The goal of management of an open fracture is to achieve primary bone union.  The wound communicating with the fracture is the most significant factor which influences when and whether it happens.  The wound influences the treatment protocol, the number of days of hospital stay, the time away from work and the cost of treatment.  The fractured bone ends unite primarily only when the wound over the fracture site heals primarily.  Though it appears to be a fact beyond doubt, quite often in the management of an individual patient this is forgotten leading to great morbidity.
Open fractures have had a bad reputation not because of paucity of skeletal fixation techniques, but because of infection and inability to cover wide gaps in soft tissues and bone. The understanding of the pathology of infection in open fractures has rightly laid emphasis on good primary wound care and early wound coverage as the significant factors for success in their management. 
.  Advances in Plastic Surgical techniques and the advent of microsurgery gave the much-needed solutions and increased the rate of limb salvage.
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