Advanced Physical Rehabilitation in Hairline Coccyx Fracture: A Case Report

Abstract

Background: The fracturing of Coccyx is an injury normally caused by trauma. A fall on the buttocks can cause a coccyx fracture that may go radiographically unnoticed. There is substantial discomfort in the patient that can persist for months. Coccygectomy is suggested in cases that, after more than 2 months of conservative treatment, demonstrate coccydynia. There is little evidence available on the feasibility of this technique, though, and it is considered to have a high complication rate. As such, it requires other treatment techniques.Here, in order to effectively minimize coccydynia in a coccyx fracture patient, we report our experience using another conservative treatment option. The care consists largely of resting, physiotherapy and analgesics.
 Presenting Symptoms and Diagnosis: : A 21-year-old girl had increased pain i.e. coccydynia after a traffic accident( RTA) induced by coccyx fracture. She visited physiotherapy department with complaints of pain in coccyx area, tenderness, difficulty in mobility (pain while standing from sitting position) and difficulty in performing activities of daily living (ADL). Patient gives history of road traffic accident 2 months ago, a autorickshaw dashed the patient from behind. She went to orthopedic department where X-ray was performed and she diagnosed with hairline coccyx fracture. On inspection, patient was in pain, her NPRS score was 8. Her pain was aggravated by movements and relieved at rest. Patient came with slight stooping posture. On palpation we did found that the swelling and tenderness was present with tightness. Whereas on musculoskeletal assessment, we found that there was decreased range of motion, hypomobile joints, increased tone and muscle spasm.
 Therapeutic Intervention and Outcomes: Patient was on medical treatment and bed-rest, treated with the analgesic and use of ring cushion was advised. She was also advised to reduce the weight bearing on buttocks. Cross-strapping of buttocks was done. After the completion of bed-rest, her condition was improved but she was having pain and could not perform squatting activities and other activities of daily living. Physiotherapy treatment was planned for the same.
 Conclusion: Timely physiotherapy treatment is quite helpful to perform her everyday activities independently. This case study reveals the patient with hairline coccyx fracture experience full recovery after conservation management.