I'm reasonably happy with rickety, but wonder if I'm not getting the full picture over the chile combo - perhaps this is a typical dish from German cuisine? Any suggestions anyone? Or perhaps it's just another example of a healthy dish.

Hmm, definitely low confidence rating here, but at least we can get the ball rolling...

coming in front of the word and keeping with the string of food metaphors, the ortopédica is refering to Eliza, ortopédico/ortopédica like an orthopedic nurse. As an excerpt from what appears to be a surrealist piece of fiction, or at least the author favors food metaphors, look at the remaining text:

le mantenían plano y perejil el abdomen - kept his abdomen flat and parsely
cebolla, la cruda gama de la artillería culinaria germana - onion, the raw spectrum of german culinary artillery
y Eliza lo mimaba como a una ortopédica zanahoria con chile - and Eliza spoiled him like an carrot with chile Orthopedic nurse.

I know, it doesn't make sense, but neither does a flat and parsley abdomen.

I'm taking "los ejercicios de caballo que hacía al despertarse" to basically mean sex since I don't think it's referring to pommel horse exercises (the literal meaning).

It seems like one of those magical-realism/surrealism type passages, but Eliza is the ortopédica zanahoria con chile and the ortopédica is being used to describe her "job".

It would be zanahoria con chile ortopédica if orthopedic where modifying what type of carrot with chile.

I think another reading is possible here. She's spoiling him with chile like he were an orthopedic carrot. I think we can maintain "orthopedic" although rickety is a great word.

You can keep it equally ambiguous by moving the order around: She spoiled him like she would an orthopedic carrot with chile.