The management of severe fractures of the lower extremities.

This review is designed to address the problem of severe fractures of the lower extremities that often accompany the patient who is polytraumatized. Although open fractures occupy a predominant place in the subsequent discussion, closed fractures also may be associated with a significant crush component, a vascular lesion, a degloving injury, or a compartment syndrome. It is of paramount importance that the treating physician understand the implications of the potential or actual soft tissue damage to maximize the outcome after these devastating injuries.