Coccyx (fracture)

Fracture of the coccyx may occur as:

• a result of a blow from behind or a fall
• following childbirth

Risk factors for coccyx fracture include:

• reduced muscle mass
• elderly
• osteoporosis
• female
• participating in certain activities, such as skating
• violence

Clinical features include:

• coccygeal pain that increases in severity when sitting or getting up from a chair, or when experiencing bowel movement
• coccygeal tenderness
• bruising/swelling over the coccyx

Diagnosis:

• history and examination including a rectal examination
  • in the presence of a coccygeal fracture it may be possible to palpate abnormal movement of the coccyx
• X-rays may or may not be required

Management

• patient should be advised to use a U shaped cushion when sitting
  • after this injury there may be persistant pain on sitting
  • if this is not relieved by cushions, an injection of local anaesthetic may be neccessary
• surgical treatment for a fracture of the coccyx is rare:
  • if there is persistent coccygeal pain then a coccygectomy might be recommended
  • surgical correction of displaced fracture
    • difficult because of powerful muscles attached to the coccyx which tend to encourage the displacement