Abstract
An open fracture with extensive skin and soft tissue loss is considered as a severely
injured lower extremity. Advances in rapid transport, resuscitation, skeletal fixation,
and microsurgical techniques to cover large soft tissue and bone defects have made
possible the salvage of these severely injured limbs. Salvage exercise is skill and
resource intensive and could take a long time frame. The goal of management is to
obtain painless independent weight bearing walking in a time frame and cost that the
patient can afford.
Decisions taken and the quality of care provided on day 1 determine the ultimate success.
Inappropriate decisions and treatment lead to increased morbidity and secondary amputation.
Infection is the commonest complication. Limb salvage scores are helpful to predict
salvage and guide the sequence of treatment. Once the decision is taken for salvage,
debridement, early skeletal fixation, and soft tissue cover are the key to success.
Keywords
open fractures - lower limb - debridement - limb salvage scores
