All open fractures require open debridement and irrigation.
The fractures should be reduced and aligned as accurately as possible and initially splinted in some fashion. As previously stated, the neurovascular status of the extremity must be established and care must be taken not to compromise the vascular status of the extremity. Biplanar radiographs are desirable to optimally treat any fracture. It should be kept in mind that the primary objective in management of extremity wounds is to optimize the situation such that early wound healing can be obtained, infection prevented, and function restored. Internal fixation of fractures resulting from war wounds is generally contraindicated in the initial stage of wound management.