Sethuraman AS, Devendra A, Rajasekaran RB, et al. - Between February 2018 and June 2019, researchers examined 78 adult patients with a severe open tibial fracture that presented to our institution, a Level 1 trauma center in India. Twenty individuals had undergone above-knee amputation, 16 had undergone below-knee amputation, and 42 had undergone limb salvage. Injury severity was assessed using [our institution's] Open Injury Severity Score (GHOISS), which has separate sub-scores for bony injury, skin injury, neuromuscular injury, and co-morbidities, and patients were only included with GHOISS > 13. They evaluated functional outcome measures as well as economic costs as primary cost levied by our institution and other secondary costs. In comparison with amputation, limb salvage results in better functional outcomes at a higher upfront cost but a likely lower lifetime cost. In India, amputation carries a heavy mental and physical toll, likely due to sociocultural differences and stigma. The study demonstrated that for patients, amputation is a difficult decision to accept and results in poorer outcomes; thus, they believe that limbs should be aggressively salvaged in the developing country.