Abstract： Objective To explore the clinical skills and outcomes of limb-salvage surgery for Gustilo ⅢB and ⅢC fractures in the lower limb. Methods From October 2008 to January 2012,82 patients with Gustilo ⅢB and ⅢC fractures in the lower limb were treated in our hospital.They were 64 men and 18 women,aged 21 to 64 years (45.3 years on average).There were 63 cases of Gustilo ⅢB fractures and 19 cases of Gustilo ⅢC fractures.The fractures involved the tibiofibula in 37 cases,the tibia in 6,the femur in 9,the bilateral tibiofibula in 5,the tibiofibula and femur in 11,and the tibiofibula and metatarsophalangeal bones in 14.By the mangled extremity severity score (MESS) system,32 patients scored from 6 to 7 points,21 below 6 points and 29 above 7 points.The treatment included debridement,skeletal reconstruction,vacuum sealing drainage (VSD) and delayed flap reconstruction.For definitive wound coverage,4 wounds received primary closure,13 a split-skin graft,16 a muscle flap,41 a local or cross-leg fasciocutaneous flap and 4 a free flap. Results The 82 patients got a follow-up from 4 to 53 months (average,17 months).Of them,78 had their injured limbs saved and 4 had to undergo secondary amputation below the knee.On average,those with successful limb salvage underwent VSD for 1.6 times and surgery for 3.7 times. Sixty-six fractures were primarily healed after an average time of 6.4 months.Seven patients were afflicted by delayed union,5 by nonunion,9 by wound infection and 3 by chronic osteomyelitis. Conclusion Gustilo ⅢB and ⅢC fractures in the lower limb can be successfully salvaged by debridement,skeletal reconstruction,VSD and delayed flap reconstruction.