Lower limb fractures are common injuries in prehospital care. Untreated fractures can lead to hypovolaemic shock especially if open, and should be treated with effective haemorrhage control and splintage. A brief assessment for open fractures, deformity, and neurovascular compromise should be followed by effective analgesia, wound management, reduction (if needed), splintage, and packaging of the patient. Early appropriate management reduces the morbidity and mortality of lower limb fractures.