Joint arthrodesis in functionally favorable position : Considerations on measurement of disability in private accident insurance

• Published in: Der Unfallchirurg 2020-12, Vol.123 (12), p.988-998
• Main Authors: Klemm, H-T, Wittchen, V, Willauschus, W, Fuhrmann, R A, Hohendorff, B
• Format: Article
• Language: ger
• Subjects: Accidents; Arthrodesis; Disability Evaluation; Expert Testimony; Insurance, Accident
• ISSN: 1433-044X
• DOI: 10.1007/s00113-020-00913-4

If an accident results in a functional disorder that persists and permanently restricts physical and/or mental capacity, this is referred to as a disability. In private accident insurance it is the task of the medical expert to assess this disability by examining the medical findings and produce an assessment taking account of the literature and comparing against generally acknowledged guidance values. The priority dismemberment disability rating schedule initially provides loss values. For the "next lowest" disability levels for arthrodesis of extremity joints, the assessment recommendations are based on a functionally favorable position although this functionally favorable position is not more precisely defined.In this article the authors have defined these functionally favorable positions based on the information available in the literature. In particular, the operatively favorable settings for arthrodesis of the affected joint that are stated in the literature on trauma and orthopedic surgery were consulted. Of course, the functional perspective has been especially emphasized.A difficulty in achieving this was that the literature on arthrodesis is now almost only of historical value due to modern endoprosthetics. The knowledge gained was checked against medical experience and is expounded here.