[Treatment of soft tissue damage--definitive management].

Fractures of the extremities combined with soft tissue damage are still a big challenge for the orthopaedic surgeon. Medical mismanagement leads very often to osteomyelitis and high treatment costs. Radical débridement is the key to therapy success. Closure of soft tissue lesions has to be done within 1 week. Methods of choice are vacuum sealing, meshgraft, flap transfer and the Ilisarov procedure. The chosen tool has to be harmonized with the fracture classification. Only individual decisions are possible. For the best results, orthopaedic surgeons should have a good knowledge of the reconstructive possibilities.