Major lower limb injuries involve skin and soft tissue, bone, vascular, and neural elements, which influences evaluation and management for optimal functional outcome. In major lower limb trauma, often polytrauma, the question is whether to salvage or amputate. This issue has conflicting and confusing data. For cultural and practical reasons, patients prefer to keep a deformed limb if it's painless and functional. This review examines the management of lower limb injuries. It also answers other questions that may improve functional outcomes for patients with major limb injuries. After reading this article, participants should be able to evaluate a patient with a lower extremity wound before medical or surgical intervention, recognise that limb amputation and salvage can both be appropriate definitive treatment options, and select proper nonsurgical or surgical techniques for wound management.

Keywords: Lower limb injuries; Management; Principles.