Retained intracranial bone fragments: analysis of 42 patients.

Forty-two patients with retained intracranial bone fragments from Vietnam war wounds were evaluated and treated at the Walter Reed General Hospital. Forty required further debridement, 16 had positive wound cultures while they were on antibiotic therapy, 23 had gross evidence of infection, and the remainder also had debris and necrosis at the retained bone fragment sites. There were eight in-hospital deaths. All surviving patients available to follow-up have been free of infection. Retained intracranial fragments of bone should be removed as early as is possible.