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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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Johansen provides care across the entire vascular surgical spectrum, with emphasis on thoracic outlet syndrome and gait salvage surgery. L8 – 10 years in practice.

There was a significant difference in the mean MESS scores in the prospective study, 4. Average duration of follow-up was six months. MESS could provide an early prognosis on the injured limb at time of Emergency Department or initial contact with healthcare system.

A decision based on a seven-part predictive index. Badole, Department of Orthopedics and Traumatology, M. 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 extremoty 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. The MESS utilizes variables that can be readily obtained without extensive maangled complicated measurements or calculations.

Trauma Scoring Systems – Trauma – Orthobullets

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. Open tibial fractures with associated vascular injuries: HPI – 17M involved in car accident.


The ideal situation is one which allows identification of those patients who will benefit from early and aggressive attempts at limb salvage and those for whom primary amputation is the correct choice. Smoldering Multiple Myeloma Prognosis Determine risk of progression to symptomatic multiple myeloma.

Out of a total of 61 injured lower limbs, 11 limbs J Bone Joint Surg Br. Footnotes Source of Support: In spite of best attempts, the functional results are often worse than an amputation.

Mangled Extremity Severity Score (MESS)

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. Vascular injuries of lower limb except the foot, including dislocations of the knee, ankle, closed tibial or femoral mangler and penetrating wounds with vascular injury noted on color Doppler or at the time of surgery.

Please login to add comment. Only large, prospective, multi-center study of the MESS found that a cut-off of 7 had poor sensitivity and mediocre specificity.

Ranson’s Criteria Estimate mortality in patients with pancreatitis. The principal investigators of the study request that you use the official version of the modified score here.

Forrest Classification Estimate risk of re-bleeding post-endoscopy for upper GI bleeding. Accordingly, in view of the fact that even a numb, insensate, immobile upper extremity may be of more use to the trauma victim than even the best upper extremity prosthesis, every effort should be made to salvage badly damaged upper extremities rather than amputating them.

Limb salvage versus traumatic amputation: Quantification Volumetric Cardiology AR: How important is this topic for clinical practice? Prospectively applied MESS at two different hospitals consisting of two separate patient populations on opposite sides of the country. Once adequate soft tissue coverage had been obtained, patient was discharged and followed up at regular intervals of two weeks for progression of fracture healing.



Mangled Extremity Severity Score (MESS Score) – MDCalc

What can be said about his outcome at 2 years if he chooses reconstruction over amputation? The retrospective study group comprised 24 patients with 25 injured limbs and the prospective study group comprised 34 patients with 36 injured limbs.

MESS is a simple and relatively easy and readily available scoring system which can help the surgeon to zeverity the fate socre the lower extremity with a high-energy injury. Iliac bone grafting was undertaken in patients with bone loss or lack of healing process at the fracture site. The second look debridement under anesthesia was undertaken 48 to 72 hrs following the injury.

Trauma Scoring Systems

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. The MESS can potentially identify at time of initial evaluation patients who are candidates for successful limb salvage vs future amputation.

He is also a clinical professor of surgery at the University of Washington School of Medicine.