Coccyx Fractures and Dislocations
Introduction
Introduction to the fracture and dislocation of the tailbone Tail fractures and dislocations are more common than tibiofibular fractures, especially in women, which are common in life and sports accidents. The degree of pain is generally more tolerable, accompanied by obvious direct or indirect tenderness, and severe cases can affect the passage of stool. Patients often do not like to sit because of the pain in the tail, and even refuse to sit, willing to rest in bed. In the early post-injury, it was not obvious. It was only seen in the direct effect of violence on the local; but it was clearly visible several days after the injury. basic knowledge The proportion of illness: 0.001% Susceptible people: more women Mode of infection: non-infectious Complications: shock
Cause
Causes of fracture and dislocation of the tailbone
(1) Causes of the disease
When falling down to sit on the ground, the ground hard object directly hits.
(two) pathogenesis
After multiple falls, the hips are directly impacted by the reaction force of the ground protrusions. Due to the contraction of the tail muscles, the direction of the external force is mostly from the lower back, which tends to shift the distal end of the fracture forward and upward, so that the tailbone on the X-ray film It is often shown as a hook that bends forward, but the anatomical variation of the caudal vertebra is large. The appendix angle formed by the caudal and posterior bones can be from an upright position to more than 90°. The difference is very large. Therefore, it is necessary to be careful in judging and must be combined. Clinical examination and detailed medical history.
Prevention
Prevention of fracture and dislocation of the tailbone
Most of the patients with caudal vertebral fractures are simple compression fractures of the thoracolumbar vertebral body. They can be placed on the wooden bed in the back, and the bolsters in the fractures can make the spine stretch. Extensor exercise can be performed after 1~2 days. It is generally forbidden to bend forward in two months.
The treatment of spinal fractures with dislocation or with attachments is complicated, especially those with cervical spine fracture and dislocation with joints. The risk is relatively high, and it is necessary to perform idle reduction or open reduction.
Complication
Complications of tail bone fracture and dislocation Complications
(1) Shock.
(2) important arterial injury: the proximal fracture of the supracondylar fracture of the humerus may damage the radial artery; the distal end of the supracondylar fracture of the femur may damage the radial artery; the upper fracture of the humerus may injure the anterior or posterior tibial artery .
(3) Peripheral nerve injury: The fracture of the upper limb may damage the phrenic nerve, median nerve and ulnar nerve. When the humeral neck fracture occurs, the common peroneal nerve injury is often caused at the same time.
Symptom
Tail fracture and dislocation symptoms Common symptoms Tail pain and rejection of the sacral pain Pain of the tailbone and abnormal activity of the abdominal wall or the back of the waist with tenderness and circulation congestion
1. Tail pain: The degree of pain is generally tolerable, accompanied by obvious direct or indirect tenderness. In severe cases, it can affect the passage of stool. Patients often do not like sitting posture due to tail pain, and even refuse to sit.
2. Local congestion: Most of the early post-injury is not obvious, only seen in the direct effect of violence on the local; but a few days after the injury is clearly visible.
3. Anal diagnosis: In addition to direct tenderness, when the end of the tail is touched, severe indirect tenderness and tension pain may occur, which is helpful for diagnosis, especially early in the injury, and to determine whether it is a fresh fracture.
Examine
Examination of tail bone fracture and dislocation
Positive, lateral position need to film, in order to determine the extent and extent of the injury, X-ray film has deformity, displacement and no clinical symptoms, many congenital malformations or old injuries, generally do not need to be diagnosed.
Diagnosis
Diagnosis of tail bone fracture and dislocation
1. History of trauma: You should pay attention to the inquiry, especially for the first time, especially when it comes to disputes.
2. Clinical manifestations: As mentioned above, local symptoms are the main symptoms, and anal digital examination should be performed routinely. This can not only confirm the diagnosis but also determine whether there is a rectal infection.
3. X-ray film: positive, lateral position need to film, to determine the extent and extent of the injury, X-ray film has deformity, displacement and no clinical symptoms, many congenital malformations or old injuries, generally do not need to be diagnosed .
