This article discusses reconstruction of the infected traumatized joint. In some cases the injured joint has posttraumatic arthritic change, and the surgeon is challenged with known or potential infection that confounds the treatment plan. Failure to treat the associated deep infection adequately results in failure to achieve the surgical goals. Ongoing infection can compromise the soft tissue envelope significantly by sinus tract formation or inflammation. The local bone may be eroded or softened which compromises the reconstructive alternatives. Attempted fusion in the face of undiagnosed and untreated infection may cause the fusion to fail. All of these issues can result in a below-knee amputation.