Klifto KM, Azoury SC, Othman S, et al. - As patients with traumatic lower extremity injuries may experience morbidity because of delays in definitive management, researchers herein compared patients with lower extremity injuries directly admitted to a tertiary hospital for definitive care vs those transferred to that hospital following initial treatment elsewhere. From PubMed, Embase, Cochrane Library, Web of Science, and Scopus databases, they identified 19 studies published from 1991 to 2020 comparing 3,367 patients directly admitted with 1,046 patients transferred to a hospital for definitive management of lower extremity injuries. Direct admission to a tertiary center linked with reduced time to first definitive surgical procedure and wound infections as well as with lower risks for diabetic patients, total number of surgeries, osteomyelitis, and total complications compared with transfers. In addition, direct admission may correlate with lower risks for systemic infections, venous thromboembolism, and postoperative bleeding compared with transfer. Overall, findings suggest that morbidity associated with transfer delays may be avoided with earlier admission to a definitive tertiary center.