The circumstances of the three characters are so altered after the accident that Ethan's feelings for Zeena and Mattie almost don't matter.  These are the new facts of life -- Zeena is well enough to care for Mattie in her recuperation and they have lived this way for the last 20+ years.  Mattie is a changed woman after the accident, much more bitter and resentful of the pain and misery she is in.  She is no longer the light, lovely, youthful joy that Ethan fell for.  He is not only a prisoner to Zeena, he is a prisoner to Mattie as well.  For the same reasons of integrity that he couldn't leave with Mattie in the first place, he is stuck in this situation now.  Mrs. Hale's remarks in the last chapter surely leave us to have sympathy for Ethan, perhaps more than the two women.  The Frome home has been a place of misery and discontent for a very long time. Any love is gone, this is just existence now.

At the end of the book, Zeena and Mattie are old and very much alike in their disposition and behavior. Ethan and Mattie are both crippled from their accident twenty-four years earlier. As a result, Zeena has had to take care of them all of this time. It is ironic because Zeena was always the sickly one, and now she must care for her husband and the woman her husband wanted to leave her for. The three of them are caught in an impossible situation where all of them are miserable. They are all prisoners in a sense because they are condemned to live together in their misery for the rest of their lives.