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November 30, 2020

A certain arm fracture may be a tell-tale sign of domestic violence

The COVID-19 pandemic is exacerbating an already troubling problem, health experts say

Women's Health Domestic Violence
Ulnar fracture domestic abuse Nino Care/Pixabay

Radiological findings of arm injuries can alert doctors to potential domestic violence cases, a new study finds.

Research shows one in four women experience intimate partner violence in non-pandemic times. So do one in 10 men. 

Right now, with COVID-19 restrictions forcing closer quarters and adding economic strain, the number of reported cases are rising, including in the Philadelphia region. 

Lori Sywensky, executive director at Turning Points, a Lehigh Valley advocacy agency, told NBC News that her group received almost 1,200 intimate partner violence calls between April and September, a 40% increase from the same time last year.

Some domestic violence agencies have reported a decline in calls, but thesay the drop-off most likely is the result of the abuser being home more often. That gives victims fewer opportunities to call for help. 

The troubling trend is being observed in hospitals, too. Abington Hospital in Montgomery County and ChristianaCares Health System in Delaware have seen an increase in violent forms of abuse in 2020. 

Data has shown that traumatic brain injuries and strangulation are among common signs of domestic violence. But new research suggests women who sustain a fracture to their ulna, a bone in the forearm, are frequently victims of domestic violence. 

An ulnar fracture is particularly telling because it often occurs as people hold up their hands to protect their faces from being struck with an object, researchers said. Their study will be presented at the virtual meeting of the Radiological Society of North America.

The researchers found that of 62 patients with an ulnar fracture, 12 had confirmed cases of intimate partner violence. In eight of the other cases, there was suspicion of abuse.

"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," said lead author Dr. Davis Sing, an orthopedic surgery resident at Boston Medical Center.

  • Call the National Domestic Violence Hotline at 1-800-799-SAFE
  • Contact a local women's shelter or crisis center. In the Philadelphia region, contact the Philadelphia Domestic Violence Hotline at 1-866-723-3014. 
  • Confide in your health care provider

"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."

All confirmed cases of intimate partner violence also were linked with homelessness, and previous emergency room visits with musculoskeletal injuries. Four of the eight patients in the suspected cases said they were injured in a fall.

However, the researchers explained that the radius – another bone in the forearm – is mostly likely to be fractured in a fall.

They hope their findings will encourage radiologists who see an ulnar fracture to let the treating physician know that it can be a red flag of abuse.

Physical violence is not the only way an intimate partner may cause harm. Controlling behavior, making threats of violence and hurling names and insults are also signs, experts say.

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