The Association between Healed Skeletal Fractures Indicative of Interpersonal Violence and Alcoholic Liver Disease in a Cadaver Cohort from the Western Cape, South Africa

• Published in: Alcohol (Fayetteville, N.Y.) Vol. 52; pp. 41 - 48
• Main Authors: Geldenhuys, Elsje-Márie, Burger, Elsie H, Alblas, Amanda, Greyling, Linda M, Kotzé, Sanet H
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-05-2016; Elsevier Limited
• Subjects: Alcohol; Alcohol use; Cadaver; Cadavers; Cohort Studies; Epidemiology; Facial Bones - injuries; Facial Bones - pathology; Facial Injuries - epidemiology; Facial Injuries - pathology; Family medical history; Female; Females; Fracture Healing; Fractures; Hepatitis; Histology; Humans; Injuries; Interpersonal Relations; Interpersonal violence; Liver cirrhosis; Liver disease; Liver diseases; Liver Diseases, Alcoholic - epidemiology; Liver Diseases, Alcoholic - pathology; Male; Males; Middle Aged; Population; Psychiatry; Retrospective Studies; Skull Fractures - epidemiology; Skull Fractures - pathology; South Africa - epidemiology; Trauma; Tuberculosis; Violence; South Africa; alcohol; cadavers; interpersonal violence; liver disease; fractures; Interpersonal violence; Alcohol; Fractures; Cadavers; Liver disease
• ISSN: 0741-8329; 1873-6823
• DOI: 10.1016/j.alcohol.2016.02.003

Abstract Interpersonal violence (IPV) and heavy alcohol consumption are major problems in the Western Cape Province of South Africa. Cranio-maxillofacial fractures, particularly nasal and zygomatic bone fractures, as well as isolated radial fractures (Colles fractures) and ulnar shaft fractures (parry fractures), are indicative of IPV, while alcoholic liver disease (ALD) is the consequence of chronic alcohol abuse. We therefore aim to investigate whether a significant association exists between the prevalence of cranio-maxillofacial fractures and parry fractures and ALD in a Western Cape population. Embalmed cadavers (n = 124) used for medical students’ anatomy training at the Division of Anatomy and Histology, Faculty of Medicine and Health Sciences, Stellenbosch University were studied. The cadavers were dissected according to departmental protocol. The liver of each cadaver was investigated for macroscopic pathology lesions. Tissue samples were removed, processed to wax, and sectioned and stained with hematoxylin and eosin (H&E). All soft tissue was removed from the skulls, radii, and ulnae, which were then investigated for healed skeletal trauma. The results showed 37/124 (29.8%) cadavers had healed cranio-maxillofacial fractures and 24/124 (19.4%) cadavers had morphologic features of ALD. A total of 12/124 (9.7%) cadavers showed signs of both ALD and healed cranio-maxillofacial trauma. More males were affected than females, and left-sided facial fractures were statistically more common compared to the right side. This study illustrated a significant trend between alcohol abuse and cranio-maxillofacial fractures in individuals from communities with a low socio-economic status (SES) where IPV is a major problem.