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The trauma segment generated an estimated $9.6 billion in worldwide sales during 2025, growing 5.8% compared to the prior year. The segment makes up 15% of the overall orthopedic market. For the second consecutive year, core trauma exceeded expectations, while procedure volume softness impacted the foot and ankle segment.
Patient demographics certainly play a role in core trauma’s growth, but that’s just part of the story. We’ve seen an innovation cycle hit the subsegment over the last few years. Companies are also doing a better job of meeting the evolving needs of surgeons and hospital staff with digital tools and operational support. Niches within core trauma like complex limb reconstruction and pediatrics have also proven to be reliable growth engines.
Company Performance
Trauma is an extremely consolidated market. Stryker and Johnson & Johnson MedTech are the top two players, accounting for 60% of the segment’s global sales, as seen in Exhibit 1.
Johnson & Johnson MedTech’s trauma business is more than three times larger than the next largest player, Zimmer Biomet, which benefited from the early-2025 acquisition of Paragon 28. Smith+Nephew and Acumed round up the market’s top five players, which account for a combined 80% of the market.
Like other players in the foot and ankle market, Stryker had a softer year for sales. However, the company’s success in core trauma more than offset the slowdown in foot and ankle. The Pangea Plating System not only drove sales growth but also increased customer awareness of Stryker’s broad trauma offering.
Johnson & Johnson’s spin-off of DePuy Synthes into a standalone orthopedics company could create some disruption in 2026 and 2027, but it was mostly business as usual last year. Johnson & Johnson Medtech’s trauma product growth improved each quarter, with the second half of the year performing far stronger than the first. International sales and the company’s VOLT Plating System were key growth drivers.
Among mid-tier companies, Zimmer Biomet worked through its Paragon 28 integration during 2025. The company had to address “contract friction” but remains bullish on the long-term growth prospects for the business.
Smith+Nephew saw good growth from the EVOS plating system, which was partially offset by slower sales of legacy systems. In late 2025, Acumed announced completion of the first wrist fixation case using Acu-Loc NEXT, an update of the original system.
Among smaller players, Treace Medical endured a rocky 2025 as it navigated evolving preferences among patients and surgeons and the broader slowdown in the foot and ankle market. Orthofix found success penetrating the U.S. market with its complex limb reconstruction portfolio, while Enovis and Globus Medical saw their trauma businesses begin to reach critical mass.
Regional Trends
While the United States is the largest trauma market, as seen in Exhibit 2, it is highly consolidated and can be difficult to penetrate without a novel, differentiated offering like Orthofix’s focus on limb reconstruction or OrthoPediatrics’ on young patients. However, international markets were an area of strength for many trauma players in 2025.
Europe’s robust demand has made it a growth engine for companies that have secured certification for their products under the European Union Medical Device Regulation (MDR). European companies have generated substantial growth in the EMEA region. Medartis’s EMEA sales, for instance, have an estimated CAGR of 11% from 2019 to 2025.
While companies have lapped the impact of volume-based procurement (VBP) price cuts in China, that market remains very much in flux. VBP’s volume benefit has largely gone to domestic Chinese companies. International players are often deciding to stay in or leave the market on a product-by-product basis, as the new paradigm is hard to make profitable.
As in Europe and the Asia Pacific region, it is hard to generalize about the orthopedic markets in the countries that make up Latin America. Companies have told us that organic growth is low in Latin America, more competitors from Europe and Asia are entering the market and the regulatory approval process for new technologies is lengthy. These factors, along with relatively little investment in healthcare, make for a fragmented market.
Market Developments
Here are five of the trends and developments we’re following in the trauma market in the coming years.
Potential Disruption on the Way. As mentioned, Johnson & Johnson plans to separate its orthopedics business to operate as DePuy Synthes by 2027. Trauma is one of J&J MedTech’s best performing segments; however, it is ahistorical to think a company can make changes of this magnitude without experiencing disruption. The spin-off will likely affect DePuy Synthes’ sales and create opportunities for other companies to take market share.
