Mangled Extremity EvaluationPatient InformationArterial InjuryNoneDistalProximalNerve InjuryNoneContusionTransectedBone FxNo FxFx / ComminutedMuscle CrushIntactCrushedSkin LossIntactLarge Loss Ischemia Time< 6h6 - 12h> 12hCalculate LSI ScoreAssign FindingsSelect the anatomical and physiologic findings to determine the salvage probability.Guidelines & EvidenceWhen to UseHow it WorksClinical PearlsNext StepsThe EvidenceSection 1When to UseSection 2How it WorksSection 3Clinical PearlsSection 4Next StepsSection 5The EvidenceVerifiedLast Review: 2026When to UseWhen to Use LSIHigh-energy extremity trauma (motor vehicle collisions, crush injuries)Mangling injuries with suspected vascular compromisePenetrating trauma with multi-structural limb damageBlast injuries affecting upper or lower extremitiesOpen fractures with soft tissue lossTraumatic limb ischemia requiring surgical decision-makingClinical PurposeObjectiveClinical ImpactPredict limb viabilityEstimate salvage potentialGuide amputation decisionsEarly vs delayed amputation strategyStandardize trauma assessmentReduces subjective variationSupport multidisciplinary planningOrthopedics + vascular + plasticsLimitationsNot a replacement for clinical judgmentLess reliable in pediatric trauma (different healing capacity)Does not directly incorporate physiologic shock severityMay underestimate infection risk in delayed presentationsRequires detailed operative or imaging assessmentKey PrincipleLimb salvage decisions must balance functional outcome, infection risk, ischemia time, and patient physiologic stability—not score alone.Last Comprehensive Review: 2026