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This textbook focuses on the application of external fixation in the acute management of severe orthopedic injuries. It details the indications for using external fixation and offers an evidence-based guide for both specialist orthopedic surgeons and trainees. The manuscript is structured into 15 chapters, covering surgical techniques and indications for injuries of the pelvis, lower limbs, and upper limbs. Detailed illustrations and clinical photographs aid in visualizing construct structures and planning surgical procedures. Additional topics include damage control orthopedics, the biomechanics of external fixation, and medico-legal considerations for injured patients, providing a comprehensive view of the orthopedic trauma patient.