Sometimes there are situations that are associated with a traumatic effect, involving such medical manipulation as reduction of the coccyx.
Injuries that led to his displacement in relation to the previous position are divided by specialists into subluxations and dislocations, with or without ruptures of the sacrococcygeal ligaments, as well as fractures and fractures.
About dislocation
Dislocation of the coccyx is accompanied by displacement of the surfaces of the sacrococcygeal joint in relation to each other. Incomplete dislocation (subluxation) is characterized by a partial violation of congruence. Dislocations and subluxations can be directed anteriorly (for example, after a person falls on the gluteal region) and backwards (for example, after delivery). These injuries can cause stretching and even rupture of the sacrococcygeal ligaments, which strengthen the joint that connects the sacrum and coccyx.
Dislocation Therapy
Therapy for subluxations and dislocations involves the followingEvents:
- Anesthesia.
- Manipulation aimed at reducing the dislocation.
- Compliance with bed or gentle rest for a week.
- Use of non-steroidal anti-inflammatory drugs and other analgesic drugs.
- Physiotherapy.
- Therapeutic exercise.
Fractures
Fracture-dislocations and fractures of the coccyx are much less common in medical practice than subluxations and dislocations. They are typical for elderly patients. The main difference between a tailbone fracture and its dislocation is that the fracture is accompanied by a displacement of fragments (usually anteriorly, in some cases laterally and anteriorly, that is, anteriorly to the side).
Fracture treatment
Therapy for a fresh coccyx fracture involves:
- Adequate anesthesia.
- Manipulations aimed at returning fragments to their original location.
- Compliance with bed rest for 2-3 weeks. The state of he alth is fully restored by the end of the first or second month after injury.
- Use of nonsteroidal anti-inflammatory drugs and other analgesics.
- Physiotherapeutic effect.
- Performing physical therapy exercises.
Find out if it hurts to set the tailbone.
Painfulness of the procedure
Immediately before the reduction procedure, the patient must receive adequate anesthesia. This is related to the fact thatthe anterior sacral surface and the surface of the coccyx are anatomically located close to the coccygeal plexus of nerves. A fresh injury to this area gives the patient severe pain, while the victim often rushes about, unable to take any gentle position. Anesthesia is performed by novocaine blockade or blockade using novocaine and lidocaine (or alcohol) to create a prolonged effect.
To perform anesthesia, the patient is placed on the right side, while the legs are brought to the stomach. In addition, a position is possible when the patient lies on his back, and his legs are fixed in special holders upwards at a right angle. First, the patient is anesthetized the skin and subcutaneous tissue, and then, controlling the process with a finger inserted into the rectum, a needle is inserted into the area between the anus and the coccyx (first through the dense muscles, then through the pararectal tissue). The needle is inserted to a depth of approximately 8 cm. For anesthesia, about 100-120 ml of anesthetic is used.
How is coccyx reduction through the rectum?
Reduction technique for dislocations
After the injured area is anesthetized, the patient is placed in the position on the stomach, and then the index finger of the right hand is inserted into the rectum and the fingers of the left hand create gentle pressure in the coccygeal region, trying to give the coccyx the correct position. After the coccyx reduction procedure, the result is checked using an X-ray examination.
With a fresh fracture, reposition of fragmentsperform in a similar way, the manipulation technique is similar to that for dislocation.
In case of old injury
Old (more than 6 months after the traumatic impact) injuries of the sacrococcygeal region are mainly subject to conservative therapy. If the patient has a severe pain syndrome, the use of analgesics and anti-inflammatory drugs, muscle relaxants with a central type of action (Sirdalud, Tolperison) is recommended. In some cases, novocaine blockades and blockades based on hydrocortisone or other GCS are carried out.
The procedure for chronic subluxation or dislocation is not performed, since the ligaments that strengthen the articulation of the coccyx and sacrum are stretched and cannot hold the surfaces of the joints in a normal position. And the possibility of their fixation for a certain period is absent due to anatomical features. In addition, an attempt to reduce the coccyx with an old dislocation can lead to additional damage to the ligamentous apparatus and the occurrence of a pronounced pain syndrome.
Stale coccyx fractures are also managed conservatively. The reasons for this are as follows:
- The callus has already formed, in connection with this, the fusion of fragments is already a fait accompli.
- In cases where fusion has not yet occurred, a false joint is formed, which facilitates the possibility of resection (coccygectomy). This is, simply put, straightening and matching fragments.
If conservative therapychronic injuries of the sacrococcygeal region does not give the desired effect, and the patient experiences severe pain that interferes with normal life, experts recommend resection of the coccyx.
Self reduction
If there is no medical education and relevant practice, then you should not try to reduce the coccyx on your own. There are many reasons for this:
- Acute injury to the coccyx causes the victim quite severe pain that prevents self-reduction in the absence of anesthesia.
- It is impossible to correct a dislocation or put fragments in place without using both hands. That is, the patient practically does not have the opportunity to independently carry out this manipulation.
- An attempt to return the tailbone on its own, if it has been dislocated, can lead to additional damage to the sacrococcygeal ligaments, the regeneration and healing of which will be very slow. The result of this may be the development of coccygodynia.
- An independent attempt to match fragments with sharp edges in case of a coccyx fracture (returning them into place) is fraught with the likelihood of damage to the walls of the rectum. This can cause infection of pararectal tissue, the development of paraproctitis, the formation of fistulous tracts.
- The severity of the pain syndrome does not allow to determine the type of injury: there are no specific complaints with such injuries. Fracture, dislocation and a simple bruise of the coccyx during a fall have the samesigns.
In addition, x-ray control is required after the procedure, which is absent after self-reduction.
Reviews on reduction of the coccyx with subluxation
Patients respond quite positively about this procedure: with adequate anesthesia, pain is practically not felt, the procedure itself takes a little time. The only thing that does not suit patients is a long rehabilitation period, but without it it is impossible to fully restore the state of he alth and, as a result, a full life.
Reviewed how the coccyx is set.
