SEARCH (Type the topic here)

Mangled Extremity Severity Score


*To predict which limbs will be salvageable after trauma, available scoring systems include the predictive salvage index, the limb injury score, the limb salvage index, the mangled extremity syndrome index, and the mangled extremity severity score. Of these, the Mangled extremity severity score was found to be most useful.

*This system, which is easy to apply, grades the injury on the basis of the energy that caused the injury, limb ischemia, shock, and the patient's age.

*The system was subjected to retrospective and prospective studies, with a score of 6 or less consistent with a salvageable limb. With a score of 7 or greater, amputation was the eventual result.

*Although we do not strictly follow these guidelines in all patients, we do calculate and document a mangled extremity severity score in the chart whenever we are considering primary amputation versus a complicated limb salvage.

*Mangled Extremity Severity Score
Type Characteristics Injuries Points
1 Low energy Stab wounds, simple closed fractures, small-caliber gunshot wounds 1
2 Medium energy Open or multiple-level fractures, dislocations, moderate crush injuries 2
3 High energy Shotgun blast (close range), high-velocity gunshot wounds 3
4 Massive crush Logging, railroad, oil rig accidents 4
Shock Group
1 Normotensive hemodynamics BP stable in field and in OR 0
2 Transiently hypotensive BP unstable in field but responsive to intravenous fluids 1
3 Prolonged hypotension Systolic BP <90 mm Hg in field and responsive to intravenous fluid only in OR 2
Ischemia Group
1 None Pulsatile limb without signs of ischemia 0[*]
2 Mild Diminished pulses without signs of ischemia 1[*]
3 Moderate No pulse by Doppler, sluggish capillary refill, paresthesia, diminished motor activity 2[*]
4 Advanced Pulseless, cool, paralyzed, and numb without capillary refill 3[*]
Age Group
1 <30 y
2 >30 – <50 y
3 >50 y

BP, blood pressure; OR, operating room.

Points × 2 if ischemic time exceeds 6 hours

1 comment:

  1. yeah i agree so nice, i recommand it to my friends and i,ll be back again and again visit Fetal Maternal Monitor for more info


Related Posts Plugin for WordPress, Blogger...
Related Posts Plugin for WordPress, Blogger...