Open fx is one of most serious injury in motor car accident. Infection /osteomyelitis/amputation and frequent admission in hospital and IV antibiotic and surgery are common complication of this problem. Life saving limb saving prior to the other practice. Take a photo by cell phone then call for help and cover the wound /control of bleeding and keep person warm is principles to management for open wound with fracture. Don’t move victim injured area care limb with splint. According to newest international guideline antibiotic injection can be reduced infection rate and other complication.