Study Claims Nightstick Fracture Might Indicate Domestic Violence
More than half of female homicides each year are linked to intimate partner violence (IPV), defined as physical, sexual, or emotional violence between current or former partners. A recent study suggests that the presence of isolated ulnar fractures or nightstick fracture might indicate IPV. The study findings were published in the Journal of the American College of Radiology on April 05, 2021.
Recognition of IPV remains challenging, as the nature and pattern of IPV-related injuries are not well described. Although nonaccidental trauma in children is well researched, delineating clear detectable patterns of abuse through radiology. However, a lack of research on IPV in radiology has led to a life-threatening knowledge gap. Therefore, Dr Bharti Khurana, MD and his team conducted a study to assess the incidence of intimate partner violence (IPV) in women with isolated ulnar fractures and compare the injury characteristics in victims of IPV with those who sustained the same fractures due to other causes.
Previously in the annual meeting of the Radiological Society of North America (RSNA) 2020, they noted, "Radiologists can help patients in this dangerous circumstance and should maintain a high degree of suspicion of IPV when identifying isolated ulnar shaft fractures, particularly if they are minimally displaced".
Using electronic health records, the researchers identified 62 women aged 18–50 years (mean age 31 years) who presented at six hospitals with isolated ulnar diaphyseal fractures between 2015 and 2019. They reviewed the radiographs for fracture location, comminution, and displacement. Demographic data, number of visits to the emergency department, and documentation of IPV. They stratified the patients into four groups based on clinical chart review: confirmed IPV(n=12), possible IPV(n=8), not suspected for IPV(n=8), and not IPV(n=34). They also performed historical imaging analysis to predict IPV.
Key findings of the study were:
- Upon comparative analysis with and without suspected cases, the researchers found an association between IPV and nondisplaced fractures (95% versus 43% and 91% versus 44%).
- They also found that confirmed cases were also linked with homelessness and previous visits to the emergency department with musculoskeletal injuries.
- They noted that formal documentation of IPV evaluation was completed in only 14 of 62 (22.5%) patients.
- Upon historical imaging analysis, they predicted IPV in 8 of 12 (75%) confirmed IPV cases.
The authors concluded, "Up to one-third of adult women sustaining isolated ulnar fractures may be the victims of IPV. Lack of displacement on radiographs, frequent emergency department visits, and homelessness would favor IPV etiology."
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