Severe injuries of the extremities are caused by high-energy trauma and are characterized by a combination of complex fractures with extensive damage of soft tissues and neurovascular structures. The potential loss of the affected limb can be associated with a life-threatening emergency for the patient irrespective of whether the injury occurs as a monotrauma or as part of multiple injuries. Substantial improvements in preclinical and inhospital treatment over the last decades reduced mortality in severe trauma meaning that more patients survive high-grade extremity injuries than in the past. This article provides the reader with an overview of the current principles of the surgical treatment of complex limb injuries and the principles of the decision-making process in limb salvage surgery versus amputation are outlined. The article is based on a literature search in PubMed and includes examples from the practical daily routine of the authors.     «

Severe injuries of the extremities are caused by high-energy trauma and are characterized by a combination of complex fractures with extensive damage of soft tissues and neurovascular structures. The potential loss of the affected limb can be associated with a life-threatening emergency for the patient irrespective of whether the injury occurs as a monotrauma or as part of multiple injuries. Substantial improvements in preclinical and inhospital treatment over the last decades reduced mortality...     »