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 . Mangled Extremity Severity Score (MESS). Introduction. used to predict necessity of amputation after lower extremity trauma. Variables. skeletal. fractures, soft tissue damage, vascular, nerve and tendon lesions. The Mangled Extremity Severity Score (MESS) is probably the most common scoring system.

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External fixator was replaced with a cast when there was no sign of infection, adequate soft tissue coverage was obtained and the fracture healing was progressing satisfactorily. Calc Function Calcs that help predict probability of a disease Diagnosis.

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Study Year Mean in salvaged limbs Mean in amputated limbs Johansen et al.

Adequate physiotherapy was carried out depending upon the circumstances. This salvage protocol was abandoned if the general condition of the patient deteriorated or once the severe infection of injured limb was mwngled or renal failure set in making amputation inevitable.

Table 2 Comparison of mean Mangled extremity severity score in the other studies. LSI score of less than 6 predicts successful limb salvage severityy LSI score of 6 or more than six predicts amputations. The mean hospitalization for primary amputation was Six months were severitj as the end point because patients who had amputation after that time would be most likely to have had major complications or intolerance to additional reconstruction efforts or both. Creating an account is free, easy, and takes about 60 seconds.


L6 – years in practice. I do not believe MESS should be considered dependable, and therefore utilized for decision-making, in kids, in upper extremity trauma or to predict longterm functional outcomes.

In the retrospective study 4. Hansen 2 in analyzing his vast personal experience with managing open fractures, noted extremiyt protracted limb salvage attempts may destroy a person physically, psychologically, socially and financially, with adverse consequences for the entire family as well.

The appropriate contemporary lower extremity threshold value we avoid the term “cut-off”!! Score taken at hospital admission. Pulseless, paresthesias, slow capillary refill.

Trauma Scoring Systems

Please vote below and help us build the most advanced adaptive severigy platform in medicine The complexity of this topic is appropriate for? Table 1 Mangled extremity severity score 4. In spite of best attempts, the functional results are often worse than an amputation. The purpose of the present study was to evaluate the clinical utility of Mangled extremity severity score MESS in severely injured lower limbs.

They concluded that MESS is not sufficiently precise to allow the decision regarding amputation to be made at the initial operation.

Trauma Scoring Systems – Trauma – Orthobullets

Log In Create Account. A decision based on a seven-part predictive index. Arterial scoree in the lower limb from blunt trauma.

The MESS can potentially identify at time of initial evaluation patients who are candidates for successful limb salvage vs future amputation. High energy high speed MVA or rifle shot. Evidence Appraisal Original study Published in based on a retrospective chart review of over lower extremity long bone fractures at Harborview Medical Center in Seattle. Journal List Indian J Orthop v. Clin Orthop Relat Res. MESS was done at the extrsmity of admission or on the operation table, according to Table 1.


While the evolution of sophisticated microsurgical reconstruction technique has created the possibility of successful limb salvage in even the most extreme scire, it has become painfully obvious that the technical possibilities are double-edged swords.

Mangled Extremity Severity Score (MESS)

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. Forrest Classification Estimate risk of re-bleeding post-endoscopy for upper GI bleeding.

Thus, enthusiasm for limb salvage techniques must be tempered by a realistic assessment of the results, not just for the injured part but for the patient as a whole.

Core Tested Community All. They also reported a prospective trial validating by index with 26 patients at a separate trauma center. However, when the limbs which required delayed amputation were analyzed, the LSI was slightly more accurate in predicting amputation.

HPI – 17M involved in car accident. Similar results are also found by Lin et al. Open tibial fractures with associated vascular injuries: MESS is a simple and 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.

Only large, prospective, multi-center study of the MESS found that a cut-off of 7 had poor sensitivity and mediocre specificity.