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It may be difficult to obtain informed consent, even with an interpreter.
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The husband may be unwilling to allow his wife to have the appropriate surgery.
Associated comorbidities in the patient increase the risk of surgical intervention.
There is the potential of not being able to obtain a satisfactory CT scan because of claustrophobia.
Postsurgical care may be jeopardized by the patient’s role as caretaker for her children, thus compromising her ability to comply with weight-bearing restrictions.
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With documented use of a competent interpreter, informed consent should not be an issue. In Hispanic families, the husband often makes the ultimate decision regarding proceeding with surgery; however, he would not be expected to withhold recommended treatment. Hispanics may have a higher risk of comorbidities, but you do not expect this to be a significant concern with this patient. Claustrophobia and some fear of the unfamiliar may make additional imaging studies more difficult to arrange, but not impossible. The real concern is that with no extended family and three small children, the postoperative demand on the patient could significantly jeopardize her ability to comply with weight-bearing restrictions and overall ambulatory demands. Discharge planning and appropriate help may be paramount for a good outcome.
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