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The timing of bone plate implantation for open fractures depends on specific circumstances. The following is a detailed analysis:
Within 6 to 8 hours: For open fractures, the wound is fresh within 6 to 8 hours. After thorough debridement, an internal fixation device such as a steel plate can be added to the fracture end. Within 8 to 12 hours, if the wound is not severely contaminated, after thorough debridement, it is also advisable to consider adding internal fixation and suturing the wound. Performing surgery during this period can reduce the risk of infection and restore the stability of the fracture site as soon as possible.
Special case handling: Debridement can still be performed within 12 to 24 hours under the protection of antibiotics, but internal fixators should generally not be implanted. Whether the wound should be sutured depends on the situation. If there is severe inflammation, debridement operation should not be performed. However, in a few cases, if the temperature is low and the pollution is mild, debridement can be performed even after more than 24 hours, and suturing may even be considered.
Waiting for soft tissue recovery: If the fracture site requires special treatments such as granulation tissue growth or secondary bone grafting, the plate may be installed after the final treatment of the fracture site is completed. For instance, in some open fractures accompanied by severe soft tissue injuries, debridement and fracture reduction are performed first under emergency conditions, and external fixation stents are used for fixation. After the soft tissue recovers and the fracture site becomes initially stable, internal fixation with plates and screws is usually carried out after 4 to 6 weeks.