Women who suffer abuse at the hands of a loved one may not be so quick to talk about it

Jan 21 2009

However, their facial injuries speak volumes. Newly released research in the January/February issue of Archives of Facial Plastic Surgery, one of the JAMA/Archives journals, shows women who are victims of intimate partner violence tend to have different patterns of facial injury than women who experience facial trauma from other causes.

Temple University facial plastic surgeon Oneida Arosarena, MD, FACS, and her colleagues reviewed six years worth of medical and dental records from 326 women treated for facial trauma at the University of Kentucky Medical Center. Arosarena also saw this type of abuse first hand.

"I remember a patient who suffered a nasal fracture at the hands of her husband," said Arosarena, an associate professor in the department of otolaryngology at the School of Medicine. "I repaired her injuries and social workers found her safe housing, but she still went back to him. That was a very touching case because it wasn't just about fixing someone's facial fracture; it involved social work and a community of health care workers trying to help this woman."

Stories like these pushed Arosarena to ask her patients difficult questions about their relationships. Those answers, coupled with her team's research, revealed women who are injured by an intimate partner tend to suffer from distinct types of upper facial injuries, while those injured from other causes, such as a car accident or fall, are more likely to suffer lower facial fractures. In other words, brain injuries or breaks around the eye socket and cheekbones would signal intimate partner violence, whereas a broken jaw might not. The findings surprised Arosarena and her co-researchers.

"We fully expected the injuries to be distributed like they are in other traumas, but they weren't."

Of the 326 women treated for facial trauma, 45 patients were assault victims, including 18 documented victims of intimate partner violence, while 24 of the remaining 26 assault victims could not or did not identify their assailant. Other common causes of injury included car crashes (139 patients), falls (70 patients) and unknown or undocumented causes (35 patients).

Unlike domestic violence, which may be perpetrated by a spouse, sibling or other family member, intimate partner violence is more specifically described as abuse by a spouse or significant other. Experts estimate more than one in four women in this country suffer from intimate partner violence. That figure along with this research has Arosarena hopeful that the particular pattern of injury may tip off doctors when women are being beaten.

"This research will hopefully make first responders and trauma surgeons more aware that there is a correlation between intimate partner violence and certain facial injuries. And we hope it prompts them to ask just how those injuries happened."

Other authors in the study include Travis Fritsch, MS, Intimate Partner Violence Surveillance Project, Kentucky Injury Prevention and Research Center; Richard Haug, DDS, University of Kentucky; Yichung Hsueh, MD, University of Louisville; and Behrad Aynehcki, MD, State University of New York, Downstate Medical Center.