One in three women who break a bone in their forearm could be victims of domestic violence warns a new study.
Fractures to the bone – the ulna – are a ‘tell-tale sign’ women are being abused by their partners, say scientists.
The breaks – dubbed ‘nightstick fractures’ – often occur when people hold up their hands to protect their faces from being struck with an object, such as nightsticks wielded by police officers.
Around 1.3 million women in the UK suffered domestic abuse last year, although the number is probably much higher as not all cases are reported.
The findings could help doctors and surgeons identify women who are afraid to speak out about their abusive relationships.
This has become especially important during the Covid-19 pandemic, as many women have been forced to stay home with their abusers.
Senior author Dr. Bharti Khurana, of Brigham and Women’s Hospital in the US, said: ‘I would see these types of injuries in men, but once in a while I would see them in women.
‘I never correlated it with intimate partner violence until recently.
‘I shared my thoughts with our orthopaedic surgeons and, with their interest and support, decided to pursue the study.’
The researchers searched electronic medical records from six hospitals for women aged between 18 and 50 who had suffered a nightstick fracture.
They identified 62 patients, of which 12 were confirmed cases of domestic violence and another eight were suspected.
Further analysis of their radiographs showed domestic abuse was ‘strongly associated’ with a specific type of fracture, where the bone had broken but not moved.
Lead author Dr. David Sing, of Boston Medical Centre, said: ‘The radiological characteristics we were looking at were the location of the fracture, the pattern of the fracture in terms of how it broke, and the displacement of the fracture.
‘Out of all those things, what we usually saw was a minimally displaced fracture, meaning the bone is broken all the way through but has not shifted significantly.’
Keeping an eye out for these fractures could help identify domestic abuse, which is not always reported as many women do not feel safe or able to talk about it.
Dr. Khurana added: ‘Women with ulna fractures from intimate partner violence who are reluctant to report the crime will often attribute their injuries to a fall.
‘However falls are much more likely to result in a fracture of the radius, the other bone of the forearm.’
Only 40% of confirmed and suspected domestic abuse cases identified in the study had been formally investigated, the researchers also found.
Radiologists who observe nightstick fractures could help close the gap by letting doctors or surgeons know if their patient is showing signs of abuse.
Confirmed cases of domestic violence were also linked to homelessness and previous visits to the emergency room with broken bones, the researchers say.
Co-author Dr. Rahul Gujrathi said: ‘Careful analysis of previous imaging exams may also help radiologists confirm their suspicion of intimate partner violence.
‘In the study, for instance, historical imaging analysis alone was able to raise suspicion in 75% of clinically confirmed intimate partner violence patients.’
Domestic abuse cases have soared during the Covid-19 pandemic, as more women are stuck at home.
Dr. Sing added: ‘We have resources that we can provide to the patients who are stuck in that situation.
‘It’s especially important during Covid-19, where we’ve seen the rate of intimate partner violence go up with people trapped at home with their abusers.’
The researchers hope their findings will raise awareness about the link between ulna fractures and domestic violence, which will in turn help provide earlier detection and prevention.
Dr Sing added: ‘The sooner we can address and change the behaviour, the better.
‘Just like radiologists want to diagnose cancer as early as possible, it’s the same thing with this.
‘If we diagnose early, we have a better chance to break the cycle of violence.’
The findings are due to be presented at the annual meeting of the Radiological Society of North America (RSNA).
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