The first step in the management of open fractures is debridement, and fresh open fracture wounds in the early post-injury period (within 8 hours) should be debrided as soon as possible to thoroughly remove inactivated tissues and foreign bodies that contaminate the wound and to close the wound to prevent infection. Therefore, efforts must be made to perform debridement and closure within 6 to 8 hours. Suturing should also be done with attention to the wound tension, but for small skin defects, suturing can be done directly without tension. First-stage closure of the wound must be performed without tension and should never be forced to close directly. Otherwise, the internal tension of the wound increases and the blood supply is affected, resulting in ischemic necrosis of the skin margins and deep tissues, which increases the risk of infection. For open fractures, proper and effective fracture fixation is required as soon as possible to minimize re-injury to the tissue. External fixation is unique for open fracture fixation, easy to use, reliable, convenient for trauma treatment, and good for functional exercise, and is suitable for all types of open fractures. Antibiotics are essential in the treatment of open fractures and must be administered as early as possible. High concentrations of local antibiotics are still effective in inhibiting bacteria or sterilization, and the intravenous route of administration of adequate antibiotics is most appropriate.