Journal of Orthopaedic Trauma
2004 Jul; 18 (6): 388-9.
Kim WY, Han CW, Kim YH.
Department of Orthopaedic Surgery, Daejon St. Mary's Hospital, The Catholic University of Korea, Daejeon, South Korea.
A sacrococcygeal dislocation is a rare occurrence, and the treatment options vary. Initial treatment is nonoperative, consisting of a manual reduction with a gloved finger and local rest. Acute operative treatment of a failed closed reduction is unusual. We report a case of an acute irreducible anteriorly dislocated coccyx successfully treated with a minimally invasive technique: joystick reduction and Steinman pin fixation.
Summary by Jon Miles:
A woman fell on stairs and was unable to walk because of the pain. She was taken to hospital, and an x-ray showed that her coccyx had been dislocated forwards. Under epidural anesthetic, a curved instrument was inserted through the skin and used to pull the coccyx into its normal alignment. A metal pin was then inserted through the skin, next to the coccyx and sacrum, to hold the coccyx in position. The end of the pin was cut on the outside of the skin and bent over.
The patient was advised not to sit for 6 weeks. The pin was removed after 4 weeks. X-rays taken after 6 months showed normal alignment, and the patient had no pain in the area.