Mangled Extremity Severity Score (MESS)

Assess limb-salvage potential in trauma to the extremity.

The global unit selector only affects unanswered questions
1.Skeletal/Soft-Tissue Injury?
2.Time Since Injury?
3.Limb Ischemia?
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1. Skeletal/Soft-Tissue Injury?

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About this Calculator

The MESS score assists in deciding between limb reconstruction and primary amputation for lower limb severe trauma in the Emergency Department.

The high specificity of the score confirms that low scores can be used to predict limb-salvage potential. However, the study by Bosse et al shows that the low sensitivity of the score fails to support its validity as predictor of amputation. The final decision is up to the surgeon on the basis of their experience in limb reconstructive surgery and on the available resources of the trauma center.


Johansen K, Daines M, Howey T, Helfet D, Hansen ST Jr.

Objective criteria accurately predict amputation following lower extremity trauma.

Journal of Trauma 1990, 30 (5): 568-72; discussion 572-3

Bosse MJ et al.

A prospective evaluation of the clinical utility of the lower-extremity injury-severity scores.

Journal of Bone and Joint Surgery. American Volume 2001, 83 (1): 3-14

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