orthopaedics vascular emergency-medicine
MESS Score (Mangled Extremity Severity Score)
Predicts likelihood of successful limb salvage vs amputation in mangled lower extremity injuries. In Johansen's two series (1990) a MESS of 7 or more predicted amputation with 100% accuracy.
Score interpretation
MESS < 7 — Limb salvage may be successful
→ Attempt limb salvage with vascular reconstruction and orthopaedic stabilisation
MESS >= 7 — Primary amputation predicted
→ High likelihood amputation needed; early discussion with patient; involve vascular and orthopaedics
Interpretation bands for the MESS Score. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
Pathways
- Hip Fracture Pathway · NICE CG124; BPT
- Cauda Equina Syndrome · Society of British Neurological Surgeons; BOA — Best Practice
- Knee Soft Tissue Injury (ACL / MCL / Meniscus) · BOA; Royal College of Surgeons
- Shoulder Dislocation · BOA; RCEM
- Scaphoid Fracture · BOA; BSSH
- Pelvic Fracture · BOA; ATLS; NICE NG39
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.
