Musculoskeletal injuries in trauma patients: a Swedish nationwide register study including 37,266 patients


  • Jonas Holtenius Division of Orthopaedics and Biotechnology, Department of Clinical Science, Intervention and Technology
  • Hans E Berg Division of Orthopaedics and Biotechnology, Department of Clinical Science, Intervention and Technology
  • Anders Enocson Department of Molecular Medicine and Surgery, Karolinska Institute, Department of Trauma and Orthopaedics, Karolinska University Hospital, Stockholm, Sweden



epidemiology, fractures, incidence, injury mechanism, musculoskeletal , orthopaedic injury, trauma


Background and purpose: Trauma causes over 4 million annual deaths globally and accounts for over 10% of the global burden of disease. Trauma patients often sustain multiple injuries in multiple organ systems. We aimed to investigate the proportion and distribution of musculoskeletal injuries in adult trauma patients.
Patients and methods: This is a register-based study using data from the national Swedish trauma register (SweTrau) collected in 2015–2019. By categorizing Abbreviated Injury Scale (AIS) codes into different injury types, we provide a detailed description of the types of musculoskeletal injuries that occurred in trauma patients.
Results: 51,335 cases were identified in the register. After exclusion of 7,696 cases that did not have any trauma diagnosis (AIS codes) registered from the trauma and 6,373 patients aged < 18, a total of 37,266 patients were included in the study. 15,246 (41%) had sustained musculoskeletal injury. Of the patients with musculoskeletal injuries, 7,733 (51%) had more than 1 such injury. Spine injuries were the most common injury location (n = 7,083 patients, 19%) followed by lower extremity injuries (n = 5,943 patients, 16%) and upper extremity injuries (n = 6,273 patients, 17%). Fractures were the dominating injury type with 30,755 (87%) of injuries being a fracture.
Conclusion: 41% of the trauma patients had at least 1 musculoskeletal injury. A spine injury was the most common injury location. Fractures was the dominating injury type constituting 87% of all injuries. We also found that half the patients (51%) with spine or extremity injuries had ≥ 2 such injuries.


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How to Cite

Holtenius, J., Berg, H. E., & Enocson, A. (2023). Musculoskeletal injuries in trauma patients: a Swedish nationwide register study including 37,266 patients. Acta Orthopaedica, 94, 171–177.