Injuries of the eye socket are common in domestic violence cases
Women who are victims of domestic violence tend to have distinct patterns of facial injuries research suggests.
A study in the Archives of Facial Plastic Surgery says these kind of assaults cause higher than expected fractures of the cheekbones and eye sockets and more brain injuries.
Domestic violence makes up 20% of all assaults in England and Wales.
The researchers hope their study will help doctors to recognise victims of this type of abuse.
They studied the medical and dental records of 326 women who were treated for facial trauma at the University of Kentucky Medical Centre between 1998 and 2004.
More complex fractures
Of the 45 patients who were assault victims, more than 40% were victims of domestic violence.
Surgeons who examined them found much higher than expected rates of cracks or breaks in the bones surrounding the eye. They also observed more frequent fractures of the cheekbones and about double the rate of brain injuries.
Dr Oneida Arosarena, who led the research, said "The purpose of the study was to make doctors aware of what to look for. Particularly with women who return with multiple injuries, some in different stages of healing."
She said it was not always possible to diagnose abuse by finding out how the injury was caused. "We had a lot of patients who reported their injuries as due to falls - 22%. And we questioned whether that was the actual mechanism of injury. Wiomen still feel there's a social stigma to reporting domestic abuse."
A proper record
Barrie Evans, President of the Association of Oral and Maxillofacial Surgeons, said "This study could help doctors and nurses to realise that interpartner violence can be a possibility when they come across these kinds of injuries."
"What is important in any patient who sustains a facial or indeed any injury as a result of an assault, is for the doctor to obtain an adequate history of the circumstances."
"My concern with this paper is that we are dealing with a small sample...Secondly, if surgeons concentrated on patients with cheekbone, eye socket and brain injuries, patients with jaw fractures which were the result of an assault by a partner could conceivably be overlooked".
Around four times as many women as men are victims of domestic violence.
Teresa Parker, a spokesperson for Women's Aid said: "Three quarters of all domestic violence is not reported to the police, but there is still one domestic violence call to the police every minute in the UK."
"Often no-one outside the relationship will be aware that domestic violence is happening, and if there are physical injuries the perpetrator may have ensured they are in an area which is usually covered in clothing."