The Orthopaedic Trauma Registry (OTR) collects data relating to the management of severe injuries to the musculoskeletal system that are caused by external sources. It encapsulates some of the most widespread surgical procedures in the UK, including repairs to common fractures such as ankle, distal femur, distal radius, hip and proximal humerus.

The OTR uses the Müller Association of Osteosynthesis (AO) classification, a universal system for categorising bone fractures by type, location and severity. It is designed to provide a unique, unequivocal definition of any bone fracture and supports the accurate comparison of cases. Trauma surgeons use this system to communicate and document injuries and to help them determine fracture severity and likely functional outcome.

About the OTR

The Secretary of State for Health and Social Care directs NHS England to operate the OTR.

The OTR lies within the implantable device-level modular framework of the Medical Devices Outcomes Registry (MDOR), which was established in 2024 to fulfil Recommendation 7 of the Independent Medicines and Medical Devices Safety Review: First Do No Harm (Cumberlege Review) to improve patient safety and outcomes and reduce variation in clinical practice associated with procedures involving implantable medical devices.

To fulfil the recommendations of the Cumberlege Review and Paterson Inquiry, the OTR captures data on the healthcare provider, patient, operation, clinician, implantable medical device(s) and AO bone fracture and dislocation classification associated with treatment for the following trauma types:

• primary
• staged
• secondary

All healthcare organisations, including independent sector organisations, that provide NHS-funded care and undertake surgical or interventional procedures involving a Class IIb or III implantable medical device must comply with the requirement to submit data to NHS England. Independent sector organisations that provide privately-funded care for the same procedures may submit data to NHS England on a voluntary basis.

OTR data collection

Data submissions to the OTR started in March 2025 through the Outcomes and Registries Clinical Application started in March 2025. Access to the system is via an approved account and requires log in.

Data is collected daily and can be entered 24 hours a day, 365 days a year. The collection is ongoing with no end date.

Supporting documentation

More information on the OTR and the wider work on the Outcomes and Registries Programme can be found in:

• Outcomes and Registries Directions 2024 outlining the legal requirement from the Secretary of State for NHS England to collect these data
• MDOR requirements specification detailing what providers in scope must do to comply with the mandate to submit data
• MDOR data specification defining what data fields are to be collected to fulfil the legal requirement
• MDOR data provision notice detailing the legal instruction to providers in scope to submit data
• MDOR transparency notice informing data subjects (patients and the public) how and why NHS England collects, uses, stores and shares their personal data

Enquiries

For OTR general enquiries and technical support from the Outcome Registries Clinical Application liaison team, please contact england.support.outcomeregistries@nhs.net