Objective Through the Gustilo Ⅲ severely destructive injury of lower limbs were limb-salvage surgery and successful cases were retrospectively analyzed and summarized, to explore Gustilo Ⅲ severe lower extremity injury limb-salvage method, the timing of the limb function reconstruction and the method and curative effect after limb salvage function. Methods In four years, 30 cases in our hospital this study included in standard Gustilo Ⅲ patients with severe lower limb destructive injury, limb salvage surgery.The screening data included intraoperative and perioperative case characteristics, flap survival, surgical complications and overall long-term prognosis.All patients included in this study underwent emergency surgery within 4 to 8 hours after injury.There were 21 cases of external fixator fixation and 9 cases of internal steel plate fixation.There were 22 cases of tibiofibular fracture, 4 cases of femoral shaft fracture, and 4 cases of femoral intercondylar open fracture with dislocation.All the selected patients underwent vascular repair at the first stage. Among them, 12 cases of directly closed wounds and 18 cases of patients who could not be directly sutured received VSD negative pressure suction dressing to cover the wounds.The18 cases underwent second-stage wound repair, 5 cases were directly sutured, 5 cases were free skin grafts, and 8 cases were covered with flaps.The external fixator was replaced with the internal fixator in 26 cases.A retrospective analysis was made on the preoperative judgment, method selection and functional efficacy of clinical limb salvage. Results This group of 30 cases of Gustilo Ⅲ destructive injury of lower limbs limb salvage treatment and successful cases, all cases received follow-up after surgery, 6 months to 24 months follow-up time.The limbs of 24 patients were in good shape, 5 patients underwent second-stage flap repair for hypertrophic scar and swollen skin flap, and 4 patients showed no effect.1 patient developed wound surface infection after surgery, and the bone cement was implanted with antibiotics after the second operation, and healed after 12 months.Among them, 29 patients had good recovery of limb mobility, and the patients were very satisfied with the curative effect of limb salvage surgery.Postoperative VAS score was used: 0-3:27 cases.4-6 points: 3 cases;7-10 points: 0 cases. Conclusion The destructive injury of lower limbs for Gustilo Ⅲ treatment, thorough debridement is the precondition of postoperative healing, microsurgical technique anastomosis is the key to successful limb salvage, choose reasonable fixed way, 1st or 2nd stage wound closure, success can make utmost limb-salvage surgery.