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Multiple-injury patients absorb a large amount of trauma energy in their trunk, resulting in multiple organ injuries and often long-bone and axial skeletal fractures. Severity of these injuries can be quantified using the Trauma Index (TI) and Injury Severity Score (ISS). These systems allow not only a comparison of mortality and morbidity among institutions, but also serve as criteria for triage, emergency, and subsequent management of patients. We reviewed 229 multiple-trauma patients with orthopedic injuries who were treated in our trauma center. Based on the aim of orthopedic intervention performed within 1 week of injury, patients were divided into four groups: group A, surgery for supporting patient's life (n=8); group B, surgery for salvaging limbs and limb function (n=81); group C, surgery for preventing the development of serious complications (n=92); and group D, minor surgery performed according to the general situation (n=48). Both the TI and ISS were compared among these four groups. Furthermore, both the TI and ISS were compared between patients who died within 24 h and those who survived for longer. The ISS was significantly different between groups B and C (P