Martine Merete Enger

• Oftebro, Ingrid; OLSEN, BØRGE; Enger, Martine Merete; Hassellund, Skjalg Stafsnes & Solberg, Lene Bergendal (2026). Variation in surgical indications across national distal radius fracture guidelines: A comparative review. Injury. ISSN 0020-1383. 57(8), p. 113480–113480. doi: 10.1016/j.injury.2026.113480. Full text in Research Archive
• Skjaker, Stein Arve; Enger, Martine Merete; Pripp, Are Hugo; Nordsletten, Lars & Bøe, Berte Marie Grimsmo (2025). Inter- and Intrarater Reliability of the Acromioclavicular Joint Injury Classification on Anteroposterior Radiographs. Orthopaedic Journal of Sports Medicine (OJSM). 13(5). doi: 10.1177/23259671251337470. Full text in Research Archive Show summary

  Background: Previous radiographic reliability studies of the acromioclavicular (AC) joint are from smaller and/or selective patient populations. Purpose: To investigate the inter- and intrarater reliability of the Rockwood classification of AC joint injuries on standard anteroposterior (AP) radiographs in an urban population. Study design: Cohort study (diagnosis); Level of evidence, 2. Methods: All suspected shoulder injuries from May 2013 to April 2014 at the Department of Orthopedic Emergency, Oslo University Hospital, were registered by admittance. Patients with anteriosuperior shoulder pain and maximum point tenderness over the AC joint were assessed. In total, 287 consective AC joint injuries were registered of the 2650 shoulder injuries in residents. From the 287 patients with AC joint injury 268 were ultimately included in the present study. On 2 occasions >6 weeks apart and blinded from each other, 2 orthopaedic consultants, 2 orthopaedic residents, and 2 musculoskeletal radiology consultants independently classified the cohort. In the interrater analyses, the raters were also stratified based on clinical experience and specialty. All raters evaluated 2 standardized nonweightbearing AP radiographs for each patient, performed by tilting the beam 15° in the cephalic and caudal direction, respectively. Reliability was assessed based on Cohen kappa (k) values. Results: Interrater reliability for all raters and for the stratified groups in rounds 1 and 2 was substantial for the Rockwood classification. The interrater reliability improved from round 1 to round 2 for all raters (agreement: 92% vs 94%, k = 0.66 vs 0.73, respectively), orthopaedic consultants (agreement: 90% vs 93%, k = 0.61 vs 0.72, respectively), orthopaedic residents (agreement: 92% vs 94%, k = 0.61 vs 0.76, respectively), and musculoskeletal radiology consultants (agreement: 93% vs 94%, k = 0.70 vs 0.73, respectively). No significant differences in intrarater reliability between the groups were seen for orthopaedic consultants (k = 0.72), orthopaedic residents (k = 0.73), and musculoskeletal radiology consultants (k = 0.79). One of the radiology consultants had the highest intrarater k value (k = 0.84), significantly higher than one of the orthopaedic consultants (k = 0.67) and one of the orthopaedic residents (k = 0.66). The three other raters had substantial intrarater agreement (k = 0.75 to 0.80). The raters had a strong majority agreement (≥4/6 raters) of the Rockwood classification in 82% of the patients in round 1, and in 83% in round 2. Rockwood type II had low majority agreement, with no 5- or 6-raters (only ≤4/6) agreement. Conclusion: Nonweightbearing unilateral AP radiographs of AC joint injuries expressed substantial inter- and intrarater reliability. There was an improvement in interrater reliability for all groups from round 1 to round 2. One of the raters had an almost perfect intrarater reliability, and the rest had substantial reliability. The majority agreement for Rockwood type II injuries was low.

• Enger, Martine Merete; Schmidt, Malte; Nordsletten, Lars; Moosmeyer, Stefan; Pripp, Are Hugo & Melhuus, Knut [Show all 7 contributors for this article] (2025). Physical examination tests in the acute phase of shoulder injuries with negative radiographs: a diagnostic accuracy study. BMC Musculoskeletal Disorders. 26(1). doi: 10.1186/s12891-025-08754-1. Full text in Research Archive Show summary

