coccyx (fracture)

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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

Last reviewed 01/2018

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