In case of polytrauma involving musculoskeletal injuries, it is often unclear whether ETC (early total care) or DCO (damage control orthopaedics) would bring about the best possible outcome.The present study was conducted to identify the timing of fracture fixation in poly-trauma patients: Early Total Care and Damage Control Orthopaedics. The study was conducted at MIOT Hospitals, Chennai, India from 1-Oct-2014 to 1-Dec-2015 for a period of 14months. One hundred and forty nine cases of poly-trauma with musculoskeletal injuries were selected and classified as stable, borderline, unstable and in extremis and received either ETC or DCO. The patients were objectively evaluated pre-operatively, post operatively and at 2weeks, 2 months, 4 months and 6months after discharge. Of the 149 cases 69 cases received DCO while 80 received ETC.