  Background Rotator cuff tears may easily be missed in patients with acute shoulder trauma. The evidence in support of shoulder physical examination tests has been considered insufficient in reviews and meta-analyses. The purpose of this study was to explore whether physical examination tests can effectively predict or rule out acute full-thickness rotator cuff tears in soft tissue shoulder injuries in emergency departments and primary health care. Methods In a combined primary care walk-in clinic and secondary care orthopaedic emergency department, 120 consecutive patients aged ≥ 40 years with acute shoulder injury without fracture on plain x-rays were enrolled prospectively at the first follow-up within three weeks of the injury. Thirteen physical examination tests and ultrasound screening as reference standard, were performed blinded to each other. Results The median age was 55 years, 51% were female. The prevalence of the target condition rotator cuff full-thickness tear and/or occult fracture of the insertion was 38% (n = 46; 38 tears and 8 occult avulsion fractures). Almost all tears involved the supraspinatus tendon (n = 36). The highest test accuracy was observed for the inability to abduct above 90°, resisted abduction pain and external rotation strength. The sensitivity, specificity and diagnostic odds ratio of the inability to abduct the arm above 90 ° was 84% (95% CI 69–93), 71% (95% CI 59–82) and 12.9 (95% CI 4.8–34.2), respectively, and 66% (51–80), 86% (77–93) and 12.4 (5.0–30.8) for external rotation strength assessed by the small finger test. Combining the inability to abduct above 90° and weakness in external rotation improved the sensitivity to above 90% and the diagnostic odds ratio to above 22, but specificity decreased. Conclusions The present study suggests that two simple tests, the inability to abduct above 90° and weakness in external rotation may effectively predict full-thickness tears of the supra- and infraspinatus and/or occult fracture at their insertion in the acute phase of soft tissue shoulder injuries. The test combination may be useful for selecting patients for advanced imaging and for diagnostic purposes when such imaging is not available. Trial registration The Norwegian Regional Ethics Committee South East (2015/195) on 24th March 2015, and retrospectively registered on ClinicalTrials.gov (NCT02644564) on 31st December 2015.

• Stray, August Vincent; SIVERTS, HENRIK; Melhuus, Knut; Enger, Martine Merete; Galteland, Pål & Næss, Ingar [Show all 8 contributors for this article] (2022). Characteristics of Electric Scooter and Bicycle Injuries After Introduction of Electric Scooter Rentals in Oslo, Norway. JAMA Network Open. p. E2226701–E2226701. doi: 10.1001/jamanetworkopen.2022.26701. Full text in Research Archive
• Stødle, Are Haukåen; Hvaal, Kjetil; Enger, Martine Merete; Brøgger, Helga Maria; Madsen, Jan Erik & Husebye, Inger Elisabeth Ellingsen (2019). Lisfranc injuries: Incidence, mechanisms of injury and predictors of instability. Foot and Ankle Surgery. ISSN 1268-7731. doi: 10.1016/j.fas.2019.06.002. Full text in Research Archive Show summary

  Background In Lisfranc injuries the stability of the tarsometatarsal joints guides the treatment of the injury. Determining the stability, especially in the subtle Lisfranc injuries, can be challenging. The purpose of this study was to identify incidence, mechanisms of injury and predictors for instability in Lisfranc injuries. Methods Eighty-four Lisfranc injuries presenting at Oslo University Hospital between September 2014 and August 2015 were included. The diagnosis was based on radiologically verified injuries to the tarsometatarsal joints. Associations between radiographic findings and stability were examined. Results The incidence of Lisfranc injuries was 14/100,000 person-years, and only 31% were high-energy injuries. The incidence of unstable injuries was 6/100,000 person–years, and these were more common in women than men (P = 0.016). Intraarticular fractures in the two lateral tarsometatarsal joints increased the risk of instability (P = 0.007). The height of the second tarsometatarsal joint was less in the unstable injuries than in the stable injuries (P = 0.036). Conclusion The incidence of Lisfranc injuries in the present study is higher than previously published. The most common mechanism of injury is low-energy trauma. Intraarticular fractures in the two lateral tarsometatarsal joints, female gender and shorter second tarsometatarsal joint height increase the risk of an unstable injury.

• Enger, Martine Merete; Skjaker, Stein Arve; Nordsletten, Lars; Pripp, Are Hugo; Melhuus, Knut & Moosmeyer, Stefan [Show all 7 contributors for this article] (2019). Sports-related acute shoulder injuries in an urban population. BMJ Open sport & exercise medicine. 5(1), p. 1–9. doi: 10.1136/bmjsem-2019-000551. Full text in Research Archive Show summary

  More than a third of sports injuries involve the upper extremity. The primary aim was to quantify and describe sports-related shoulder injuries in a general population cohort. A secondary aim was to compare aspects of these injuries to those that were not sports-related.We performed a prospective registration of the activity at the time of shoulder injury in all cases admitted during 1 year in a combined primary care and orthopaedic emergency department serving a defined population. The electronic patient records and patient reported questionnaires were reviewed.Twenty-nine per cent (n=781) of 2650 registered shoulder injuries were reported to be sports-related, with the highest proportion in acromioclavicular injuries (>50%). Patients with sports injuries were younger than those injured during other activities (median age 28 and 43 years, respectively, p<0.001), and more often male (78% and 52%, respectively, p<0.001). There was a strong gender disparity in incidence of sports-related shoulder injuries in adolescents and young adults, which was not observed in non-sports shoulder injuries. Football (soccer) (6–29 years), cycling (30–49 years), skiing (50–69 years) and martial arts were the dominating sports activities. Fractures were more common in skiing and cycling than in other major sports in the study.Almost a third of the shoulder injuries occurred during sports. The types of sports involved varied with age and gender. The comparison of sport to non-sport shoulder injury incidence rates suggests that the increased risk of shoulder injuries in young males is mainly attributable to sports injuries.

