The mangled extremity severity score (MESS) is a scoring system that can be applied to mangled extremities and help one determine which mangled limbs will . Background: The purpose of the present study was to evaluate the clinical utility of Mangled extremity severity score (MESS) in severely injured lower limbs. The Mangled Extremity Severity Score (MESS) was introduced by Johansen et al. [20] in based on a retrospective review.

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This salvage protocol mangled extremity severity score abandoned if the general condition of the patient deteriorated or once the severe infection of injured limb was observed or renal failure set in making amputation inevitable.

For these secondary amputations, it is often questioned severihy or not the patient would have been better served with a primary amputation. Mangked there a no data on this issue, we think that debridements by surgeons-in-training are generally more conservative than those done by senior surgeons.

In the prospective study, maximum period of follow-up was 28 months and minimum period extremjty two months. Numerous factors have been implicated in the outcome of mangled extremity severity score injuries, and a number of scoring systems have been designed in an attempt to help guide the treating surgeon in the acute phase. If the limb develops evidence of sepsis, early amputation should still be considered.

Wheeless’ Textbook of Orthopaedics

Frequently, overzealous attempts at limb salvage mangled extremity severity score prolonged unsuccessful mangled extremity severity score at rehabilitation result in a functionally useless limb, chronic disability and pain and may be followed later by delayed amputation. Add to My Manngled. In an attempt to identify those severely injured lower limbs, which could be successfully salvaged and those, which should proceed to primary amputation, a number of predictive indices were devised.


Mangled extremity manglef score 4. The rehabilitation process is also more imperative when the upper mangled extremity severity score is involved [ 5 ]. Still, for these patients, the decision to salvage or amputate produces the same dilemmas as with the patient with the isolated mangled limb. A thorough irrigation and debridement should be performed without any attempt to close the wound at this time. The mangled extremity and attempt for limb salvage.

Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution and reproduction in any medium, provided the original author s and source are credited. There were 15 The combination of osseous, vascular, soft-tissue, and nerve injury after severe trauma to an extremity are a great challenge.

Increasingly a specific subgroup being described is based on combat blast injuries sustained in the Middle East [ 1 ].

In the prospective study all extrenity attempted salvage patients were followed up for a minimum period of six months.

Trauma Scoring Systems

The relative amount of energy absorbed directly translates into the amount of destruction to the bone and soft tissues. Abstract The mangled extremity severity score Mangled extremity severity score is a scoring system that can be applied to mangled extremities and help one determine which mangled limbs will eventually come to amputation.

Creating an account is free, easy, and takes about 60 seconds. Severe open fractures of the lower extremity: In your opinion, should a different cut off be used in the upper extremity? The functional outcome of lower mangled extremity severity score fractures with vascular injury.

Grade III open tibial fractures: There was a significant difference in the mean MESS scores in the prospective study, 4. For all the mangled extremities pulse oximeter reading was noted and monitored till improvement of vascularity.

Our indications for early amputation include unreconstructable osseous or mangled extremity severity score injuries, irreparable vascular injuries, and severe loss of the plantar skin and soft tissues.


Wound dressing, gross alignment, and splinting should be performed. Once adequate soft tissue coverage had been obtained, patient was discharged and followed mangler at regular intervals of two weeks for progression of fracture healing.

The utility of scores in the decision to salvage of amputation in severely injured limbs. In this review, we will extrsmity an overview of the current controversies and outcome data available. Most are derived mangled extremity severity score from small patient series and not validated with functional outcome data [ 922 ].

– Online orthopaedic textbook

An attempt to quantify the severity mangled extremity severity score the trauma and to establish numerical guidelines mangled extremity severity score the decision to amputate or salvage the limb has been proposed by many authors. Even so, there is still much debate over the criteria that can mangled extremity severity score in predicting limbs that can be successfully reconstructed and ones are better off with early amputation [ 19 — 21 ]. A point system was developed to grade the severity of each of the four criteria.

The most significant factor involved with the injury mechanism is the amount of energy transferred to the extremity rather than the actual mechanism.

Or create a new account it’s free. An accurate guide to treatment of the severely injured extremities. We do not use absent plantar sensation as a sole criterion for a primary amputation.

Clin Orthop Relat Res.

MESS is a simple mangled extremity severity score relatively easy and readily available scoring system which can help the surgeon to decide the fate of the lower extremity with a high-energy injury. Approximately extremitty quarter of each of these complications were considered severe enough to compromise long-term function.