Department of Radiology, Division of Emergency Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Eur Radiol. 2021 Aug;31(8):5713-5720. doi: 10.1007/s00330-020-07672-1. Epub 2021 Jan 18.
OBJECTIVES: To recognize most common patterns of upper extremity (UE) injuries in victims of Intimate Partner Violence (IPV). METHODS: Radiological review of 308 patients who reported physical IPV at our institution from January 2013 to June 2018, identified 55 patients with 88 unique UE injuries. Demographic data and injury patterns and associations were collected from the electronic medical records. RESULTS: The cohort included 49 females and 6 males (age 19-63, mean 38). At the time of injury, IPV was reported in 15/88 (17%) and IPV screening was documented for 22/88 (25%) injuries. There were 46 fractures, 8 dislocations or subluxations, and 34 isolated soft tissue injuries, most commonly involving the hand (56/88). Fractures most commonly involved the fingers (21/46, 46%) and the 5th digit (8/27, 30%). Medial UE fractures (5th digit, 4th digit) constituted 44% of hand and finger fractures (12/27) and 26% of all fractures (12/46). Comminuted and displaced fractures were rare (8/46, 17%). Head and face injuries were the most common concomitant injuries (9/22, 41%) and subsequent injuries (21/61, 35%). Of 12 patients with recurrent UE injuries, 6 had recurrent injuries of the same hand. Five of 6 non-acute fractures (83%) were of the hand. CONCLUSIONS: Hand and finger injuries are the most common UE injuries in patients with IPV, with finger being the most common site and medial hand the most common region of fracture. Repeated injuries involving the same site and a combination of medial hand and head or face injuries could indicate IPV. KEY POINTS: • Upper extremity injuries in victims of intimate partner violence are most commonly seen in the hand and fingers. • Fingers are the most common site of fracture and the medial hand is the most common region of fracture in the upper extremity in victims of intimate partner violence. • In intimate partner violence victims with upper extremity injuries, concomitant injuries and subsequent injuries are most commonly seen in the head and neck region.
目的:识别亲密伴侣暴力(IPV)受害者上肢(UE)损伤的最常见模式。
方法:对 2013 年 1 月至 2018 年 6 月在我院报告身体 IPV 的 308 名患者进行放射学回顾,确定了 55 名患者的 88 处 UE 损伤。从电子病历中收集了人口统计学数据以及损伤模式和关联。
结果:该队列包括 49 名女性和 6 名男性(年龄 19-63 岁,平均 38 岁)。受伤时,有 15/88(17%)例报告了 IPV,22/88(25%)例记录了 IPV 筛查。有 46 处骨折,8 处脱位或半脱位,34 处单纯软组织损伤,最常见于手部(56/88)。骨折最常见于手指(21/46,46%)和第 5 指(8/27,30%)。手部和手指骨折中,内侧 UE 骨折(第 5 指、第 4 指)占 44%(12/27)和所有骨折的 26%(12/46)。粉碎性和移位性骨折很少见(8/46,17%)。头面部损伤是最常见的伴随损伤(9/22,41%)和后续损伤(21/61,35%)。在 12 例 UE 复发性损伤的患者中,有 6 例为同一手部的复发性损伤。6 例非急性骨折中有 5 例(83%)发生在手。
结论:IPV 患者的上肢损伤最常见于手部和手指,手指是最常见的部位,手部内侧是最常见的骨折部位。同一部位的反复损伤以及手部内侧和头面部损伤的组合可能提示存在 IPV。
重点:• IPV 受害者的上肢损伤最常见于手部和手指。• 手指是最常见的骨折部位,手部内侧是 IPV 受害者上肢骨折最常见的部位。• 在有上肢损伤的 IPV 受害者中,头颈部最常见的是伴随损伤和后续损伤。
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