• Liavaag, Sigurd; Stiris, Morten Georg; Svenningsen, Svein; Enger, Martine Merete; Pripp, Are Hugo & Brox, Jens Ivar (2011). Capsular lesions with glenohumeral ligament injuries in patients with primary shoulder dislocation: magnetic resonance imaging and magnetic resonance arthrography evaluation. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 21(6), p. E291–E297. doi: 10.1111/j.1600-0838.2010.01282.x. Full text in Research Archive Show summary

  The glenohumeral ligaments are important structures for the stability of the shoulder. They are integrated parts of the capsule and are at risk to be injured in a traumatic shoulder dislocation. The aim was to examine the prevalence of capsular ligament lesions in the acute phase and at minimum 3 weeks' follow-up after first-time traumatic shoulder dislocation. Forty-two patients aged 16-40 years were included. All patients underwent computed tomography and magnetic resonance imaging (MRI) scans shortly after the injury and MR-arthrography (MRA) at follow-up. The median time from dislocation to MRI was 7 (range 2-14) days and to MRA 30 (range 21-54) days. We found capsular ligament lesions in 22 patients (52.4%) in the acute stage and in five patients (11.9%) at follow up. Nine patients (21.4%) had a humeral avulsion of the anterior glenohumeral ligament (HAGL lesion) on MRI. Three patients (7.1%) had this lesion at follow-up. The rate of HAGL lesions in the acute stage was higher than reported previously, but the prevalence at follow-up was in keeping with earlier published studies.

• Liavaag, Sigurd; Svenningsen, Svein; Reikerås, Olav; Enger, Martine Merete; Fjalestad, Tore & Pripp, Are Hugo [Show all 7 contributors for this article] (2011). The epidemiology of shoulder dislocations in Oslo. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 21(6), p. E334–E340. doi: 10.1111/j.1600-0838.2011.01300.x. Full text in Research Archive
• Liavaag, Sigurd; Brox, Jens Ivar; Pripp, Are Hugo; Enger, Martine Merete; Soldal, Lars Atle & Svenningsen, Svein (2011). Immobilization in External Rotation After Primary Shoulder Dislocation Did Not Reduce the Risk of Recurrence A Randomized Controlled Trial. Journal of Bone and Joint Surgery. American volume. ISSN 0021-9355. 93A(10), p. 897–904. doi: 10.2106/JBJS.J.00416. Full text in Research Archive
• Liavaag, S; Stiris, Morten Georg; Lindland, ES; Enger, Martine Merete; Svenningsen, S & Brox, Jens Ivar (2009). Do Bankart lesions heal better in shoulders immobilized in external rotation? A randomized single-blind study of 55 patients examined with MRI. Acta Orthopaedica. ISSN 1745-3674. 80(5), p. 579–584. doi: 10.3109/17453670903278266. Full text in Research Archive

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• Bredesen, Ida Marie; Johansen, Edda Aslaug; Bååth, Carina Barbro; Grøndahl, Vigdis Abrahamsen & Enger, Martine Merete (2025). Riktig behandling av hudflenger reduserer risikoen for alvorlige sår. Sykepleien. ISSN 0039-7628. doi: 10.4220/Sykepleiens.2025.99090. Full text in Research Archive
• Bredesen, Ida Marie; Enger, Martine Merete; Beeckman, Dimitri; Bååth, Carina; Grøndahl, Vigdis Abrahamsen & Johansen, Edda Aslaug (2025). Do knowledge levels in skin tear management change following a conference lecture? A pre-post study at the Norwegian orthopaedic nurse congress. Full text in Research Archive
• Eeg-Henriksen, Hanne & Enger, Martine (2023). Taushetsplikt, opplysningsrett og avvergingsplikt. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 143(16). doi: 10.4045/tidsskr.23.0486. Full text in Research Archive
• Sundstrøm, Terje; Wester, Knut; Enger, Martine Merete; Melhuus, Knut; Ingebrigtsen, Tor & Romner, Bertil [Show all 7 contributors for this article] (2013). Nye retningslinjer for hodeskader. 133, p. 2342–2343. doi: 10.4045/tidsskr.13.1291. Full text in Research Archive
• Sundstrøm, Terje; Wester, Knut; Enger, Martine Merete; Melhuus, Knut; Ingebrigtsen, Tor & Romner, Bertil [Show all 7 contributors for this article] (2013). Skandinaviske retningslinjer for akutt håndtering av voksne pasienter med minimal, lett eller moderat hodeskade. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 133, p. E1–E6. doi: 10.4045/tidsskr.13.0916. Full text in Research Archive

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