Intrapartum Coccygeal Fracture, A Cause for Postpartum Coccydynia: A Case Report

Coccydynia can result from a varying number of causes, parturition being one of them. Although strains
and sprains of the ligaments attached to the coccyx have been thought to be the usual cause for
coccydynia occurring after childbirth, an intrapartum coccygeal fracture dislocation can result in the
same. A 28-year-old female presented to the orthopaedic department 4 weeks after the birth of her
first child with the complaint of coccygeal pain. Examination revealed marked local tenderness over
the coccyx but no crepitus was felt. Radiographs established the diagnosis of fracture and posterior
dislocation between the second and third coccygeal fragments. Conservative treatment in the form of
rest, doughnut ring, local heat, and avoidance of direct pressure over the area resulted in considerable
improvement over the next 4 weeks. Coccygeal fracture dislocation may result in introital dyspareunia
and tension myalgia of the pelvic floor. Pain from this lesion may become recurrently symptomatic.
The diagnosis must be established at the outset and appropriate treatment instituted to avoid these
complications. (Journal of Surgical Orthopaedic Advances 14(3):136–137, 2005)
Key words: coccydynia, coccyx, fracture dislocation, parturition complications