The term “Damage Control Orthopedics” refers to provisional immobilization or xation of long bone fractures to minimize the risk of complications such as soft tissue damage, fat embolism, increased inammatory response or severe hemorrhage. Essentially, the use of less invasive and time-con­suming methods of fracture xation to provide tem­porary stabilization of fractures to allow time for stabilization of the patient until denitive xation can be performed. The primary purpose of this is to avoid the “second hit” effect. High energy trauma and shock provoke high levels of inammation that can progress to a dysregulated immunologic response, the development of organ dysfunction, and ultimately multisystem organ failure. A “sec­ond hit” from prolonged surgical intervention may precipitate this process. The goal of damage control orthopedics is to provide stabilization to these inju­ries when possible while avoiding massive blood loss, prolongation of surgical time, and further aggravation of the patient’s inammatory response. Once adequate resuscitation has been performed and the patient is stable from the perspective of life­threatening sequelae from polytrauma, denitive xation may then be safely performed.