<s>[INST] I had an open fracture to my elbow 3weeks ago they put in surgery an irrigated it and closed it up however the did not fix anything else it was dislocated as well as radial and fracture to my humorous is it too late now if I need more surgery or pins I also broke my wrist [/INST] Hello, I have studied your case and I think that you need surgery. Some time when there is open fracture that time putting plate and screw is not advisable, so some surgeon prefers only external fixation.  If there is dislocated bone then you need fixation once wound is healed and preferably with in three weeks.  If you want further opinion then you can ask direct questions Fromm with x-ray report. I hope this will help you. Thanks </s>