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