ABSTRACT
The objective when managing any injured person is to restore maximum function with minimum risk. The first duty is to identify and treat any immediate threats to life. The management of skeletal injuries has to take its rightful place in the overall care of the patient. For the multiply injured, following the Advanced Trauma Life Support (ATLS) system, this rightful place is usually when the primary survey and initial resuscitation have been completed. Very occasionally the haemorrhage associated with a fracture may be life-threatening; thus a pelvic injury may require urgent stabilisation or a major open fracture direct pressure to control blood loss. Most often, extremity injuries are encountered in the secondary survey. The relevant history, including the mechanism of the incident, a top-to-toe clinical examination and appropriate special investigations can be taken into account. Extremity injuries are identified and diagnosed, and their treatment is then planned and executed according to priority.
