Post-Accident Orthopedic Concerns: Managing Recovery and Risks

Post-operative issues following a car accident?

Thank you very much, Dr.
You, for patiently addressing my concerns.
I understand that many medical issues require cooperation between the patient and the physician to achieve the best treatment outcomes.
I later explained the situation to my elder family member, but considering their advanced age, they are reluctant to undergo surgery or other complex treatments, and I cannot force them to pursue further management.
As a child, I still feel anxious and fearful about this situation, and with no other options, I have to reach out to the doctor again.
1.
I would like to inquire about the potential consequences if no further treatment or surgery is performed in this situation.
What kind of sequelae might occur, and how severe could the condition worsen in the future?
2.
Currently, my family member is doing passive rehabilitation exercises and towel pulls from behind, along with some active movements and the use of a low-frequency electrical stimulation device.
Are these rehabilitation activities sufficient? Are there specific movements or angles that should be avoided or emphasized?
3.
Regarding daily activities, my mother reaches for items from high places and practices dance movements that involve swinging her arms to lift them.
Is this acceptable? Can she safely use and move her arms in daily life (for example, handling light objects or doing simple household chores)?
4.
Additionally, for daily care, I plan to encourage my family member to consume foods rich in calcium.
Are there any other recommendations or considerations regarding this situation?

Mr. J, 30~39 year old female. Ask Date: 2021/04/22

Dr. You Dianqi reply Orthopedics

I would like to offer a small piece of advice.
Considering the current severe situation of the COVID-19 pandemic, it is unlikely that surgery can be considered in the short term.
Additionally, it seems that the patient is not inclined towards surgery based on the article.
Therefore, pursuing conservative treatment may be a viable option.
It's important to maintain a positive outlook and avoid excessive panic, allowing the patient and your family to return to a more stable life.

In summary, your family member's shoulder condition has largely stabilized, and any further deterioration will likely occur gradually with age-related degeneration, with some minor changes (though the rate of deterioration varies from person to person).
It is quite normal for your family member to use the shoulder appropriately and reasonably without causing significant pain.
If you wish to help your mother supplement her calcium intake through food, you might consider options such as milk, legumes, nuts, vegetables, and small dried fish.

Reply Date: 2021/04/22

More Info

Post-accident orthopedic concerns can be quite complex, especially when dealing with recovery and potential long-term implications. It's commendable that you are seeking to understand the situation better for your family member. Let’s address your questions one by one.

1. Potential Long-term Consequences of Not Pursuing Further Treatment: If your family member chooses not to undergo further treatment or surgery, there could be several outcomes. The specific risks depend on the nature and severity of the initial injury. Common concerns include chronic pain, reduced mobility, and the potential for the injury to worsen over time. For instance, if there is a fracture that has not healed properly, it could lead to malunion or nonunion, which may require surgical intervention later. Additionally, compensatory mechanisms may develop, where other parts of the body compensate for the injured area, potentially leading to secondary injuries or conditions such as arthritis in the affected joint.

2. Effectiveness of Current Rehabilitation Exercises: Passive rehabilitation and gentle active movements, such as those you mentioned (like using a towel for stretching), are crucial in the early stages of recovery. However, the adequacy of these exercises largely depends on the specific injury and the recommendations from the treating physician or physical therapist. It’s essential to ensure that the exercises do not exacerbate the injury. If there are any signs of increased pain or swelling, it’s advisable to consult with a healthcare provider. They may suggest additional exercises or modifications to the current regimen to enhance recovery.

3. Daily Activities and Safety: Engaging in daily activities, such as reaching for items on high shelves or practicing dance movements, should be approached with caution. If these actions cause pain or discomfort, they should be avoided. It’s important to encourage your family member to listen to their body and not push through pain. Light activities, such as simple household chores, can generally be safe, but they should be done carefully and with proper body mechanics to avoid straining the injured area.

4. Nutritional Considerations: A diet rich in calcium and vitamin D is beneficial for bone health, especially during recovery from an orthopedic injury. Foods such as dairy products, leafy greens, and fortified foods can help support bone healing. Additionally, incorporating protein-rich foods can aid in muscle recovery and overall healing. Staying hydrated and maintaining a balanced diet is also crucial. If there are specific dietary restrictions or concerns, consulting with a nutritionist may provide tailored advice.

In conclusion, while it’s understandable that your family member may be hesitant to pursue more invasive treatments, it’s essential to remain vigilant about their recovery process. Regular follow-ups with healthcare providers, adherence to rehabilitation protocols, and a focus on nutrition can significantly influence recovery outcomes. Encourage open communication with their medical team to ensure that any concerns are addressed promptly. This collaborative approach can help manage recovery effectively and mitigate the risks of long-term complications.

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