Refusing to sit due to tail pain
Introduction
Introduction Patients with fractures and dislocations of the tailbone often do not like to sit because of the pain in the tail, and even refuse to sit, and would like to rest in bed. Tail fractures and dislocations are more common than tibiofibular fractures, especially in women, which are common in life and sports accidents. After the fall, the hips are directly hit by the reaction force of the ground protrusions. Due to the contraction of the coccygeal muscle, the direction of the external force is mostly from the posterior lower part, which tends to shift the distal end of the fracture forward and upward, so that the tailbone on the X-ray film is mostly shown as a forward curved hook. However, the anatomical variation of the caudal vertebra is large, and the appendix angle formed by the ankle and the coccyx can be from an upright position to more than 90°, which is a big gap.
Cause
Cause
(1) Causes of the disease
When falling down to sit on the ground, the ground hard object directly hits.
(two) pathogenesis
After the fall, the hips are directly hit by the reaction force of the ground protrusions. Due to the contraction of the coccygeal muscle, the direction of the external force is mostly from the posterior lower part, which tends to shift the distal end of the fracture forward and upward, so that the tailbone on the X-ray film is mostly shown as a forward curved hook. However, the anatomical variation of the caudal vertebra is large, and the appendix angle formed by the ankle and the coccyx can be from an upright position to more than 90°, which is a big gap. Therefore, it is necessary to be cautious in the judgment, and it is necessary to combine clinical examination and detailed medical history.
Examine
an examination
Related inspection
Bone and joint soft tissue CT examination of spinal MRI
1. Pain in the tail:
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.
2. Local congestion:
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.
3. Anal diagnosis:
In addition to direct tenderness, severe indirect tenderness and tension pain can occur when the end of the tail is touched. This is helpful for diagnosis, especially early in the injury, and to determine whether it is a fresh fracture.
4. History of trauma:
Attention should be paid, especially to first-time patients, especially when it comes to disputes.
5. Clinical manifestations:
As mentioned earlier, local symptoms are predominant. Anal digital examination should be performed routinely, which can confirm the diagnosis and determine whether there is a rectal injury.
6. X-ray film:
Both the positive and the lateral positions are required to be filmed to determine the extent and extent of the injury. X-ray films have deformity, dislocation and no clinical symptoms, many congenital malformations or old injuries, generally do not need to be diagnosed.
Diagnosis
Differential diagnosis
Currently no relevant information
1. Pain in the tail:
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.
2. Local congestion:
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.
3. Anal diagnosis:
In addition to direct tenderness, severe indirect tenderness and tension pain can occur when the end of the tail is touched. This is helpful for diagnosis, especially early in the injury, and to determine whether it is a fresh fracture.
4. History of trauma:
Attention should be paid, especially to first-time patients, especially when it comes to disputes.
5. Clinical manifestations:
As mentioned earlier, local symptoms are predominant. Anal digital examination should be performed routinely, which can confirm the diagnosis and determine whether there is a rectal injury.
6. X-ray film:
Both the positive and the lateral positions are required to be filmed to determine the extent and extent of the injury. X-ray films have deformity, dislocation and no clinical symptoms, many congenital malformations or old injuries, generally do not need to be diagnosed.
