Musculoskeletal injuries from gender-based violence at a tertiary hospital orthopaedic centre, central South Africa

Introduction

Limited research describing the pattern of orthopaedic musculoskeletal injuries among gender-based violence (GBV) victims has been conducted in South Africa. With the high prevalence of GBV in our locality, there is a need for healthcare workers to identify this vulnerable population for early management, intervention, and prevention of subsequent assaults. This study aimed to describe the pattern of musculoskeletal injuries resulting from physical assaults due to GBV.

Methods

This retrospective analysis was conducted in the orthopaedic department of a tertiary hospital in South Africa. Medical records of GBV victims between 01 January 2021 and 31 December 2021, including adult males and females with acute musculoskeletal injuries, were analysed.

Results

Of the 138 GBV victims, 92.7 % were female, with a median age of 32 (range 19–80). Most (66.7 %) were unemployed, while 63.8 % of cases occurred within intimate partner relationships. The predominant mechanism of injury was blunt force trauma (35.5 %), stab injuries (22.4 %), and fall from standing height (19.5 %). Men predominantly sustained soft tissue injuries (60.0 %), while women sustained upper limb fractures (53.9 %). Soft tissue injuries were noted in 34.1 % of victims, of which 23.3 % were lacerations. Just over half (51.5 %) of victims had upper limb fractures, and 19.6 % had lower limb fractures. A significant difference was found between gender and upper limb fractures (p = 0.0328). Isolated ulnar fracture was the predominant upper limb fracture (18.8 %). Males (70.0 %) and females (60.9 %) were predominantly injured between 16:00 and 00:00; 50.7 % of assaults occurred over weekends. Overall, 47.1 % reported alcohol use, which was strongly associated with female gender as 48.4 % of females reported its use either by themselves or their assailant, compared to 30.0 % of male victims (p = 0.026).

Conclusion

The pattern of musculoskeletal injuries in our study may be due to defensive manoeuvres from assaults, especially among female victims. This is worsened by the association between alcohol use and GBV and, therefore, underlines the importance of interventions to identify and protect this vulnerable population.