More than 60 percent of injuries involve the musculoskeletal system, and more than half of hospitalized trauma patients have at least one musculoskeletal injury that could be life threatening, limb threatening, or result in significant functional impairment. These orthopaedic injuries are often associated with significant health care costs, decreased productivity in the workplace, and, in some cases, long-term disability. The optimal management of trauma patients with orthopaedic injuries requires significant physician and institutional commitment. The American College of Surgeons (ACS) Resources for the Optimal Care of the Injured Patient, 2014 includes several key hospital and providerlevel orthopaedic trauma criteria that must be met in order to attain American College of Surgeons trauma center verification. Although these criteria are important, they do not cover the entire breadth of orthopaedic trauma care. Furthermore, trauma centers may identify areas in need of improvement that are unique to their hospital. These best practice guidelines represent a compilation of the best evidence available for each respective topic. In areas where the literature is inconclusive, incomplete, or controversial, expert opinion is provided.