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Urgent- car accident over half a year!

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March 10th, 2011
Hi there, just registered, and am looking for as much information as to "what to do next" as possible pertaining to my current condition.

I was in a car accident a little over half a year ago and received the following injuries.

Concussion
Brachial Plexus (dorsal scapular) nerve damage and impingement ; Left Shoulder with winging shoulder blade
C2, C3, C4 lumbar discs bulging into my spinal cord

And the most important, Hip Dysplasia, now this is why I'm here primarily, I'm 22 years old used to weigh about 180LBS but ever since losing work, car, money from an auto accident my body has atrophied to roughly 150LBS, will be 23 on the 26th of March, and only about 2 months after the accident have I been experiencing NEW, god awful back pain, then turned into what I was told by an orthopedic doctor phrasing it as, "Left Rib/Back Flank" pain, which is producing femoral and sciatic pain like hell.

Which in turn if forcing my posture off balance, and has been tearing up my knee ever since, I can't move without the interior of my left hip joint feeling like it's sliding in and out of location, and then the left ass cheek into the core of my hip erupts into pain. I can't even sit here and type this without being in pain or feeling extremely uncomfortable. Now keep in mind, THIS IS ALL BRAND NEW regarding symptoms.

My youth history has been nothing but pain free physically active sports, played soccer for nearly a decade, no problems, even trained to be a SEAL in the navy when I was 19, worked in an extremely physically demanding environment for 4-6 years, no problems, get in a car accident and 2 months following can't even sit or stand right.

Now I know that most orthopedic doctors will call any kind of hip dysplasia something you already had, something innate ; something you're born with. According to my orthopedic doctor, on the x-ray when I initially found out, it appeared to be extremely faint, that my pelvis was just barely showing signs of not covering my left femur properly. So in a car accident, going anywhere from 40-30MPH to a dead stop in a compact car ( inertia intense enough to scar your left armpit from the seat belt ), what else can I assume or think ?

My main problem with all of this is, the way I was raised, in the family I grew up with, every time you got hurt, like the times I rolled my right ankle and possibly broke it a second time, I was told to just shut up and suck it up no matter how bad the pain. "Broke your leg ? Put some duck tape on it" type stuff. So with that type of mentality beaten into my brain, there aren't any other CT's or X-rays from the past (that I know of) to confirm as to wether or not this is new, or was caused by the accident.

Being able to find this out, and what kind of treatment I should be looking at, is what I'm asking for here, how do you find out if something caused this or not ? All pain and injuries are completely left sided, left knee, hip, back, ribs, neck, shoulder, head.

What scares me most is, I don't know enough about this to develop a better understanding of what this means for me in the future, I heard when I'm much older, this could mean a hip replacement, and that scares the life right out of me.

SOMEONE HELP !
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Gaelic
replied March 10th, 2011
Especially eHealthy
Kmail,
The term hip dysplasia, by itself, is usually a veterinarian term, used to described hip problems that dogs are born with, due to poor breeding techniques (puppy mills); especially in the large canine breeds. That said, it can be used to refer to humans (but is very uncommon). It still refers to a problem that the person was born with or developed at a very young age. This is usually called DDH (Developmental Dysplasia of the Hip). In older texts you can also find it called CDH (congenital Dysplasia of the Hip). It was changed because some people's hips are normal at birth, but they develop a problem in early childhood.
Now, it could be that you may have had a problem when you were real little. It wasn't very bad, but the acetabulum (hip socket) didn't form quite right. It wasn't bad enough to keep you from doing the activities that you wanted to do. The car accident probably brought it to the forefront. How can an orthopedic surgeon tell? Well, the acetabulum should look a certain way. And we know from long term studies how the various stages/forms of DDH progress and change throughout life.
You have a lot going on. The hip, even if you did have some developmental problems, was probably injured in the accident. You don't say if it was dislocated or not. But either way, hitting your knee on the dashboard can push the ball of the femur against the socket really hard, damaging the cartilage or subchondral bone. Are your x-rays of the hip changing? Showing signs of AVN (avascular necrosis)?
You also have neurological problems, with your winging scapula in the upper extremity and what sounds like sciatica in the lower. Sciatica can be caused by a posterior hip dislocation. And if you have a shallow hip socket the hip could have gone out, then reduced spontaneously. The bulging discs could be a problem, though 40% of people off the street will show disc bulges on MRI. You may need to have some nerve testing done in the lower extremities (which you probably have had done in the upper extremities already).
Unfortunately, predicting the future is impossible. About the only way to advise a patient is for a physican to get to know him/her, do a good exam, review all of the previous studies, and then sit down with the patient. It's only then that someone could possibly advise the patient of the typical course for someone in his/her position.
It's not a definite that you will need a total hip replacement. However, as orthopedic surgeries go, total joints have been very successful, when done in the right patient for the right reasons. But, that's down the road, as you are usually considered too young for a THR. There are still other things that can be done at your age.
You need to discuss all of this and all of your concerns with your surgeon(s). Make sure you understand what the surgeon is telling you. Don't be afraid to ask questions till you are satisfied. Don't worry about upsetting the doctor, he/she works for you.
Sounds like you still have a long road ahead. But, if you can do SEAL training, you can do this.
Good luck
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Kmail
replied March 11th, 2011
I just need to know how to go about future treatment regarding my hip and lumbar spine, how can I tell or what should I look for regarding diagnostic testing to determine not only how to better go through whatever treatment is chosen to be in my best interest, or how to figure out if this is something new.

Because I really do not buy this being something that I was born with, the contrast between before and after pertinent to pain and limitations, is staggering.

Now I know there are older people who slip and fall on sidewalks and have this problem, with the actual blunt force of the incident causing it, how would I be able to spot this if evident, with diagnostic testing with my orthopedic doctor ?
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Gaelic
replied March 11th, 2011
Especially eHealthy
Your question is a little convoluted, so I'm not exactly sure what you are asking. However, in terms of the hip. It can be determined through measurements if a person has DDH. This is not a condition that either you have or you don't: it's a spectrum, from very mild or totally disabling. These measurement are taken from plain x-rays and/or CT scans. You probably have a very mild DDH, which did not cause you any problems. And, it is not the root of your current problem. It should be noted in your medical records, but you were injured in an accident and that is what the attention should be centered on. In reality, your DDH is a red herring.
Probably the two best studies to determine if there is something wrong with the hip itself, are good plain x-rays (AP and frogleg) and an MRI. The x-rays look best at the bony architecture and the MRI can look at the surrounding soft tissues and the bone marrow within the head of the femur.
In terms of the spine, usually an MRI is the study of choice for an overall look. It can give a static look at the anatomy of the spinal cord, the disc complexes, the vertebral bodies, the posterior facet joints, and the epidural space. It can also look at the structures surrounding the spine - the muscles, ligaments, nerve plexuses, etc. If it is the status of the nerves themselves you're interested in, then electrical studies are the best. Electromyography (EMG) and nerve conduction velocities (NCV) will tell how the nerves are sending their signals and if the muscles are responding to the signals correctly.
Again, this is something you need to discuss with your surgeons. If your current surgeons are brushing you off, saying there is nothing that can be done, or you were born with a problem - change doctors. Get a second or third opinion. It's your future. No one on the internet can really tell you what exactly is going on, or what you should do. Only general information, based on the information you have provided, is possible.
Talk with your physicians (or new ones). They are in the best position to answer your questions. Good luck.
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