Document Detail
Salvage versus amputation: Utility of mangled extremity severity score in severely injured lower limbs
Abstract/OtherAbstract :
<b>Background:</b> The purpose of the present study was to evaluate the clinical utility of Mangled extremity severity score (MESS) in severely injured lower limbs. <b> Materials and Methods:</b> Retrospectively 25 and prospectively 36 lower limbs in 58 patients with high-energy injuries were evaluated with the use of MESS, to assist in the decision-making process for the care of patients with such injuries. Difference between the mean MESS scores for amputated and salvaged limbs was analyzed. <b> Results:</b> In the retrospective study 4.65 (4.65 &#x00B1; 1.32) was the mean score for the salvaged limbs and 8.80 (8.8 &#x00B1; 1.4) for the amputated limbs. In the prospective study 4.53 (4.53 &#x00B1; 2.44) was the mean score for the salvaged limbs and 8.83 (8.83 &#x00B1; 2.34) for the amputated limbs. There was a significant difference in the mean scores for salvaged and amputated limbs. Retrospective 21 (84&#x0025;) and prospective 29 (80.5&#x0025;) limbs remained in the salvage pathway six months after the injury. <b> Conclusion:</b> MESS could predict amputation of severely injured lower limbs, having score of equal or more than 7 with 91&#x0025; sensitivity and 98&#x0025; specificity. There was a significant difference in the mean MESS scores in the prospective study (n=36), 4.53 (4.53 &#x00B1; 2.44) in thirty salvaged limbs (83.33&#x0025;) and 8.83 (8.83 &#x00B1; 2.34) in six amputated limbs (16.66&#x0025;) with a <i> P</i> -value 0.002 (<i> P</i> -value &lt; 0.01). Similarly there was a significant difference in the mean MESS score in the retrospective study (n=25), 4.65 (4.65 &#x00B1; 1.32) in twenty salvaged limbs (80&#x0025;) and 8.80 (8.8 &#x00B1; 1.4) in five amputated limbs (20&#x0025;) with a <i> P</i> -value 0.00005 (<i> P</i> -value &lt; 0.01). MESS is a simple and relatively easy and readily available scoring system which can help the surgeon to decide the fate of the lower extremity with a high-energy injury.
Authors :
Kumar M, Badole C, Patond K
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Contributors :
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Publication Detail :
Publisher :  Medknow Publications     Type :  -     Format :  -    
Date Detail :
2007
Subject :
Mangled lower extremity, Mangled extremity severity score, salvage versus amputation
Coverage :
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Relation :
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Source :
Indian Journal of Orthopaedics
Copyright Information :
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Languages :  EN    
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