How to treat the fractures in polytrauma patients is still controversial. Some incline to the view that early internal fixation for fractures in polytrauma patients is not indicated. However others advocate the early internal fixation for fractures. The author designed a policy of treating fractures with early internal fixation in polytrauma patients in Beijing Emergency Medical Center and 215 cases (1989—1991) have been reported. In all the cases, early internal fixation of major fracture was adopted routinely. Traffic accident was the leading cause (59% of the total). The severity was estimated with AIS₉₀ —ISS calculations for all of the cases. The average ISS was 30.1 for each case. Eighty—nine cases were multiple system injuries with an average ISS of 4 3, and 12 6 cases multiple fracture—dislocations with an average ISS of 21. Ninety—one cases were complicated with shock. The intracranial injuries occurred in 49 cases, thoracic injuries in 22 cases, abdominal injuries in 22 cases, neurovascular injuries in 33 cases and open injuries in 141 cases. The internal fixation of fractures was performed in 12 hours for 117 cases (54%),24 hours for 151 cases (70%), 48 hours for 181 cases (84%) and 72 hours for 203 (94%). The internal fixation and intramedullary nailing were the first choice for major bone fractures. The mortality was 2.8% (6 cases). Of the 6 deaths, 3 died of severe intracranial injury and 3 multiple organ failure. The ISS of all the 6 non—survival cases were greater than 60. One hundred and eighty—seven cases (87%) had anatomical reduction of fracture and 28 cases (13%) functional reduction. Four cases of open tibial fractures with skin necrosis after surgery resulted in delayed union. Non-union had not occurred. Postoperative wound infection occurred in 11 cases (5%) without osteomyelitis. Amputation was performed in 4 cases due to non—salvable damages. With a discussion on estimation of injury severity, related factors and evaluation of fracture treatment, the author recommended that the major fractures in polytrauma patients should be treated with the early internal fixation immediately following systemic stabilization. This policy proved to be beneficial to prevent systemic complications and raise the survival rate. It provides also a basis for better rehabilitation and functional result.