McMaster University

McMaster University

A battered woman sits curled in a corner at the bottom of the stairs.

Intentional Injuries in Women

Principal Investigators

A photo link to the bio of Dr.Mohit Bhandari

Dr. Mohit Bhandari

A photo link to the bio of Dr.Brad Petrisor

Dr. Brad Petrisor

Sheila Sprague, PhD

Sheila Sprague, PhD

Current Research Initiatives


PRAISE-2 logo

PRAISE-2 is a pilot prospective cohort study of 300 women with fractures that aims to determine the feasibility of a large multinational cohort study that will examine surgical outcomes (time to fracture healing, fracture-related adverse events, and return to pre-injury function) among those injured women who report, or do not report, a history of abuse. This will be the first study to evaluate differences in orthopaedic outcomes between abused and non-abused women and preliminarily assess whether an injury can lead to worsening abuse by an intimate partner.

IPV Scoping Review

This scoping review will the first of its kind and will characterize the available literature to inform the development of an intimate partner violence identification and assistance program for use in musculoskeletal injury clinics and describe the gaps that exist in the current intimate partner violence literature to inform future research.


The World Health Organization reports that one in three women globally will experience physical or sexual intimate partner violence (IPV) or domestic abuse in their lives.  Every six days, a woman in Canada is killed by her intimate partner. Intimate partner violence is a prevalent social issue which poses significant health concerns.  It disproportionately affects women and is a leading cause of non-fatal injury in females in North America. The cost of IPV in Canada is estimated at $5 billion annually. Victims of abuse experience more physical and mental health problems, including orthopaedic injuries and, consequently, use health care resources more frequently than non-abused women. A recent systematic review of IPV prevalence studies showed that the lifetime prevalence of IPV in emergency and family medicine is 40% and 38% respectively.

Intimate partner violence affects a high percentage of women presenting to a number of health care settings.  Our global prevalence study of 2,945 women, which was recently published in the Lancet, gained international media attention for finding that one in six women presenting to orthopaedic fracture clinics with musculoskeletal injuries had experienced IPV in the past year.  In addition, we found that one in 50 women presented to the orthopaedic fracture clinic as a direct consequence of IPV and that these women experienced serious injuries, including fractures and dislocations that required the care of an orthopaedic surgeon.  As orthopaedic surgeons frequently see IPV victims in their fracture clinics, our research will enhance the care of abused patients with musculoskeletal injuries and improve the lives of IPV victims.

The next steps in our research program on intentional injuries in women are:

  • To examine health outcomes in women experiencing fractures from domestic violence.
  • To characterize and identify knowledge gaps in the available literature to inform the development of an IPV identification and assistance program for use in musculoskeletal injury clinics, and to inform future research. 

Recent Publications

  • Lancet. 2013 Sep 7;382(9895):866-76.

    Prevalence of abuse and intimate partner violence surgical evaluation (PRAISE) in orthopaedic fracture clinics: a multinational prevalence study.

  • J Bone Joint Surg Am. 2013 Jul 3;95(13):e911-10.

    The POSITIVE Investigators. Patient Opinions of Screening for Intimate Partner Violence in a Fracture Clinic Setting POSITIVE: A Multicenter Study.

  • BMC Musculoskelet Disord. 2013 Apr 5;14:122.

    Health Care Providers’ Perceived Barriers to and Facilitators for Intimate Partner Violence Screening of Women in Orthopaedic Fracture Clinics.

  • BMC Musculoskelet Disord. 2013 Jan 15;14(1):23.

    Intimate partner violence and Musculoskeletal injury: bridging the knowledge gap in Orthopaedic fracture clinics.

  • Clin Orthop Relat Res. 2013 Apr;471(4):1074-80.

    Orthopaedic Surgeons' Knowledge and Misconceptions in the Identification of Intimate Partner Violence Against Women.

  • J Inj Violence Res. 2013 Jan 1;5(1):1-10.

    Perceptions of Intimate Partner Violence: a cross sectional survey of surgical residents and medical students.

  • J Interpers Violence. 2013 May;28(7):1455-75.

    Feasibility of Screening for Intimate Partner Violence at Orthopedic Trauma Hospitals in India.

  • Women Health. 2012;52(6):587-605.

    Barriers to screening for intimate partner violence.

  • J Interpers Violence. 2012 Mar;27(5):881-98.

    Screening for intimate partner violence in orthopedic patients: a comparison of three screening tools.

  • J Bone Joint Surg Am. 2011 Jan 19;93(2):132-41.

    The prevalence of intimate partner violence across orthopaedic fracture clinics in Ontario

  • Trauma Violence Abuse. 2010 Apr;11(2):71-82.

    Pattern of physical injury associated with intimate partner violence in women presenting to the emergency department: a systematic review and meta-analysis.

  • BMC Musculoskelet Disord. 2010 Apr 23;11:77.

    Prevalence of Abuse and Intimate Partner Violence Surgical Evaluation (P.R.A.I.S.E.): rationale and design of a multi-center cross-sectional study.

  • J Manipulative Physiol Ther. 2008 Jul-Aug;31(6):424-33.

    Ontario chiropractors' knowledge, attitudes, and beliefs about intimate partner violence among their patients: a cross-sectional survey.

  • J Bone Joint Surg Am. 2008 Jul;90(7):1590-7.

    Violence Against Women Health Research Collaborative. (Mis)perceptions about intimate partner violence in women presenting for orthopaedic care: a survey of Canadian orthopaedic surgeons.

  • Violence Against Women. 2008 Jul;14(7):833-43.

    Child protection involvement and victims of intimate partner violence: is there a bias?

  • J Trauma. 2006 Dec;61(6):1473-9.

    Violence Against Women Health Research Collaborative. Musculoskeletal manifestations of physical abuse after intimate partner violence.

  • J Manipulative Physiol Ther. 2006 Jun;29(5):386-92.

    Chiropractors' perceptions about intimate partner violence: a cross-sectional survey.

  • BMC Musculoskeletal Disorders

    Barriers to and facilitators for screening women for intimate partner violence in surgical fracture clinics: A qualitative descriptive approach

  • Trauma, Violence and Abuse

    A Comparison of the Types of Screening Tool Administration Methods Used for the Detection of Intimate Partner Violence: A Systematic Review and Meta-Analysis

  • Violence Against Women

    Prevalence of Intimate Partner Violence Across Medical and Surgical Health Care Settings

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    Orthopaedic Trainees Retain Knowledge After a Partner Abuse Course: An Education Study

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    Media coverage of violence against women in India: a systematic study of a high profile rape case

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    A comparison of the types of screening tool administration methods used for the detection of intimate partner violence: a systematic review and meta-analysis

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    Predictors of change in mental health and distress among women attending a women's shelter

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    Intimate Partner Violence and Mental Health

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