Patient defies the laws of recovery after head-on auto accident

Domenico Vecchie has fully recovered from the multiple injuries he received during a head-on car collision last July

All mid-July mornings last year started the same way for Domenico Vecchie. Shortly after waking in the Surgical Intensive Care Unit at North Shore University Hospital (NSUH), the 23-year-old from Franklin Square would welcome a kind and friendly face into his room. This was the only constant in his life, and he waited with anticipation for the daily visit from his surgeon, Ariel Goldman, MD, an attending orthopedic surgeon at NSUH and LIJ Medical Center, and a specialist in the care of severe fractures and trauma.

About a week after surviving a head-on car collision on Old Country Road, Mr. Vecchie finally wanted to understand what he had endured in the wee hours of July 10, 2011. Staring at the computer screen in his room with Dr. Goldman by his side, Mr. Vecchie viewed the X-rays of his shattered left hip socket, broken left tibia and broken left elbow before his operations, and it was a heart-stopping sight to see so much of his body in pieces.

“That morning, I wanted to know what really happened,” said Mr. Vecchie, a banquet manager at a catering hall in Carle Place. “I still didn’t understand what I had broken, since so much of my body was in a cast. Dr. Goldman came by every morning to see how I was healing, and I appreciated that he kept me informed of what was going on and what he had done.”

What Dr. Goldman and the multidisciplinary team who cared for Mr. Vecchie did was nothing short of extraordinary. It is a prime example of how a collaborative and coordinated approach to urgent patient care can yield not only lifesaving results but also the best chance of returning to life as it was for patients with life-threatening trauma injuries.

Teamwork at Its Best

Dr. Goldman led a 12-hour marathon surgery in which he inserted a titanium metal rod through the middle of Mr. Vecchie’s tibia to stabilize bone that was broken in several pieces; repaired his elbow with three screws and a metal plate; and fixated his shattered hip socket, an extremely complicated and time-consuming procedure that very few orthopedic surgeons have the training to perform.

Unlike the knee or elbow, which can be felt externally, the hip joint lies deep behind muscle and is surrounded by vital arteries and nerves. To reach down and expose the entire hip joint, Dr. Goldman had to maneuver carefully through muscle and safely move major blood vessels, arteries and the sciatic nerve. “Managing this delicate anatomy carefully was imperative because we were dealing with a hip fracture that had very sharp spikes of bone that could potentially puncture them,” said Dr. Goldman.

As if the long and complicated orthopedic surgery was not difficult enough, Dr. Goldman and his team members had to factor in the vascular surgery Mr. Vecchie had undergone days before to repair his aorta, which had been torn down to a hairline.

“Mr. Vecchie just had vascular surgery on a major heart vessel, causing significant blood loss. As a result, we looked for the earliest possible window, when he was stable enough to undergo an even longer surgery to repair his injuries,” said Dr. Goldman. “Mr. Vecchie’s trauma surgery required a comprehensive group effort from the surgery and anesthesiology teams to ensure that the appropriate amount of fluids and blood transfusions were administered during the procedures. It was a risky surgery, but we all worked together to make sure he came through it OK and experienced the best long-term outcome.”

The Come-Back Kid

Mr. Vecchie’s recovery was miraculous to say the least. A little more than two weeks after the accident, the next phase in his continuum of care began at Glen Cove Hospital’s Acute Inpatient Rehabilitation Unit, where he benefited from its extensive treatment services.

“Dr. Goldman gave me so much encouragement, assuring me that I was recovering faster than he expected,” said Mr. Vecchie. “I also remember the two men who moved me from North Shore University Hospital to Glen Cove Hospital. They read over my chart and wanted to make sure it was correct because they couldn’t understand why I was leaving so soon. After 14 days and multiple injuries, they couldn’t believe that I was ready to start rehab. They thought I shouldn’t be going in for another month. But I am young, I didn’t give up and I kept a good attitude. I just wanted to get home, get back to work and start enjoying life again.”

His rehabilitation therapists at Glen Cove Hospital were equally baffled. They would have happily kept him as an inpatient longer, but there was nothing more Mr. Vecchie needed to accomplish; he could easily work on the rest at home with a physical therapist. After completing his inpatient rehab in only 16 days, Mr. Vecchie returned home in mid-August. He continued to practice his physical therapy at home and through Sports Therapy and Rehabilitation Services (STARS) in Manhasset. By Thanksgiving, Mr. Vecchie happily returned to work.

“I don’t know why, but meeting Dr. Goldman was the first thing I recalled after my accident,” said Mr. Vecchie. “His constant presence and guidance during the days leading to my surgery are so clear in my memory.” Mr. Vecchie attributes his survival and quick recovery to his positive attitude, the support he received from his family and friends, and the skill, knowledge, attentiveness and encouragement of Dr. Goldman, who has left a lasting impression on him.

We’ll help you get moving again.

The North Shore-LIJ Orthopaedic Institute specializes in multidisciplinary care for the entire spectrum of musculoskeletal disorders to help patients regain mobility and return to active, independent lives. For a referral to one of our orthopedic specialists, please call 516-465-8663.

The Rehabilitation Network provides inpatient and outpatient treatment for orthopedics, neurology, pulmonary medicine, cardiology and generalized debilitation due to chronic illness. STARS’ convenient locations are in Manhasset, Roslyn Heights, East Meadow and Forest Hills. Call 888 REHAB-03 (734-2203) to learn more.

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