Outcome and utility of scoring systems in the management of the mangled extremity*

https://doi.org/10.1016/S0002-9610(96)00245-0Get rights and content

Background

The role of scoring systems as predictors of amputation and functional outcome in severe blunt extremity trauma was examined. Methods: All severe extremity injuries treated over a 10-year period were scored retrospectively using four scoring systems: Mangled Extremity Syndrome Index (MESI), Mangled Extremity Severity Score (MESS), Predictive Salvage Index (PSI), and Limb Salvage Index (LSI).

Results

Twenty-three upper (UE) and 51 lower extremity (LE) injuries were evaluated. Sensitivity and specificity, respectively, were MESI 100% and 50%, MESS 79% and 83%, PSI 96% and 50%, and LSI 83% and 83%. For each system, there were no differences between patients with good and poor functional outcomes.

Conclusion

All of the scoring systems were able to identify the majority of patients who required amputation. However, prediction in individual patients was problematic. None of the scoring systems were able to predict functional outcome.

References (23)

  • GregoryRT et al.

    The mangled extremity syndrome (M.E.S.): a severity grading system for multisystem injury of the extremity

    J Trauma

    (1985)
  • Cited by (0)

    *

    Presented at the 48th Annual Meeting of the Southwestern Surgical Congress, Scottsdale, Arizona, April 28–May 1, 1996.

    View full text