The high energy trauma induces severe open fractures and soft tissue crushing injuries on extremities. These mangle limb injuries are always big challenges for orthopedic and plastic surgeons on their daily clinical practices. In this presentation, we will discuss the optimal options for limbs salvage based on the orthopedics point of view. The content of discussion involves the following key points:
1. The paradigm of orthopedic treatment policy for the open fracture management.
2. The evolution of implants for bony treatment of these mangle limbs which included instructions for temporary bony stabilization and implants for definite bony osteosynthesis.
3. The evolution of orthopedic techniques for bony restoration while treating patients with comminuted bony fracture or segmental bone deficit.
4. The alternative bony fixation policy that orthopedic surgeons should take while treating the mangle extremities with significant soft tissue compromise.
After this discussion, we wish that we can set up a better cooperation between the orthopedic and plastic surgeon in order to provide better treatment options for those patients with mangle limb injuries.