Aim: The objective of this study was to evaluate different bone fixation techniques and skin coverage methods in the treatment of open leg fractures in high-risk environments.Methods: This retrospective, observational study was conducted over a four-year period, involving patients aged 15 years and older who underwent osteosynthesis and plastic surgical procedures for fracture site coverage. A total of 50 patients were included in the study.Results: The study cohort comprised 40 men and 10 women. The leading cause of injury was road traffic accidents (90%, n=40), followed by workplace accidents involving heavy objects falling on the leg (10%, n=5). Based on the Gustilo and Anderson classification, wounds were classified as Type II (40%, n=20) and Type IIIB (60%, n=30).Conclusion: Open leg fractures are common and severe injuries, with a rising incidence primarily due to the increase in road traffic accidents. These fractures have a significant socioeconomic impact, particularly affecting young, active males. Their management poses a considerable challenge in daily clinical practice.Following meticulous debridement and tissue trimming, external fixation is the most frequently used bone stabilization technique, while muscle flaps are preferred for covering extensive soft tissue defects. The study's results were satisfactory and comparable to findings from similar research conducted under analogous conditions. Based on the AO classification, the tibial fracture was categorized as simple in 54% of cases and complex in 46%.