In the United Kingdom (UK), police receive an average of one call per minute from people reporting domestic violence.  In England and Wales, 20% of all physical assaults are the result of domestic violence.  Even so, an estimated 75% of all such assaults go unreported, signaling a lingering social stigma associated with this sign of dangerously rocky relationships.

The problem is similarly prevalent in the United States, where a research team, examining records from the University of Kentucky Medical Center, concluded the facial injuries typical of domestic violence leave telling fractures that could signal the need for more than medical treatment.  Victims of domestic violence often have facial injuries that include fractures to the bone of the eye socket and cheekbones.  Brain injuries are common as well.

The research team, led by Dr. Oneida Arosarena, of Temple University School of Medicine in Philadelphia, examined medical and dental records of 326 women treated for facial trauma at the Kentucky medical center from 1998 to 2004.  Of them, 45 patients were victims of assault and more than 40% of those assaults were domestic violence.

The surgeons treating these assault victims found the rate of cracks or breaks in the bones that surround the eye to be much higher than expected.  Also common in domestic violence patients were fractured cheekbones and a rate of brain injury double that of other assault victims.  In spite of rather obvious signs of violence, about 22% of the patients seeking medical treatment said they received their facial injuries during a fall.

Arosarena says it’s important for medical personnel to be aware of the distinctive pattern of injuries associated with domestic violence, even when the patient says the injury is due to other activities or events.  She feels medical personnel should be especially suspicious when the same patient returns with similar injuries or when evidence of multiple fractures healing in different stages is apparent.

Speaking on behalf of the Association of Oral and Maxillofacial Surgeons, its president, Barrie Evans, expressed the hope that this study will help doctors and nurses identify domestic violence victims more readily and suggest social services to alleviate the threat of future violence.  He also expressed concern that focusing on just injuries to the eye socket, cheekbones, and brain will distract from injuries to the jaw, where fractures are also common in cases of domestic violence.

Domestic violence is often a closely guarded secret, with few people outside the troubled relationship even aware of its occurrence.  Adding to the veil of secrecy is the fact that many injuries are sustained in parts of the body most often covered by clothing.  While not limited to women alone, about four times as many women fall victim to domestic violence as men.

The Arosarena study has been published in the current issue of the ‘Archives of Facial Plastic Surgery.’