Founder and Director, Trauma Imaging Research and Innovation Center, Brigham and Women's Hospital, Boston, Massachusetts; Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; Associate Professor of Radiology, Harvard Medical School, Boston, Massachusetts.
Trauma Imaging Research and Innovation Center, Brigham and Women's Hospital, Boston, Massachusetts; Department of Orthopedic Surgery, Boston University Medical Center, Boston, Massachusetts.
J Am Coll Radiol. 2021 Aug;18(8):1108-1117. doi: 10.1016/j.jacr.2021.03.006. Epub 2021 Apr 3.
This study aimed 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.
Electronic health records from three level I trauma centers were queried to identify a cohort of women, aged 18 to 50, sustaining isolated ulnar fractures from 2005 to 2019. Radiographs were reviewed for fracture location, comminution, and displacement. Demographic data, number of visits to the emergency department, and documentation of IPV were also collected. Patients were stratified into four groups based on clinical chart review: confirmed IPV, possible IPV, not suspected for IPV, and not IPV. Historical imaging analysis for IPV prediction was also performed.
There were 62 patients, with a mean age of 31 years (IPV: 12 confirmed, 8 possible, 8 suspected not IPV, 34 confirmed not IPV). Comparative analysis with and without suspected cases demonstrated IPV to be associated with nondisplaced fractures (95% versus 43%; P < .001 and 91% versus 44%; P = .012). Confirmed cases were also associated with homelessness (46% versus 0%; P < .001), and the number of documented emergency department visits (median 7.0; interquartile range 2.0-12.8 versus 1.0; interquartile range 1.0-2.0; P < .001). Formal documentation of IPV evaluation was completed in only 14 of 62 (22.5%) patients. Historical imaging analysis predicted IPV in 8 of 12 (75%) confirmed IPV cases.
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.
本研究旨在评估单纯尺骨骨折女性中亲密伴侣暴力（IPV）的发生率，并比较 IPV 受害者与因其他原因导致相同骨折的受害者的损伤特征。
从三个一级创伤中心的电子健康记录中查询了 2005 年至 2019 年期间年龄在 18 至 50 岁之间的单纯尺骨骨折女性队列。对 X 线片进行了骨折部位、粉碎和移位的评估。还收集了人口统计学数据、急诊就诊次数和 IPV 记录。根据临床图表回顾将患者分为四组：确诊 IPV、可能 IPV、疑似非 IPV 和非 IPV。还对 IPV 预测进行了历史影像学分析。
共有 62 名患者，平均年龄为 31 岁（IPV：12 例确诊，8 例可能，8 例疑似非 IPV，34 例非 IPV）。对疑似病例和非疑似病例进行比较分析显示，IPV 与无移位骨折相关（95%与 43%；P<0.001 和 91%与 44%；P=0.012）。确诊病例还与无家可归相关（46%与 0%；P<0.001），以及记录的急诊就诊次数（中位数 7.0；四分位距 2.0-12.8 与 1.0；四分位距 1.0-2.0；P<0.001）。仅在 62 名患者中的 14 名（22.5%）完成了 IPV 评估的正式记录。历史影像学分析预测 12 例确诊 IPV 中有 8 例（75%）为 IPV。
多达三分之一的单纯尺骨骨折成年女性可能是 IPV 的受害者。X 线片无移位、频繁急诊就诊和无家可归更支持 IPV 的病因。