Mid-tier Players Build a Base. Globus Medical and Enovis are among the largest players in orthopedics but until recently had very little representation in the trauma market. According to our estimates, both companies surpassed $100 million in trauma sales in 2025. Globus
Medical’s legacy trauma offering is about 80% complete and benefited from the addition of NuVasive’s specialized orthopedic products. Enovis experienced slowing foot and ankle volumes last year but noted signs of a rebound starting in the third quarter.
Large and medium-sized orthopedic companies are seeing success as they expand their presence in the trauma market. Arthrex and Orthofix are additional examples. We expect companies to continue to focus on trauma portfolio opportunities that are synergetic with their other offerings.
Bunion Market Changing Quickly. Numerous companies have entered the bunion market in recent years, creating a competitive, rapidly evolving environment that is shifting toward minimally invasive osteotomies. As companies have expanded their portfolios, they’ve been met with softening procedures volume. Treace Medical conducted a survey of its surgeons, which indicated a 7% volume decline year-over-year as patients deferred elective procedures, especially those with commercial insurance.
Rise in Non-Metal Implants. Bio-integrative and absorbable implants are experiencing greater market adoption. Companies like OSSIO and Bioretec have improved the weight-bearing strength and degradation process of their implant materials, creating opportunities for fractures to heal without the need for long-term metal implants. Advancements in this technology could be meaningful for pediatric and young adult patients, who often undergo a second surgery to have their metal screws removed after their fractures heal.
Filling Gaps in Niche Indications. Smaller companies are entering the market with novel technologies that address the needs of patients undergoing more complex procedures or those with high revision rates. Specifically, pelvis and hip fractures are on the rise as the population ages, and these patients could benefit from improved implant offerings.
CurvaFix recently received FDA clearance for its Low Profile System, a percutaneous solution for the fixation of pelvic fractures. Hyprevention received Breakthrough Device Designation for its Y-STRUT Hip Implant for patients with cancer presenting with bone metastasis or lesions in the proximal femur.
Market Forecast
We expect the trauma market to continue its mid-single growth trajectory and surpass $11.7 billion in global sales in 2029. The health of the global population, return of the foot and ankle market, and expansion of enabling technology into the segment will drive revenue.
Demographic Tailwinds. The trauma market benefits from a longer life expectancy and increased incidence of diabetes and obesity among potential patients who have compromised bone quality and structural integrity. According to the U.S. Department of Health and Human Services, just under a quarter of the population will be 65 or older by 2040. According to the Centers for Disease Control and Prevention (CDC), the prevalence of diagnosed diabetes in the U.S. population is about 9%. Likewise, 2023 data from the CDC showed a staggering 73% of the U.S. adult population was overweight or obese.
Foot and Ankle Volumes Down. While foot and ankle enjoys a high-single digit growth rate, surgical volumes are choppy. The number of procedures slowed in late 2023 and remained inconsistent throughout much of 2024 and 2025. How much longer could the soft market last? There were signs of life in the second half of 2025, and Stryker, for one, thinks 2026 will bring a better market environment.
Companies are still bullish on the market as a high single-digit growth segment and believe there are plenty of unsolved clinical problems that require creative solutions.
Digital Solutions on the Horizon. We expect more trauma-focused enabling technologies to hit the market in the coming years. Eric Tamweber, Stryker’s Vice President and General Manager of Trauma, identified enabling technology as the biggest growth opportunity in core trauma.
How much value can technology bring to trauma care? We’ve seen its impact on revenue and growth in joint replacement and, to a lesser extent, spine. However, the complexity and variability of fractures pose a difficult problem to solve.
It feels like a matter of time before we see robust enabling technology offerings in trauma. Fracture care has such a high degree of variability from case to case that any solution will have to be unique compared to what’s on the market right now. This could be an area where AI-assisted technology might be more than just investor hype.
