Utility of mangled extremity severity score in severely injured lower limbs

Introduction: Massive lower extremity trauma,in particular open tibial fractures with associated vascular injuries, present an immediate and complex decision-making challenge between a limb salvage attempt and primary amputation. Medical and surgical advances of the past two decades have improved t...

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Autores principales:	Toya Raj Bhatta, B Gyawali, R Tamrakar, BK Acharya, SK Shrestha, NMS Pradhan, SK Giri
Formato:	article
Lenguaje:	EN
Publicado:	Society of Surgeons of Nepal 2017
Materias:	Amputation MESS Salvage Surgery RD1-811
Acceso en línea:	https://doaj.org/article/3f36be5154c7497f99dba119036b404f
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spelling	oai:doaj.org-article:3f36be5154c7497f99dba119036b404f2021-12-05T19:16:16ZUtility of mangled extremity severity score in severely injured lower limbs10.3126/jssn.v18i1.172101815-39842392-4772https://doaj.org/article/3f36be5154c7497f99dba119036b404f2017-04-01T00:00:00Zhttps://www.nepjol.info/index.php/JSSN/article/view/17210https://doaj.org/toc/1815-3984https://doaj.org/toc/2392-4772 Introduction: Massive lower extremity trauma,in particular open tibial fractures with associated vascular injuries, present an immediate and complex decision-making challenge between a limb salvage attempt and primary amputation. Medical and surgical advances of the past two decades have improved the ability to reconstruct severely injured limb. Limbs that once would have been amputated are now routinely managed with complex reconstruction protocol. Mangled extremity severity score is one of the scoring systems to predict the fate of limbs after severe limb injuries. Methods: Patients fulfilling the inclusion criteria were evaluated with MESS, at the same time treatment protocol for management of injuries of lower limb were followed independently by attending orthopedic surgeon. Mean MESS for salvaged and amputated limbs were calculated and its reliability for prediction of fate of injured limb was assessed using software SPSS v16. Result: The age of patient ranges from 10 to 65 yrs with mean age 35.83. The most common mechanism of injury was Road Traffic Accident followed by fall from height. The mean MESS score for salvaged limbs was 4.18 and for amputated limbs was 8.12 suggesting significant difference in mean scores. The sensitivity (the probability that limbs requiring amputation will have MESS at or above 7) was found to be 75%. The specificity of MESS (the probability that salvage limbs will have MESS < 7) was 95.45%. Conclusion: MESS is a reliable indicator in decision making process whether a limb can be salvaged or needs amputation. The mangled lower extremity with the score of less than 7 may be salvaged and 7 or more may need amputation. JSSN 2015; 18 (1), Page: 23-25 Toya Raj BhattaB GyawaliR TamrakarBK AcharyaSK ShresthaNMS PradhanSK GiriSociety of Surgeons of NepalarticleAmputationMESSSalvageSurgeryRD1-811ENJournal of Society of Surgeons of Nepal, Vol 18, Iss 1 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Amputation MESS Salvage Surgery RD1-811
spellingShingle	Amputation MESS Salvage Surgery RD1-811 Toya Raj Bhatta B Gyawali R Tamrakar BK Acharya SK Shrestha NMS Pradhan SK Giri Utility of mangled extremity severity score in severely injured lower limbs
description	Introduction: Massive lower extremity trauma,in particular open tibial fractures with associated vascular injuries, present an immediate and complex decision-making challenge between a limb salvage attempt and primary amputation. Medical and surgical advances of the past two decades have improved the ability to reconstruct severely injured limb. Limbs that once would have been amputated are now routinely managed with complex reconstruction protocol. Mangled extremity severity score is one of the scoring systems to predict the fate of limbs after severe limb injuries. Methods: Patients fulfilling the inclusion criteria were evaluated with MESS, at the same time treatment protocol for management of injuries of lower limb were followed independently by attending orthopedic surgeon. Mean MESS for salvaged and amputated limbs were calculated and its reliability for prediction of fate of injured limb was assessed using software SPSS v16. Result: The age of patient ranges from 10 to 65 yrs with mean age 35.83. The most common mechanism of injury was Road Traffic Accident followed by fall from height. The mean MESS score for salvaged limbs was 4.18 and for amputated limbs was 8.12 suggesting significant difference in mean scores. The sensitivity (the probability that limbs requiring amputation will have MESS at or above 7) was found to be 75%. The specificity of MESS (the probability that salvage limbs will have MESS < 7) was 95.45%. Conclusion: MESS is a reliable indicator in decision making process whether a limb can be salvaged or needs amputation. The mangled lower extremity with the score of less than 7 may be salvaged and 7 or more may need amputation. JSSN 2015; 18 (1), Page: 23-25
format	article
author	Toya Raj Bhatta B Gyawali R Tamrakar BK Acharya SK Shrestha NMS Pradhan SK Giri
author_facet	Toya Raj Bhatta B Gyawali R Tamrakar BK Acharya SK Shrestha NMS Pradhan SK Giri
author_sort	Toya Raj Bhatta
title	Utility of mangled extremity severity score in severely injured lower limbs
title_short	Utility of mangled extremity severity score in severely injured lower limbs
title_full	Utility of mangled extremity severity score in severely injured lower limbs
title_fullStr	Utility of mangled extremity severity score in severely injured lower limbs
title_full_unstemmed	Utility of mangled extremity severity score in severely injured lower limbs
title_sort	utility of mangled extremity severity score in severely injured lower limbs
publisher	Society of Surgeons of Nepal
publishDate	2017
url	https://doaj.org/article/3f36be5154c7497f99dba119036b404f
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Utility of mangled extremity severity score in severely injured lower limbs

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