This practical and generously illustrated text presents current concepts regarding the management of the mangled extremity, including microsurgery, vascular surgery, free tissue, nerve, hand, and replantation surgery. Since the advent of microsurgical reconstruction, significant progress has been made in the areas of replantation, free tissue transfer, as well as the refinement of skeletal fixation techniques. The scope will encompass the initial triage of a patient with a mangled upper or lower extremity, the initial and subsequent reconstructive efforts, to include skeletal fixation, vascular and soft tissue reconstruction, muscle and tendon transfers, psychological impact, therapy requirements, amputation considerations, and current data on salvage versus amputation in these scenarios. Case examples will be included to add further depth and context to the techniques and recommendations provided. It will be an ideal resource for orthopedic and trauma surgeons, residents and fellows, as well as emergency surgeons facing these intense, traumatic injuries.