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(a) Initial lateral standing coccyx x-ray demonstrating no displacement. White arrow: disruption of coccyx with inline fracture appearing as normal anatomy. (b) MRI coccyx showing marrow edema (white arrow).
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Lateral sitting and standing x-rays in the past and during this evaluation were reported to have no fractures (Fig. 1a). Due to the clinical picture, a MRI coccyx was obtained, which revealed increased marrow edema consistent with stress reaction from healing fracture or contusion (Fig. 1b).
(a) Initial posterior dissection of the coccyx with free space left by removal of free fragment from previous fracture (white arrow). (b) Close up of removed free fragment.
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During the surgery, careful dissection revealed a freely mobile and unattached distal segment (Fig. 2).