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PubMed2001

[Paget-von Schroetter syndrome as an occupational accident].

HISTORY AND CLINICAL FINDINGS: Two men and one woman developed typical symptoms of a thrombosis in the arms after unusual physical effort at their work place (a coal miner after a bad fall, a radiographer after having to catch a patient, a painter after jerkily moving a heavy piece of furniture). INVESTIGATIONS AND DIAGNOSIS: In all three patients a thrombosis of the subclavian vein was demonstrated by duplex scans or phlebography. In two patients tests for hypercoagulability were unremarkable. None of the patients had a thoracic outlet syndrome. TREATMENT AND COURSE: After initial local thrombolytic or heparin therapy alone, phenprocoumon treatment over several months was given in two cases, and in one case low-molecular-weight heparin was administered over several months. All three patients complained of strain-related residual symptoms in the affected arm (pain, swelling, easy fatigability). In all three cases, the accident insurer recognized the incident to be a work-related accident. CONCLUSION: Patients with a Paget-Schroetter syndrome resulting from a sudden and unusual physical effort at work, which is covered by statutory accident insurance, must be reported to the accident insurer as a work-related accident in order to safeguard individual medical claims of the patient and for general medical and epidemiological reasons.

Accidents, Occupational↗
PubMed1978

[Insurance system. Prevention from viewpoint of the insurer].

The purpose of an insurance must not be restricted to the payment of claims to those insured persons who suffered a loss, for loss prevention is much preferable to claim settlement. A whole range of different institutions and measures has been established by the Swiss insurers, in which many insurance branches participate. The loss preventing activities can be listed as follows:--Activities of the fire insurers to prevent and fight fires. This is the prevailing duty of the Consulting Agency for Fire Prevention (BfB) as well as the Fire Prevention Service for Industry and Trade (BVD).--Activities of the accident insurers to prevent accidents. The fight against accidents, mostly traffic accidents, in sports and at home is the foremost task of the Swiss Council for the Prevention of Accidents (BfU), an institution created by the Conference of Accident Insurance Managers (UDK) and the Swiss National Accident Insurance Fund (SUVA).--The Health Service in life insurance, after all the periodical medical examinations and consultations granted by many insurers to their insured persons, as well as the pamphlets aiming at health education published by several Companies and finally institutions and measures to promote fitness, e.g. VITA-Parcours.

Accident Prevention↗
PubMed1975

[Whiplash injuries of the cervical spine and Swiss insurance against accidents (author's transl)].

The indemnity for the consequences of a whiplash injury on the cervical spine by the Swiss Insurance against Accidents is discussed. The number of these cases can be only roughly extimated. We can calculate yearly with about 600 distortions of the cervical spine resulting from motoring accidents. The definition of the whiplash injury is defined on the base of recent German literature. The supposed mechanical assumptions for a lesion of the cervical spine are based mainly on the works of Erdmann (Frandfurt). The relations between the lesion of the cervical spine an the rebound injuries of the skull are discussed. The significance of the preexistent degenerative alterations of the cervical spine in the whiplash injury and the problem of the psychogenic superposition are presented by means of 46 observed cases.

Cervical Vertebrae↗
PubMed2000

[Recommendations for diagnosis and expert assessment of traumatic rotator cuff lesions].

Traumatic rotator cuff lesions are a very rare condition. However, this article represents a comprehensive survey according to current knowledge on anatomy, biomechanics, and pathogenesis of rotator cuff pathology. Because of the relatively high prevalence of degenerative changes with increasing age, including partial and complete rotator cuff tears, it may be difficult to demonstrate the causality of an acute traumatic rotator cuff tear. Therefore, a catalogue of potential adequate and inadequate trauma mechanisms is proposed. Emphasis is also placed on posttraumatic diagnostic steps following persistent rotator cuff deficient shoulder function (e.g., ultrasound, MRI). From a legal aspect (e.g., private accident insurance, workers compensation claim), different minor and major criteria are defined, which could help experts to judge the causality of posttraumatic rotator cuff deficiency. These criteria mainly refer to distinct details concerning patients' history, trauma mechanism, primary clinical appearance, and diagnostic findings.

Diagnosis, Differential↗