SPINE FRACTURE, TAILBONE (COCCYX) |
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General Information
DEFINITION--A complete or incomplete break in the coccyx (tailbone).
BODY PARTS INVOLVED
Coccyx (lower tip of the spine).
Joints connecting the coccyx to the sacrum.
Soft tissue around the fracture site, including muscles, nerves, tendons, ligaments, periosteum (covering to bone), blood vessels and connective tissue.
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SIGNS & SYMPTOMS
Pain at the fracture site.
Swelling and bruising of soft tissue around the fracture.
Tenderness to the touch.
CAUSES
Falling into a sitting position on the tailbone.
Direct blow or kick to the tailbone.
RISK INCREASES WITH
Skating.
Contact sports.
History of bone or joint disease, especially osteoporosis.
Obesity.
Poor nutrition, especially calcium deficiency.
If surgery or anesthesia are needed, surgical risk increases with smoking and use of drugs, including mind-altering drugs, muscle relaxants, antihypertensives, tranquilizers, sleep inducers, insulin, sedatives, beta-adrenergic blockers or corticosteroids.
HOW TO PREVENT
Use appropriate protective equipment, such as sacral or "tailbone" pads, during participation in contact sports.
Ensure an adequate calcium intake (1000mg to 1500mg a day) with milk and milk products or calcium supplements.
WHAT TO EXPECT
APPROPRIATE HEALTH CARE
Doctor's treatment to manipulate the broken coccyx.
Hospitalization (sometimes) for anesthesia and surgery to remove the fractured coccyx.
Physical therapy and rehabilitation exercises.
Self-care during rehabilitation.
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Medical history and exam by a doctor.
X-rays of injured areas, including all of the lower back, pelvis and hips.
POSSIBLE COMPLICATIONS
AT THE TIME OF FRACTURE:
Shock.
Pressure on or injury to nearby nerves, ligaments, tendons, blood vessels or connective tissues. AFTER TREATMENT OR SURGERY:
Excessive bleeding.
Impaired blood supply to the healing bone.
Infection introduced during surgical treatment.
Unstable or arthritic tailbone joint following repeated injury.
Continuing pain long after injury.
Avascular necrosis (death of bone cells) due to interruption of the blood supply.
PROBABLE OUTCOMEThe average healing time for this fracture is 6 to 8 weeks. Healing is considered complete when there is no motion at the fracture site and when X-rays show complete bone union.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
FIRST AID
Cut away clothing, if possible, but don't move the injured area to do so.
Apply ice packs to the injured site to decrease swelling and pain.
Elevate the injured part above the level of the heart to reduce swelling and prevent accumulation of excess fluid. Use pillows to prop the lower part of the body or elevate the foot of the bed.
Keep the injured person warm. Cover with blankets to decrease the possibility of shock.
The doctor will manipulate the broken coccyx into normal position in a "closed" procedure (without surgery) or will remove the coccyx surgically. Manipulation should be done as soon as possible after injury. Six or more hours after the fracture, bleeding around the injury and displacement of body fluids may lead to shock. Also, many tissues lose their elasticity and become difficult to return to a normal position.
CONTINUING CARETreatment after manipulation or surgical removal:
Use frequent ice massage. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the tailbone area in a circle about the size of a softball. Do this for 15 minutes at a time, 3 or 4 times a day.
Apply heat instead of ice, if it feels better. Use heat lamps, hot soaks, hot howers, heating pads, or heat liniments or ointments.
Take whirlpool treatments, if available.
Massage gently and often to provide comfort and decrease swelling.
MEDICATIONYour doctor may prescribe:
General, spinal or local anesthesia during surgery to remove the fractured coccyx.
Narcotic or synthetic narcotic pain relievers for severe pain, and acetaminophen for mild pain.
Stool softeners to prevent constipation due to inactivity.
Antibiotics to fight infection if skin is broken or surgery is needed.
ACTIVITYBegin reconditioning and rehabilitation after clearance from your doctor. Resume normal daily activities gradually after treatment.
DIET
Drink only water before manipulation or surgery to treat the fracture. Solid food in your stomach makes vomiting while under anesthesia more hazardous.
During recovery, eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity.
REHABILITATIONBegin daily rehabilitation exercises when movement is comfortable. Use ice massage for 10 minutes prior to exercise. See section on rehabilitation exercises.
CALL YOUR DOCTOR IF
You have signs or symptoms of a fractured tailbone after a hard fall or injury.
Any of the following occur after surgery:
Increased pain, swelling or drainage in the surgical area.
Signs of infection (headache, muscle aches, dizziness, or a general ill feeling and fever).
Numbness or complete loss of feeling below the fracture site.
Nausea or vomiting
Constipation.
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