According to the World Health Organization, approximately 30 percent of women in North and South America experience intimate partner violence during their lifetimes. In North America, domestic violence also is the most common cause of non-fatal injuries among women, often resulting in broken bones.
However, research from the University of Missouri has found 74 percent of orthopedic trauma surgeons, who treat many victims of domestic violence, substantially underestimate the prevalence of domestic violence injuries among their patients, and only 23 percent had training to recognize such injuries.
"In our study, we found that most orthopedic surgeons believe identifying injuries caused by domestic violence is an important aspect of providing medical care, and they also believe that receiving education to recognize signs of intimate partner violence could help them to stop violence in some cases," said Gregory Della Rocca, MD, PhD, an associate professor of orthopedic surgery at the MU School of Medicine and co-director of orthopedic trauma services at MU Health Care. "In the United States, most orthopedic surgeons receive training in techniques for recognizing signs of child abuse, but training to recognize abuse of adults is far less common. Only 23 percent of the surgeons we surveyed had received any training on recognizing and responding to intimate partner violence."
The study was based on a survey of 153 orthopedic trauma surgeons, mostly in North America. The respondents were asked questions about the importance and ability for medical professionals to recognize and respond to signs of intimate partner violence, their beliefs about the causes of domestic violence, and estimates about the prevalence of domestic-violence injuries among their patients.
An international study of the prevalence of intimate partner violence among orthopedic trauma clinics recently published in The Lancet found that 40 percent of North American patients reported having experienced violence. However, Della Rocca said his survey showed most orthopedic surgeons significantly underestimated how often they see domestic violence injuries, with 74 percent of orthopedic surgeons estimating only 5 percent or less of their patients were victims of intimate partner violence. Della Rocca also was part of the steering and writing committees and the investigation team of 80 investigators for the study published in The Lancet.
"Based on our research about the high prevalence of intimate partner violence among orthopedic trauma patients and the misconceptions about how common it actually is, I encourage orthopedic surgeons to seek out education on the topic and learn about community resources where they can refer patients for help," Della Rocca said. "Since the publication of these studies, my orthopedic trauma surgeon colleagues at the University of Missouri and I have started screening all our patients -- male and female -- for intimate partner violence, and we are creating an educational program for training our orthopedic surgery residents."
- Gregory Della Rocca et al. Prevalence of Abuse and Intimate Partner Violence Surgical Evaluation (PRAISE) in Orthopaedic Fracture Clinics: A Multinational Study. The Lancet, September 2013
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