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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Hemodynamic monitoring and support for prevention and management of AKI. In the prospective study all the attempted salvage patients were followed up for a minimum period of six months. Unfortunately, while limb preservation is frequently possible, the salvaged limb may have significant functional deficits and may have ultimately required secondary ablation. 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.

Enter your email address extremify we’ll send you a link to reset your password. Open in a separate window. Only large, prospective, multi-center study of the MESS found that a cut-off of 7 had poor sensitivity and mediocre specificity.

The study includes a total of 58 patients with 61 limbs. Vascular repair, if indicated, and primary fracture alignment and stabilization were carried out. The appropriate contemporary lower extremity threshold value we avoid the term “cut-off”!!

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Mangled Extremity Severity Score (MESS)

Very high energy high speed trauma with gross contamination. Bleeding Risk in Atrial Fibrillation: 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.


In the retrospective study, maximum period of follow-up was done at the end of six and half years and minimum period of follow up was done at the end of two and half years. The functional outcome of lower extremity fractures with vascular injury. S, Sewagram -Wardha manglwd, India. Thank you extrmeity rating! In the s, while I was Chief of Vascular Surgery at Harborview Medical Center, amngled Level I trauma center here in Seattle, several trauma victims with severely damaged lower extremities died after vain and, in retrospect, misguided attempts at limb salvage.

Score taken at hospital admission. Similarly there was a significant difference in the mean MESS score in the retrospective study, 4. How would you treat this patient? General supportive management of patients with AKI, including management of complications.

The management of massive lower extremity trauma is a subject of considerable interest and controversy. Smoldering Multiple Myeloma Prognosis Determine risk of progression to symptomatic multiple myeloma. However, when the limbs which required delayed amputation were analyzed, the LSI was slightly more accurate in predicting amputation.

Trauma Scoring Systems

The MESS was based on retrospective review of 26 limbs. MESS is a simple and relatively easy and readily available scoring system which can help the extremityy to decide the extfemity of the lower extremity with a high-energy injury.

The validity of the mangled extremity severity score in the assessment of upper limb injuries. Bondurant et al from Houstonand led to a retrospective analysis of such patients to discern whether objective clinical and demographic data available early in such patients’ course might predict the likelihood of success vs. External sevetity or cast was removed once the fracture was soundly united and adequate physiotherapy was advised. Log In Create Account.

In the retrospective study, all the attempted salvage patients were followed up for a period of two and a half years. Radiographs of the mangled extremity were taken. Objective criteria accurately predict amputation following lower extremity trauma. Pulseless, paresthesias, slow capillary refill.


Johansen suggests, upper extremities are profoundly more important than lower extremities and prosthesis much more primitive, so nearly every effort at salvage should be attempted.

On admission to emergency ward all resuscitative measures according to the advanced trauma life support ATLS protocol were followed. His injuries have been graded as severe but not life-threatening injury to the chest 3 pointsmoderate injury to the abdomen 2 pointsand severe injuries but with probable survival injury to the the face or neck 4 points using the criteria for the Modified Injury Severity Score MISS.

This article has been cited by other articles in PMC. 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. A comparison of two predictive indices.

Mangled Extremity Severity Score (MESS) | Calculate by QxMD

Severe open fractures of the lower extremity: In India, Sharma et al. We caution to keep realistic expectations regarding the ultimate functional result. Sckre and general management of patients with and at risk for AKI.

In the prospective study, maximum period of follow-up was 28 months and minimum period was two months.

Please review our privacy policy. How important is this topic for clinical practice? There was a significant difference in the mean MESS scores in the prospective study, 4. Results of the present study are consistent with the western and Indian studies [ Table 3 ]. In fact, given the advent of improved imaging modalities, minimally-invasive revascularization techniques, the WoundVac concept, sophisticated free tissue transfer options, Ilizarov methods for limb-length discrepancy etc.

An editorial emphasizing this view, to be submitted to the Journal of Trauma, is in preparation. This is a very important question.