Department of Orthopaedic Surgery and Sports Medicine, University of Washington, Seattle, Washington.
WWAMI School of Medicine, University of Alaska Anchorage, Anchorage, Alaska.
JBJS Rev. 2024 Aug 6;12(8). doi: e24.00082. eCollection 2024 Aug 1.
Intimate partner violence (IPV) is a prevalent issue in the United States, despite universal screening measures for women of reproductive age. Orthopaedic surgeons have a unique opportunity to intervene in cases of IPV as musculoskeletal injuries, including fractures, are the second most common type of injury seen in IPV patients. This systematic literature review aims to identify patterns in musculoskeletal injuries caused by IPV to increase identification of patients afflicted by IPV.
A comprehensive search of PubMed, PsycINFO, and Web of Science yielded 316 articles. Included were cohort studies and literature reviews of patients with an IPV-associated orthopaedic injury. Excluded were case studies, perspective articles, material predating 2003, and studies with pediatric or elderly populations. Sixteen articles met criteria.
Data supported historical findings that musculoskeletal injury is the second most common injury in patients with IPV, with upper extremity fractures prevailing. Minimally displaced phalanges fractures were most common (9.9%-64%), and isolated ulnar fractures had significant relative risk of IPV association (8.5-12.8). Patients with multiple fractures of varying chronicity were more likely to be victims of IPV (sensitivity 25.2%, specificity 99.2%, positive predictive value 96.2%), and these chronic fractures matched patterns of acute injury caused by IPV. New findings in male victims included a higher proportion of lower extremity and pelvic fractures seen in male cohorts.
This study synthesizes evidence of IPV-related orthopaedic injuries, offering objective criteria for identifying victims. Despite limitations in fracture descriptions, the findings aid various physicians in recognizing IPV victims. Considering ongoing IPV prevalence and screening challenges, further research on injury patterns is recommended.
Level III. See Instructions for Authors for a complete description of levels of evidence.
尽管美国普遍对育龄期女性进行了亲密伴侣暴力（IPV）筛查，但 IPV 仍是一个普遍存在的问题。由于肌肉骨骼损伤（包括骨折）是 IPV 患者中第二常见的损伤类型，因此矫形外科医生有机会干预 IPV 病例。本系统文献综述旨在确定由 IPV 引起的肌肉骨骼损伤模式，以提高对受 IPV 影响的患者的识别能力。
对 PubMed、PsycINFO 和 Web of Science 进行全面检索，共获得 316 篇文章。纳入的研究包括与 IPV 相关的矫形损伤的队列研究和文献综述。排除的研究包括病例研究、观点文章、早于 2003 年的资料以及针对儿科或老年人群的研究。符合标准的有 16 篇文章。
数据支持历史研究结果，即肌肉骨骼损伤是 IPV 患者中第二常见的损伤，以上肢骨折为主。轻度移位的指骨骨折最为常见（9.9%-64%），孤立性尺骨骨折与 IPV 相关性具有显著的相对风险（8.5-12.8）。不同慢性程度的多发性骨折患者更有可能成为 IPV 的受害者（敏感性 25.2%，特异性 99.2%，阳性预测值 96.2%），这些慢性骨折与 IPV 引起的急性损伤模式相匹配。男性受害者的新发现包括男性队列中下肢和骨盆骨折的比例较高。
本研究综合了与 IPV 相关的矫形损伤证据，为识别受害者提供了客观标准。尽管骨折描述存在局限性，但这些发现有助于各种医生识别 IPV 受害者。考虑到持续存在的 IPV 流行率和筛查挑战，建议进一步研究损伤模式。
三级。请参阅作者指南，以获取完整的证据等级描述。
