. 2025 Apr 26;20(1):418.

doi: 10.1186/s13018-025-05616-3.

Intimate partner violence injuries in Australian orthopaedic clinics: a survey of clinician perspectives

Ariella Smith¹, Naomi Pinto^{2

3}, Brett Dyer⁴, David Graham^{5

6

7

8

9}, Brahman Sivakumar^{10

11

12

13

14

15}

Affiliations

¹ Department of Orthopaedic Surgery, Hornsby Ku-ring-gai Hospital, Hornsby, NSW, 2077, Australia.
² Department of Orthopaedic Surgery, Canberra Hospital, Garran, ACT, 2605, Australia. naomipinto@ymail.com.
³ 12 4 Mallee Rd, Springvale, NSW, 2650, Australia. naomipinto@ymail.com.
⁴ Griffith Biostatistics Unit, Griffith Health, Griffith University, Gold Coast, QLD, Australia.
⁵ Department of Musculoskeletal Services, Gold Coast University Hospital, 1 Hospital Blvd, Southport, QLD, 4222, Australia.
⁶ School of Medicine and Dentistry, Griffith University, Parklands Drive Southport, QLD, 4222, Australia.
⁷ Department of Orthopaedic Surgery, Queensland Children's Hospital, 501 Stanley St, South Brisbane, QLD, 4101, Australia.
⁸ Australian Research Collaboration on Hands (ARCH), Suite 4/75 Railway St, Mudgeeraba, QLD, 4213, Australia.
⁹ School of Medicine, University of Queensland, 288 Herston Rd, Herston, QLD, 4006, Australia.
¹⁰ Department of Orthopaedic Surgery, Hornsby Ku-ring-gai Hospital, Hornsby, NSW, 2077, Australia. brahman.sivakumar@gmail.com.
¹¹ Australian Research Collaboration on Hands (ARCH), Suite 4/75 Railway St, Mudgeeraba, QLD, 4213, Australia. brahman.sivakumar@gmail.com.
¹² Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, Australia. brahman.sivakumar@gmail.com.
¹³ Department of Hand and Peripheral Nerve Surgery, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia. brahman.sivakumar@gmail.com.
¹⁴ Department of Orthopaedic Surgery, Nepean Hospital, Kingswood, NSW, 2747, Australia. brahman.sivakumar@gmail.com.
¹⁵ Westmead Clinical School, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia. brahman.sivakumar@gmail.com.

PMID: 40281640
PMCID: PMC12032775
DOI: 10.1186/s13018-025-05616-3

Intimate partner violence injuries in Australian orthopaedic clinics: a survey of clinician perspectives

Ariella Smith et al. J Orthop Surg Res. 2025.

. 2025 Apr 26;20(1):418.

doi: 10.1186/s13018-025-05616-3.

Authors

Ariella Smith¹, Naomi Pinto^{2

3}, Brett Dyer⁴, David Graham^{5

6

7

8

9}, Brahman Sivakumar^{10

11

12

13

14

15}

Affiliations

¹ Department of Orthopaedic Surgery, Hornsby Ku-ring-gai Hospital, Hornsby, NSW, 2077, Australia.
² Department of Orthopaedic Surgery, Canberra Hospital, Garran, ACT, 2605, Australia. naomipinto@ymail.com.
³ 12 4 Mallee Rd, Springvale, NSW, 2650, Australia. naomipinto@ymail.com.
⁴ Griffith Biostatistics Unit, Griffith Health, Griffith University, Gold Coast, QLD, Australia.
⁵ Department of Musculoskeletal Services, Gold Coast University Hospital, 1 Hospital Blvd, Southport, QLD, 4222, Australia.
⁶ School of Medicine and Dentistry, Griffith University, Parklands Drive Southport, QLD, 4222, Australia.
⁷ Department of Orthopaedic Surgery, Queensland Children's Hospital, 501 Stanley St, South Brisbane, QLD, 4101, Australia.
⁸ Australian Research Collaboration on Hands (ARCH), Suite 4/75 Railway St, Mudgeeraba, QLD, 4213, Australia.
⁹ School of Medicine, University of Queensland, 288 Herston Rd, Herston, QLD, 4006, Australia.
¹⁰ Department of Orthopaedic Surgery, Hornsby Ku-ring-gai Hospital, Hornsby, NSW, 2077, Australia. brahman.sivakumar@gmail.com.
¹¹ Australian Research Collaboration on Hands (ARCH), Suite 4/75 Railway St, Mudgeeraba, QLD, 4213, Australia. brahman.sivakumar@gmail.com.
¹² Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, Australia. brahman.sivakumar@gmail.com.
¹³ Department of Hand and Peripheral Nerve Surgery, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia. brahman.sivakumar@gmail.com.
¹⁴ Department of Orthopaedic Surgery, Nepean Hospital, Kingswood, NSW, 2747, Australia. brahman.sivakumar@gmail.com.
¹⁵ Westmead Clinical School, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia. brahman.sivakumar@gmail.com.

