Mangled Extremity Severity Score in the Assessment of Extremity Injuries - Is it Reliable?

The mangled extremity severity score (MESS) was established 28 years ago to decide performing an amputation in cases of limb trauma. It assigns points for 4 aspects of the injury: the extent of soft tissue and skeletal injury, limb ischemia and ischemic duration, shock, and age. A score of 7 or higher indicates that primary amputation is required.