Coccyx fracture

Acoccyx fractureis afractureof thecoccyx,commonly called abroken tailboneor ‘puzzle fracture.’

Coccyx fracture
Lateral radiograph showing a fracture of the coccyx, as well as a lower lumbar fracture
Specialty	Orthopedic

The coccyx is located at the base of thespine,under thesacrum.It is the last section of the apevertebral column.Most commonly inhumansit comprises 3 to 5 fused (or, more rarely, separate)vertebrae,and is approximately 4 to 10 cm in length. The coccyx is attached to the sacrum by afibrocartilaginous joint,called thesacrococcygeal symphysis,allowing for some (but little)movement.

Anatomical diagram of a healthy coccyx

Causes

Causes of coccyx fracture can vary greatly, but are most commonly confined tofallsinto the seated position, orchildbirth.

Risk factors

The following risk factors have been identified for coccyx fracture:

• Lack of/reducedmuscle mass
• Advanced age
• Osteoporosis
• Being of thefemalesex (due to the widerpelvistypically found in females)
• Violence

Symptomsof coccyx fracture include:

• Painthat increases inseveritywhen sitting or getting up from achair,or when experiencingbowel movement
• Provoked painover thetailbone
• Nausea
• Bruisingorswellingin the tailbone area

Diagnosis

The standard workup of a suspected coccyx fracture includesmedical historyand aphysical examinationincluding arectal examination.

X-rayhas no quantifiable clinical impact,and is regarded as a waste of resources and unnecessaryexposure to ionizing radiation.

Treatment

If the coccyx fracture is severe enough, short-termhospitalisationmay be required, although this is extremely rare. More often, self-care at home is administered.

Sitting on soft surfaces is recommended, as this reducespressureon the coccyx. A 'donut' or 'wedge' cushion may be purchased – these are simplycushionswith a hole in them to ensure that no weight is placed in the injured tailbone.Painkillerssuch asibuprofenare also recommended, as is a diet high infibreto soften stools and avoid constipation.

Doctors will not usually attempt to correct a bad alignment, as muscles in the area are powerful and can pull the bone back into the 'bad' position. The bone is also very difficult to immobilise simply due to the sheer number of muscles attached to it, as well as the position.

Surgery

Following a coccyx fracture,surgeryis not usually required. However, if the pain continues even after the fracture has healed, and is severe enough to cause seriousdisability,surgical removal of the coccyx (coccygectomy) may be required.

See also

• Sacral fracture(rarer)