The data of examination and treatment of 356 victims with extremely severe combined injury and shock of III degree were analyzed. All the patients had a medical unfavorable life prognosis. On the basis of the research, it was proved, that the modern approach of treatment of such trauma should include an adequate anti-shock treatment in conditions of the first-level trauma center. The operative activity should be increased in cases of combined trauma of bones by their early external fixation. The authors re commend an application of up-to-date prevention sepsis treatment, late reconstructive - restorative operation performance after its full relief and nutritive metabolic therapy. This approach allowed reducing of the rate of life-threaten infectious complications on 32,4% and noninfectious - on 31,7%, the lethality - on 24%.