American Journal of Obstetrics and Gynaecology
1924, 7: 199-205
Hirst JC, Wachs C
Gynecological Service, Mount Sinai Hospital, Philadelphia
Injury to the coccyx is a not uncommon result of childbirth and its consequences are a source of much annoyance to the patient. The solution of continuity is either an actual fracture of the bone or much more commonly a rupture of the joint between the first and second segments. It can also be produced by falls, kicks or other injuries, and in these cases of single injury it does not cause disability of long duration. Aside from excessive soreness for a few weeks, and a marked disinclination on the patient's part to sit down, few if any symptoms remain after the injury has had a chance to heal. These do not ordinarily give the patient trouble of long duration and require no treatment.
The mechanism of the injury, of which the effects are permanent, is as follows: (1) The patient at some time has had a fall or kick upon the buttock, impinging upon the relatively exposed coccyx. (2) This bends the coccyx sharply into the pelvic canal and ruptures the posterior longitudinal ligament of the coccyx. (3) This injury heals in the course of a few weeks, leaving, however, the coccyx permanently bent into the pelvic canal (4) The patient becomes pregnant, and at delivery the child's head descends into the pelvic canal and is temporarily arrested by the deformed bone. (5) Either . . .