adhesion, poor blood metabolism, and causing chronic refractory pain. Coronary ligament injury is closely related to knee osteoarthritis.

4.Treatment

Needle-knife treatment: The patient is in a supine position, the knee joint is flexed, and a pillow rest is placed under the knee. Palpation confirmed the cord-like swelling mass of the medial space, which was the diseased coronary ligament. Determine three fixed points inside, inside, and outside, mark the conventional disinfection, apply 5 to 10 ml of 1% lidocaine locally, infiltrate anesthesia locally, take sterile gloves, take a No. 3 disposable needle knife, and take three injections The point is the treatment point of the needle knife, the incision line is parallel to the coronary ligament, the needle passes through the coronary ligament to the edge of the meniscus, and the lateral strip is performed 1 or 2 times before the needle is lifted into the coronary ligament. 2 times, then lift to the surface of the coronary ligament, repeat the above method, and finally retract the needle to the skin. The needle is inclined 40 degrees to the proximal side (femur) and penetrated into the edge of the tibial plateau to make a longitudinal cut 1 or 2 times. The pinhole was applied for a while and the band-aid was applied. The operation was completed.

Manual treatment: After grasping the sacrum with both hands to do up-and-down and left-right movements 3 to 5 times, flexion and extension of the knee joint is repeated 3 to 5 times. If the medial collateral ligament is damaged, except for the treatment of the medial collateral ligament, Then cooperate with the lateral plate method to perform the lateral plate of the knee joint 3 to 5 times, and then fix it with elastic bandages. Return to the ward for a short while.

Note: When injecting local anesthesia, you should quickly pierce and pass through the coronary ligament to the edge of the meniscus, and then withdraw the needle to the skin while injecting. It is required to inject the liquid into the meniscus and the coronary ligament and subcutaneously. Avoid injection into the ligament. Prevent adverse consequences.

When using manual treatment, do not use simple and rude methods. We must gradually improve dysfunction in a gradual manner. The method is light, soft, comfortable and generous.