Repair of a long-standing coccygeal hernia and open wound.

Plastic and Reconstructive Surgery

1997 Jul, 100: 1, 96-9

Zook NL; Zook EG

Southern Illinois University School of Medicine, Institute for Plastic and Reconstructive Surgery, Springfield 62794-1511, USA.

Coccygectomy is a rarely used treatment for coccygodynia because of its high failure rate and various complications, such as bowel herniation, as seen in our patient. The limited number of literature articles available on coccygectomy discussed the few successes but failed to mention the complications and treatment of such. As a result of coccygectomy, our patient suffered from bowel herniation, unsuccessfully treated twice with prosthetic mesh. Bilateral gluteus maximus muscle flaps plicated in the midline reduced our patient's hernia successfully. This procedure appears to be an effective treatment for this postcoccygectomy complication.

Note from Jon Miles: Zook's claim that "Coccygectomy is a rarely used treatment for coccygodynia because of its high failure rate and various complications" is nonsense. There is a large literature on coccygectomy, showing that it is successful in 80% of cases. A review of 24 papers covering 671 operations found complications such as infection in some cases, but nothing as serious as bowel herniation. I guess that there was an incompetent surgeon in Zook's case. For details of the outcome of coccygectomy, see for instance Surgical treatment of coccygodynia: an analytic review of the literature.

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