Missed Opportunities in Orthopaedics for Intimate Partner Violence Identification: A Retrospective Review Over 24...

Area of Science:

• Orthopaedic Surgery
• Public Health
• Trauma Surgery

Background:

• Intimate partner violence (IPV) frequently results in musculoskeletal injuries, yet orthopaedic surgeons often underestimate its prevalence.
• This study addresses the gap in understanding IPV within orthopaedic patient populations.

Purpose of the Study:

• To educate on IPV prevalence and manifestations in orthopaedic injuries.
• To examine referral patterns to Domestic Abuse Intervention Programs (DAIP) from orthopaedic departments.
• To characterize IPV cases identified by orthopaedic providers.

Main Methods:

• A retrospective cohort study analyzed DAIP registry data from 2000-2024.
• Referrals were categorized by department, and orthopaedic cases were further analyzed for characteristics.
• Statistical comparison of referral rates used the 2-proportion z-test.

Main Results:

• Orthopaedic surgery accounted for only 0.3% of IPV referrals to DAIPs, significantly lower than other departments (e.g., ED, behavioral health, OB/GYN).
• Most orthopaedic referrals involved female patients, often identified during inpatient encounters with high-energy fractures.
• Social workers managed most orthopaedic referrals, with disclosures occurring to nurses, residents, and advanced practice providers.

Conclusions:

• Orthopaedic surgery has significantly missed opportunities for IPV intervention due to low referral rates.
• Improved IPV awareness and screening protocols in orthopaedics can enhance patient safety and long-term care.
• AI integration may offer targeted screening solutions within current orthopaedic practice.