The primary treatment for traumatic extremity injury with arterial compromise is surgical restoration of blood flow. Fracture fixation, arterial repair, fas-ciotomy to prevent compartment syndrome, and replantation selected cases, are necessary interventions for limb salvage. Hyperbaric oxygen is an important adjunctive treatment, especially if the tissue is at risk for reperfusion injury The skeletal muscle is particularly at risk due to its sensitivity to ischemia. The degree of muscle damage from I-R injury is proportional to the ischemic interval, especially in cases of warm ischemia, Some degree of permanent damage to the muscle can be expected when ischemia times exceed 4 to 6hours.