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'''Original Editors '''  
'''Original Editors '''  


'''Lead Editors''' - Your name will be added here if you are a lead editor on this page.  [[Physiopedia:Editors|Read more.]]
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== Search Strategy  ==
1. SEARCH STRATEGY ARTICLES
<br>Keywords: <br>• Coccyx fracture ( 55 results and 3 free full texts): Most successful search<br>• Coccygectomy (85 results and 16 free full texts)<br>• Coccygeoplasty (1 free full text). <br>• Coccyx fracture AND physiotherapy (1 result)
<br>Search engines : Pubmed / Web of knowledge<br>It is also very useful to check the references of each usable article.
<br>2. SEARCH STRATEGY BOOKS
<br>Keywords:<br>• Traumatology<br>• Fractures<br>• Orthopaedics
<br>Search engines: VUBIS catalogus / UA catalogus<br><br>
== Definition/Description  ==
== Definition/Description  ==


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== Clinically Relevant Anatomy  ==
== Clinically Relevant Anatomy  ==


The coccyx, also known as the tailbone, is a small triangular bone that is usually formed by fusion of the four rudimentary coccygeal vertebrae, although in some people there may be one less or one more. The coccygeal vertebra 1 (Co1) may remain separate from the fused group, but with increasing age Co1 often fuses with the sacrum and the remaining coccygeal vertebrae usually fuse to form a single bone. (level of evidence D) <br>The forward movement of coccyx is performed actively by the M. levator ani, and the backward movement of coccyx is passively caused by relaxation of these muscles. The coccyx also provides the site of attachment for the M. gluteus maximus as well as the M. levator ani, which is responsible for voluntary control of bladder and bowel. (level of evidence B) The coccyx does not participate with the other vertebrae in support of body weight when standing, however when sitting it may flex anteriorly, indicating that it’s receiving some weight. ( level of evidence D)i
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The coccyx is part of the sacrococcygeal joint, an cartilaginous joint with an IV disc. Fibrocartilage and ligaments join the apex of the sacrum to the base of the coccyx. The anterior and posterior sacrococcygeal ligaments are long strands that reinforce the joint. (level of evidence D) <br>The coccyx is also attached with the margin of the anus by the anococcygeal ligament. (level of evidence D)iii<br><br>


== Epidemiology /Etiology  ==
== Epidemiology /Etiology  ==


Fracture of the coccyx often arise after a fall on the buttock, most prevalent a fall of the stairs on the tailbone, or by an impact directly applied. (level of evidence D) An especially difficult childbirth occasionally injures the mother’s coccyx. ( level of evidence D) <br><br>
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== Characteristics/Clinical Presentation  ==
== Characteristics/Clinical Presentation  ==


1. GENERAL SYMPTOMS<br>General symptoms that appear are (level of evidence D)iv,vii,viii :<br>• Pain that increases in severity when sitting or getting up from a chair<br>• Provoked pain over the tailbone<br>• Bruising or swelling in the tailbone area<br>• Bowel movements and straining are often painful<br>• There are no neurological signs
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<br>2. CLINICAL PRESENTATION IN PATIENTS WITH SPINAL CORD INJURY<br>Patients with SCI, suffering from painful symptoms in the low back, gluteal, hip and thigh region, have coccyx fracture with a frequency of 34,6%. Patients who had coccyx fracture have higher pain scores when compared with those who don’t have any fracture, however the difference is only statistical significant regarding Sensory Pain Index (SPI) and total McGill scores.( level of evidence C)
 
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== Differential Diagnosis  ==
== Differential Diagnosis  ==
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== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==


see tutorial on [[Adding PubMed Feed|Adding PubMed Feed]]
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== References  ==
== References  ==


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[[Category:Vrije_Universiteit_Brussel_Project|Template:VUB]]
[[Category:Vrije_Universiteit_Brussel_Project]]

Latest revision as of 00:30, 26 January 2020

Welcome to Vrije Universiteit Brussel's Evidence-based Practice project. This space was created by and for the students in the Rehabilitation Sciences and Physiotherapy program of the Vrije Universiteit Brussel, Brussels, Belgium. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!

Original Editors

Top Contributors - Sanne Delporte, Admin and Kim Jackson  

Definition/Description[edit source]

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Clinically Relevant Anatomy[edit source]

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Epidemiology /Etiology[edit source]

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Characteristics/Clinical Presentation[edit source]

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Differential Diagnosis[edit source]

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Diagnostic Procedures[edit source]

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Outcome Measures[edit source]

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Examination[edit source]

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Medical Management
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Physical Therapy Management
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Key Research[edit source]

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Resources
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Clinical Bottom Line[edit source]

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References[edit source]

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