Mangled Extremity
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- Ability of lower-extremity injury severity scores to predict functional outcome after limb salvage.
- Ly TV, Travison TG, Castillo RC, Bosse MJ, MacKenzie EJ; LEAP Study Group.
- J Bone Joint Surg Am. 2008 Aug;90(8):1738-43.
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Rationale for inclusion: This multi-center prospective study confirmed the inability of multiple scoring systems including the Mangled Extremity Severity Score, Limb Salvage Index, Predictive Salvage Index, and Hannover Fracture Scale-98 to accurately predict functional recovery after limb salvage following severe extremity trauma.
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- A prospective evaluation of the clinical utility of the lower-extremity injury-severity scores.
- Bosse MJ, MacKenzie EJ, Kellam JF, Burgess AR, Webb LX, Swiontkowski MF, Sanders RW, Jones AL, McAndrew MP, Patterson BM, McCarthy ML, Cyril JK.
- J Bone Joint Surg Am. 2001 Jan;83-A(1):3-14.
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Rationale for inclusion: This prospective study challenged the ability of the Mangled Extremity Severity Score (MESS) to accurately predict need for primary amputation. Using 556 high energy lower-extremity injuries, MESS accurately predicted limb salvage when low, but was not sensitive to predict amputation rate when high and concluded the MESS should be used with caution.
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- Limb salvage versus amputation. Preliminary results of the Mangled Extremity Severity Score.
- Helfet DL, Howey T, Sanders R, Johansen K.
- Clin Orthop Relat Res. 1990 Jul;(256):80-6.
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Rationale for inclusion: Using the Mangled Extremity Severity Score complied of readily accessible data regarding skeletal/soft-tissue damage, ischemia, shock, and age, need for primary amputation was accurately predicted in a prospective fashion in 26 lower-extremity open fractures. MESS>7 was 100% predictable for amputation.
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- Objective criteria accurately predict amputation following lower extremity trauma.
- Johansen K, Daines M, Howey T, Helfet D, Hansen ST Jr.
- J Trauma. 1990 May;30(5):568-72; discussion 572-3.
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Rationale for inclusion: This study reviewed objective data confirming the use of the Mangled Extremity Severity Score, compiling skeletal/soft-tissue damage, ischemia, shock, and age, as a valid tool to predict need for limb amputation after devastating extremity trauma.
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- The mangled extremity syndrome (M.E.S.): a severity grading system for multisystem injury of the extremity.
- Gregory RT, Gould RJ, Peclet M, Wagner JS, Gilbert DA, Wheeler JR, Snyder SO, Gayle RG, Schwab CW.
- J Trauma. 1985 Dec;25(12):1147-50.
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Rationale for inclusion: This series is one of the firs t to identify and define a grading system to characterize the Mangled Extremity Syndrome in order to identify the potential for limb salvage versus need for likely amputation.
Citations - To review the number of citations for this landmark paper, visit Google Scholar.