Mangled extremity: limb salvage for reconstruction versus primary amputation.

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Abstract

[Indexed for MEDLINE] 2. Vasc Endovascular Surg. 2023 Jul;57(5):445-450. doi: 10.1177/15385744231152024. Epub 2023 Jan 13. Mangled Extremity Severity Score in the Assessment of Extremity Injuries - Is it Reliable? Abdo EM(1)(2), Farouk N(1), EIimam SE(1), Elshinawy WE(1), Abdelhafez AA(3), Hamza M(3), Dahy AA(4), Abu-Elsoud A(5). Author information: (1)Department of Vascular Surgery, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt. (2)Consultant of Vascular Surgery at King Khalid Hospital, Hail, Saudi Arabia. (3)Department of Vascular Surgery, Faculty of Medicine (for Boys), Al-Azhar University, Cairo, Egypt. (4)Department of Plastic and Reconstructive Surgery, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt. (5)Department of Plastic and Reconstructive Surgery, Faculty of Medicine (Assiut), Al-Azhar University, Cairo, Egypt. The mangled extremity severity score (MESS) was established 28 years ago to decide performing an amputation in cases of limb trauma. It assigns points for 4 aspects of the injury: the extent of soft tissue and skeletal injury, limb ischemia and ischemic duration, shock, and age. A score of 7 or higher indicates that primary amputation is required. Thirty-one patients with MESS scores of 7 to 8 underwent limb salvage surgeries, with 13 limbs being saved and 18 limbs being amputated. Upper extremities trauma had a salvage rate of 62.5%, whereas lower extremity trauma had a salvage rate of 20%. MESS is not a sensitive predictor of amputation in upper limb trauma, but it is useful in lower limb injuries. DOI: 10.1177/15385744231152024