What’s Worse, an Injury with Surgery or without Surgery?
It depends. Undergoing surgery does not make an injury more serious or worth more at a trial of an accident case.
Some injuries require immediate surgery while some injuries can be treated without surgery but the lack of surgery is not an indicator of long-term consequences.
Injuries Requiring Surgery Will Likely Get Worse
An example of an injury requiring immediate surgery is a displaced broken femur (thigh bone). A displaced fracture is where the bone is broken without maintaining proper alignment so that the pieces can move and should be fixated.
We represented a client whose femur was fractured (broken in two pieces). He had immediate surgery with excellent results and he was able to go back to work in six months as a motorcycle police officer.
At the Suffolk County Supreme Court trial, the insurance company offered only $100,000 to settle, which we declined. The insurance company argued at trial that the surgery was successful and he was “repaired” so that he could return to work without restrictions. The insurance company paid the jury verdict of $425,000.
While our client is able to work without restrictions in a physically demanding occupation, he will experience serious symptoms in the future. The impact on his femur transmitted the energy to both ends of the femur, the knee and hip causing stress to those areas. The stressed areas will develop traumatic arthritis and pain years in the future.
At a Nassau County Supreme Court trial where GEICO offered $20,000 to settle where our client had a knee injury consisting of a torn meniscus with arthroscopic surgery, the jury understood that the injury will develop arthritis later in life. The jury gave a verdict of $465,000.
But what about similar injuries without surgery such as a non-displaced fracture; torn rotator cuff; or meniscus tear? These injuries may be treated with or without surgery.
Injuries without Surgery Will Also Likely Get Worse
Injuries such as a non-displaced fracture; rotator cuff tear; or a torn meniscus which are treated with therapy instead of surgery, have similar outcomes to the examples above with surgery.
An example, close to home for me, is my stepmother who was injured in a car accident 30 years ago. She was hit on the driver’s side by a truck which ran a red light. She injured her left shoulder and knee but did not get surgery.
Over the years, she began experiencing pain and today is extremely disabled. She now needs a quad cane to walk and is unable to use her left arm to lift anything. I purchased a lift chair because she is unable to get out of a chair.
Would the current symptoms of her injuries been lessened if she had surgery after the accident? Maybe, maybe not.
If she would have been better off today if she had surgery, then this is an example of a case that is more serious and worth more money without surgery than it would have been with surgery.
Depending upon age and how active the patient was prior to the accident, surgery may be recommended to some patients but not to others.
The article, DO ALL ACL TEARS NEED SURGERY? by Ty E. Richardson, M.D., shows how an ACL tear (anterior cruciate ligament) of the knee may be recommended for a professional athlete but not to a “30 year-old office worker who runs a couple of days a week and plays a little golf on the weekends and tore his ACL at a church softball game.”
The article shows how ACL patients who can be treated without surgery can do very well with physical therapy and return to activity with excellent neuromuscular control, quadriceps strength and ankle stability. They are even able to remain active in sports.
However, Dr. Richardson reports that the long-term effects of an ACL tear without surgery shows “there is a pattern of ongoing damage to other supporting structures in the knee as well as the long-term development of arthritis”
A delay in getting surgery shows patients develop tears in one or both of the meniscus with an increased risk of developing arthritis over time.
Dr. Richardson reports that the rate at which arthritis develops appears to be slowed down by surgical reconstruction but not eliminated.
10 years after surgery, arthritis will develop in approximately 50% of patients without surgery and 20% of patients with surgery. Dr. Richardson states, 20 years after the surgery, “the numbers are about the same, regardless of treatment.”
Thus, it appears that surgery can result in improved condition in the early years after an accident but 20 years after the accident, the patient’s condition is the same regardless of getting surgery or not.
Insurance companies and even you may think that a non-displaced fracture will heal in a few weeks and isn’t a serious injury. But is that really true?
A non-displaced fracture, which is a broken bone that is still properly aligned, may be allowed to heal without surgery but the trauma which caused the fracture may cause arthritis and tendon or ligament tears.
The energy transmitted to the bone at the point of impact is dissipated throughout both ends of the bone to joints, ligaments and tendons causing damage which appears later.
According to Fractures of the greater tuberosity of the humerus: a study of associated rotator cuff injury and atrophy (NIH), a non-displaced fracture of the greater tuberosity can result in residual displacement, full rotator cuff tear and muscle atrophy.