The overarching approach for the session is to improve recognition/understanding of fracture environment, configuration, forces acting upon the bone(s) and joints, and how that may dictate the chosen method of fixation. This presentation presents thought processes behind the use of external skeletal fixation for fracture stabilization. The presentation is heavily case-based, highlighting the creativity and versatility of linear, hybrid and circular ring ESF and why it’s important that surgeons have these implants and techniques in their toolbox.