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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This experience reflected recent observations from other trauma centers e. Scors Center for Biotechnology InformationU. However, when the limbs which required delayed amputation were analyzed, the LSI was slightly more accurate in predicting amputation.

Table 3 Comparison of results with other studies.

Trauma Scoring Systems – Trauma – Orthobullets

Open in a separate window. L8 – 10 years in practice. Cases were selected as per the following inclusion criteria:.

CT Severity Index Pancreatitis Predict complication and mortality rate in pancreatitis, based on CT findings Balthazar score Expected spleen size Provides upper limit of normal for spleen length and volume by ultrasound relative to body height and gender. Average duration of follow-up was six months.

Objective criteria accurately predict amputation following lower extremity trauma. Please login to add comment.

Formula Addition of the assigned points; if there has been limb ischemia for more than 6 hours, the “limb ischemia” points are mxngled. In spite of best attempts, the functional results are often worse than an amputation. The validity of the mangled extremity severity score in the assessment of upper limb injuries.


Trauma Scoring Systems

The occurrence of just one of two absolute indications complete posterior tibial nerve disruption in adults; crush injuries with longer than six hours of warm ischemia time warrants primary amputation, while at least two of three relative indications serious associated polytrauma, severe ipsilateral foot trauma or projected long course to full recovery must be present to reach that decision.

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 observed or renal failure set in making amputation inevitable.

More recent case series from reported two cases with MESS scores of 11 and 7, both of which were salvaged successfully. Med treatment and more Treatment. The clinical utility of MESS has been extensively evaluated with varying results. Author information Copyright and License information Disclaimer. Johansen provides care across the entire vascular surgical spectrum, with emphasis on thoracic outlet syndrome and gait salvage surgery.

While the evolution of sophisticated microsurgical reconstruction technique has created the possibility of successful limb salvage in even the most extreme cases, it has become painfully obvious that the technical possibilities are double-edged swords. The management of severe lower limb injury remains one of the most controversial subjects in Orthopedic surgery. Clin Orthop Relat Res. Failed attempts at limb salvage result extemity prolonged hospitalization including multiple surgical procedures, pain and psychological trauma, as well as economic hardship to the patient.

Kaj Johansen’s publications, visit PubMed.

Mangled Extremity Severity Score (MESS) | Calculate by QxMD

In your opinion, should a different cut off be used in the upper extremity? Vascular injuries of lower limb except the foot, including dislocations of the knee, ankle, closed tibial or femoral fractures and penetrating wounds with vascular injury noted on color Doppler or at the time of surgery. The present study comprised 58 patients with 61 injured lower limbs. After initial stabilization and resuscitation in the Emergency Department, urgent orthopedics consultation or transfer to a higher level of care is critical as time of ischemia plays a significant role in the MESS.


An accurate guide to treatment of the severely injured extremities. The retrospective study group comprised 24 patients with 25 injured limbs and the prospective study group comprised 34 patients with 36 injured limbs. The MESS was based on retrospective review of 26 limbs.

There were 15 Was there a clinical experience that inspired you to create this tool for clinicians? This study was carried out from January to June Table 2 Comparison of mean Mangled extremity severity score in the other studies.

Similar results are also found by Lin et al. Open tibial fractures with associated vascular injuries: In the prospective study of 36 injured limbs, three limbs 8. 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.