J Trauma. 1990 May;30(5):568-72; discussion 572-3.

Objective criteria accurately predict amputation following lower extremity trauma.

Johansen K, Daines M, Howey T, Helfet D, Hansen ST Jr.

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Department of Surgery, Harborview Medical Center, University of Washington School of Medicine, Seattle 98104.

Abstract

MESS (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.

PMID:: 2342140; [PubMed - indexed for MEDLINE]

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Objective criteria accurately predict amputation following lower extremity trauma.

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