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MESS values did not differ between amputees, limb salvage patients
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Among service members with combat-related type III open tibia fractures, no significant difference was found in Mangled Extremity Severity Score values between amputees and those treated with limb salvage, according to study results.
Researchers reviewed patient records for 155 service members with combat-related type III open tibia fractures to characterize injury and outcomes, including limb salvage vs. amputation, age, gender, mechanism of injury, injury pattern, associated injuries and presence of complications. Main outcome measures included Mangled Extremity Severity Score (MESS), amputation or limb salvage.
Overall, 110 patients had salvaged limbs and 45 patients had lower-extremity amputations. The mean MESS values for amputees was 5.8 compared with 5.3 for patients treated with limb salvage, according to the researchers.
Study results revealed the sensitivity of a MESS of seven or greater predicting amputation was 35%, whereas the specificity was 87.8%. The researchers also found a positive predictive value of 50% with a MESS value of 7 or greater.
Among patients treated with amputation, 33% had an associated vascular injury compared with 12.7% of patients treated with limb salvage, according to the researchers.
Disclosure: The authors have no relevant financial disclosures.
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