PMID: 40281640
PMCID: PMC12032775
DOI: 10.1186/s13018-025-05616-3

Abstract

Background: There is increasing recognition that intimate partner violence (IPV) is a global public health issue (1). In Australia, one in 6 women and one in 17 men experience IPV (2, 3). Musculoskeletal injuries are the second most common pathology suffered due to IPV, and previous studies have reported that as many as 1 in 50 patients present to orthopaedic outpatient clinics as a direct result of IPV (4, 5). Thus, this setting provides a unique opportunity to recognise patients at risk and facilitate intervention.

Aim: To investigate the perceptions and experiences of Australian orthopaedic clinicians regarding IPV injuries in outpatient clinics, and to identify barriers that prevent the detection of IPV in this setting.

Methods: Orthopaedic surgeons and registrars were surveyed using a secure online platform distributed via the Australian Orthopaedic Association (AOA) from December 2023 to February 2024. Responses were analysed using Chi-square, Mann-Whitney U and Kruskal-Wallis tests with a 5% significance threshold.

Results: Responses were provided by 101 fellowship trained surgeons or orthopaedic registrars. 92% either 'agree' or 'strongly agree' that IPV is a significant public health issue. Clinicians treated a mean of 5 patients per year (range 0-30) with reported IPV injuries, accounting for 0.4% (range 0-5.8%) of outpatient clinic presentations. Patients with IPV related injuries presented more frequently to public clinics than private rooms (p = 0.04). The most common perceived barriers to identifying and managing IPV are partners attending with patients (n = 84), time constraints (n = 75), lack of privacy (n = 58), and lack of social supports in clinic (n = 57).

Conclusion: Despite its prevalence in the wider community, few IPV-related injuries are identified or reported in Australian orthopaedic outpatient clinics, and many barriers exist. Understanding experiences and perceptions of this issue is key to improving our ability to provide care for this vulnerable population.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval: Ethics approval has been granted by Human Research Ethics Application (HREA). Approval number: 2022/ETH01657: Clinician survey regarding domestic violence related injuries in orthopaedic clinicians. This research project was deemed ‘negligible risk’ as it utilised de-identified survey data obtained from clinicians. There are no risks associated with participation. Participants were contacted by email and informed consent was indicated in writing. The benefits of assessing the quality patient care and informing future research on the topic outweigh the minimal risks of harm associated with the study. No funding arrangements have been made. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

**Fig. 1**
Orthopaedic clinician survey responses regarding perceptions of IPV

See this image and copyright information in PMC

References

1. Policy Finder | AMA [Internet]. policysearch.ama-assn.org. Available from: https://policysearch.ama-assn.org/policyfinder/detail/Violence%20and%20A...
1. Krug E, Dahlberg L, Mercy J, Zwi A, Lozano R. World report on violence and health Edited by [Internet]. 2002. Available from: https://iris.who.int/bitstream/handle/10665/42495/9241545615_eng.pdf?seq...
1. Della Rocca GJ, Sprague S, Dosanjh S, Schemitsch EH, Bhandari M. Orthopaedic surgeons’ knowledge and misconceptions in the Identification of Intimate Partner Violence Against Women. Clin Orthop Relat Res. 2013;471(4):1074–80. - PMC - PubMed
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1. Bhandari M, Dosanjh S, Tornetta P, Matthews D. Musculoskeletal manifestations of physical abuse after intimate Partner violence. J Trauma: Injury Infect Crit Care. 2006;61(6):1473–9. - PubMed

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Intimate partner violence injuries in Australian orthopaedic clinics: a survey of clinician perspectives

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Intimate partner violence injuries in Australian orthopaedic clinics: a survey of clinician perspectives

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