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The Prevalence of Intimate Partner Violence across Orthopaedic Fracture Clinics in Ontario
Mohit Bhandari, MD, PhD, FRCSC1; Sheila Sprague, MSc1; Sonia Dosanjh, MSW1; Bradley Petrisor, MD, MSc, FRCSC1; Sarah Resendes, BSc1; Kim Madden, BSc (Cand.)1; Emil H. Schemitsch, MD, FRCSC2;
1 Division of Orthopaedic Surgery, Department of Surgery and Department of Clinical Epidemiology & Biostatistics, McMaster University, 293 Wellington Street North, Suite 110, Hamilton, Ontario L8L 2X2, Canada. E-mail address for M. Bhandari: bhandam@mcmaster.ca
2 Division of Orthopaedics, Department of Surgery, University of Toronto, St. Michael's Hospital, Suite 800, 55 Queen St. East, Toronto, Ontario M5C 1R6, Canada
View Disclosures and Other Information
Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. Dr. Bhandari is funded, in part, by a Canada Research Chair (>$10,000). This funding is unrelated to the P.R.A.I.S.E. study.

Investigation performed at Hamilton Health Sciences—General Site, Hamilton, and St. Michael's Hospital, Toronto, Ontario, Canada
The Writing Committee included Mohit Bhandari, MD, PhD, FRCSC, Sheila Sprague, MSc, Sonia Dosanjh, MSW, Bradley Petrisor, MD, MSc, FRCSC, Sarah Resendes, BSc, Kim Madden, BSc (Cand.), and Emil H. Schemitsch, MD, FRCSC. Please see note preceding reference section for additional details regarding the authors and investigators. P.R.A.I.S.E. = Prevalence of Abuse and Intimate Partner Violence Surgical Evaluation.

Copyright © 2011 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2011 Jan 19;93(2):132-141. doi: 10.2106/JBJS.I.01713
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From 1999 to 2004, an estimated 653,000 women in Canada were either physically or sexually abused by their current or previous intimate partners. We aimed to determine the proportion of women presenting to orthopaedic fracture clinics for the treatment of musculoskeletal injuries who had experienced intimate partner violence, defined as physical, sexual, or emotional abuse, within the past twelve months.


We completed a cross-sectional study of 282 injured women attending two Level-I trauma centers in Canada. Female patients presenting to the orthopaedic fracture clinics anonymously completed two previously developed self-reported written questionnaires, the Woman Abuse Screening Tool (WAST) and the Partner Violence Screen (PVS), to determine the prevalence of intimate partner violence. The questionnaire also contained questions that pertain to the participant's demographic characteristics, fracture characteristics, and experiences with health-care utilization.


The overall prevalence of intimate partner violence (emotional, physical, and sexual abuse) within the last twelve months was 32% (95% confidence interval, 26.4% to 37.2%). Twenty-four (8.5%) of the injured women disclosed a history of physical abuse in the past year. Seven women indicated that the cause for their current visit was directly related to physical abuse. Ethnicity, socioeconomic status, and injury patterns were not associated with abuse. Of the twenty-four women who reported physical abuse, only four had been asked about intimate partner violence by a physician; none of these physicians were the treating orthopaedic surgeons.


Our study suggests a high prevalence of intimate partner violence among female patients with injuries who presented to two orthopaedic fracture clinics in Ontario. Surgeons and health-care personnel in fracture clinics should consider intimate partner violence when interacting with injured women.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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