The anterior sacrococcygeal ligament connects the anterior surfaces of the sacrum and coccyx, reinforcing the sacrococcygeal joint anteriorly. It is a continuation of the anterior longitudinal ligament.
Resists excessive posterior coccyx flexion, maintains the sacrococcygeal joint, and provides the anterior fibrous support of the coccygeal region.
Anterior sacrococcygeal ligament injury from direct posterior trauma (falling onto the coccyx) produces coccydynia. In sacrococcygeal teratoma resection, the anterior ligament and associated structures must be carefully dissected from the presacral space to avoid rectal injury.
Disruption of the anterior sacrococcygeal ligament from fall trauma producing chronic coccyx pain, managed by manipulation, injection, or coccygectomy for refractory cases.
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