• J Trauma · May 1990

    Objective criteria accurately predict amputation following lower extremity trauma.

    • K Johansen, M Daines, T Howey, D Helfet, and S T Hansen.
    • Department of Surgery, Harborview Medical Center, University of Washington School of Medicine, Seattle 98104.
    • J Trauma. 1990 May 1; 30 (5): 568573568-72; discussion 572-3.

    AbstractMESS (Mangled Extremity Severity Score) is a simple rating scale for lower extremity trauma, based on skeletal/soft-tissue damage, limb ischemia, shock, and age. Retrospective analysis of severe lower extremity injuries in 25 trauma victims demonstrated a significant difference between MESS values for 17 limbs ultimately salvaged (mean, 4.88 +/- 0.27) and nine requiring amputation (mean, 9.11 +/- 0.51) (p less than 0.01). A prospective trial of MESS in lower extremity injuries managed at two trauma centers again demonstrated a significant difference between MESS values of 14 salvaged (mean, 4.00 +/- 0.28) and 12 doomed (mean, 8.83 +/- 0.53) limbs (p less than 0.01). In both the retrospective survey and the prospective trial, a MESS value greater than or equal to 7 predicted amputation with 100% accuracy. MESS may be useful in selecting trauma victims whose irretrievably injured lower extremities warrant primary amputation.

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