1990/05/01 by Kaj Johansen, Michael Daines, THOMAS HOWEY +2 · 3 citations
Medicine · #Amputation #Bone fractures and treatments #Emergency medicine #Injury Severity Score #Injury prevention #Lower limb #Medicine #Orthopedic Infections and Treatments #Poison control #Prospective cohort study #Retrospective cohort study #Surgery #Trauma and Emergency Care Studies
paper · doi:10.1097/00005373-199005000-00007
openalex publication_date 1990/05/01 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/18
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.