Infection after depressed fracture of skull

Abstract

✓ The authors analyze and discuss the 10% infection rate among 359 civilians with compound skull fractures. Infection results from incomplete debridement, for which antibiotics are no substitute. Inadequate treatment usually derives from missing the diagnosis of depressed fracture completely, but sometimes from underestimating the seriousness of the individual injury. Many patients with this injury never lose consciousness, do not have immediate x-ray studies, and are not admitted to hospital; infection is a serious risk in this group. Complete removal of all bone fragments, as recommended for missile injuries, is not necessary. If bone is replaced, the incidence of infection (and of epilepsy) is not greater, and the need for cranioplasty avoided; bone can be safely replaced even when surgery is delayed for 24 hours and when the dura is torn.