Mangled Extremity Severity Score (MESS)

Assess limb-salvage potential in trauma to the extremity.


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.

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

Bosse MJ et al.

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

The Mangled Extremity Severity Score (MESS) calculator is created by QxMD.

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1. Skeletal/Soft-Tissue Injury?

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