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OrthoVellum

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Trauma
intermediate
X-Type

Mangled Extremity Assessment - MESS Score and Limb Salvage Decision

Limb Salvage

A 34-year-old motorcyclist presents after a high-speed collision with a truck. His right leg has an open tibial fracture with extensive soft tissue degloving, absent dorsalis pedis pulse, and he reports complete numbness below the ankle. He is hypotensive with systolic BP of 70 mmHg requiring vasopressors. Warm ischemia time is estimated at 5 hours. The trauma team calculates his MESS score and discusses limb salvage versus primary amputation with the vascular surgery and orthopaedic teams. Regarding mangled extremity assessment and management:

Mark each as TRUE or FALSE

A

The Mangled Extremity Severity Score (MESS) includes 4 components: skeletal/soft tissue injury (1-4 ...

B

The LEAP study (Lower Extremity Assessment Project) demonstrated that scoring systems including MESS...

C

Limb salvage consistently produces better functional outcomes than early amputation with modern pros...

D

Absolute indications for primary amputation include complete tibial nerve disruption at or above the...

E

Temporary vascular shunting (Argyle, Javid, or Pruitt shunts) can restore blood flow rapidly to redu...

Answer the questions to see explanations

Click T (True) or F (False) for each option