Der Unfallchirurg
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In Germany, the medical assessor is subject to the law on contracts for work and services ("Werksvertragsrecht"). When a medical expert assesses a subject on behalf of a third party, there is no contractual relationship between them. In the field of private insurance law and in social insurance law, the medical expert is faced with various procedural requirements. ⋯ In the absence of third party interest worthy of protection, the right of access to assessment records has to be granted to the subject, who will then authorize the examining medical expert to exercise this right. In private insurance law, only the private health insurance has its regulation concerning obtaining information about treatment or the access to medical assessments. In other types of insurance the medical assessor's right of access to medical examination data and/or the basis for medical findings can only be derived from secondary obligations as part of the insurance contract or directly from general constitutional personal rights.
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Review
[Anatomy of the acromioclavicular and coracoclavicular region : Functional and clinical aspects].
The acromioclavicular (AC) joint connects the acromion with the lateral end of the clavicle and constitutes an important load-transmitting element between the upper extremity and the skeleton of the trunk. ⋯ Current clinical classification schemes fail to sufficiently include these multidirectional dislocating forces; however, they have to be considered when choosing the appropriate treatment modality. Thus, understanding the anatomical and functional context of the AC/CC region is essential for a sound management of AC joint injuries and fractures of the distal clavicle.
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Acute and chronic acromioclavicular (AC) joint dislocation is frequently encountered in the routine clinical practice. This injury can lead to significant impairment of shoulder girdle function. Therapy based on the severity of injury is recommended to re-establish correct shoulder function. ⋯ Treatment of acute injuries is recommended within 1-3 weeks after trauma but there is no clear evidence of a cut-off for the presence of chronic injuries. Various surgical techniques have been described in the literature. This article presents an arthroscopically assisted technique that addresses both vertical and horizontal instability of the AC joint.