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AAST Bladder Injury Scale AAST Bowel Injury Scale AAST Cardiac Injury Scale AAST Diaphragm Injury Scale AAST Hepatic Injury Scale AAST Kidney Injury Scale AAST Lung Injury Scale AAST Pancreatic Injury Scale AAST Rectal Injury Scale AAST Splenic Injury Scale AAST Vascular Injury Scale ABC Score (Massive Transfusion)ACS COT Field Triage Guidelines ATLS Hemorrhagic Shock Classification Abbreviated Injury Scale (AIS)Ankle-Brachial Index (ABI) in Trauma Base Deficit in Trauma Brain Injury Guidelines (BIG) Score Cardiac Wound Index Chest Trauma Score (CTS)Damage Control Decision Score (DCDS)Denver Criteria (BCVI)Esophageal Perforation Severity Score (PSS)Expanded Denver Criteria (BCVI)Flint Colon Injury Scale Frailty Index in Trauma (mFI-5)Geriatric Trauma Outcome Score (GTOS)Hard Signs of Vascular Injury Checklist Hemorrhage Control Decision Aid (Wound Packing vs. Tourniquet)ICP-based Cerebral Perfusion Pressure (CPP) Calculator Injury Severity Score (ISS)Injury Severity Score — Age-adjusted (ISS-Age)Lethal Triad / Trauma Triad of Death Calculator Limb Salvage Index (LSI)Mangled Extremity Severity Score (MESS)Mechanism, Glasgow Coma Scale, Age, and Arterial Pressure (MGAP)Memphis Criteria (BCVI)Modified Shock Index (MSI)Nerve Injury, Ischemia, Soft-tissue, Skeletal Injury, Shock, Age (NISSSA)New Injury Severity Score (NISS)Open Abdomen Classification (Björck)Pediatric Trauma Score (PTS)Pelvic Trauma Hemorrhage Risk Score Penetrating Abdominal Trauma Index (PATI)Physiologic Extreme Emergency in Trauma (FEET)Predictive Salvage Index (PSI)REBOA Zone Selection Guide Resuscitative Thoracotomy Indications (EAST/WTA Guidelines)Revised Trauma Score (RTS)RibScore Shock Index (SI)TASH Score TRISS Index Thoracic Trauma Severity Score (TTS)Tile Classification of Pelvic Fractures Trauma and Injury Severity Score — Pediatric (PTS)Young–Burgess Pelvic Fracture Classification

Mangled Extremity Severity Score (MESS)

TRAUMAMESS Score (Mangled Extremity)

Skeletal / Soft Tissue Injury

Limb Ischemia

Ischemia Duration > 6 hours

Note: Points are doubled for ischemia duration > 6 hours.

Systemic Shock

Patient Age

Awaiting Trauma Data

Input skeletal injury, ischemia, and shock status to assess the likelihood of limb salvage versus amputation.

Guidelines & Evidence

Verified

Last Review: 2026

When to Use

The MESS score is the most historically significant clinical tool used to assist in the high-stakes decision between primary amputation and limb salvage in severe lower extremity trauma. It focuses on energy mechanism, ischemia, shock, and age.

MESS is a clinical adjunct. Modern studies (e.g., the LEAP study) have shown that no single score, including MESS, is 100% predictive of outcome. A multidisciplinary approach is mandatory.

Related Scores in Practice

In clinical practice, this assessment is frequently evaluated alongside other validated measures. Depending on the patient's presentation and specific diagnostic requirements, you may also need to utilize the Nisssa Score, Psi Score, Lsi Score, or the Abi Trauma to formulate a comprehensive care plan.

Last Comprehensive Review: 2026

Related Trauma Surgery Tools

Mechanism, Glasgow Coma Scale, Age, and Arterial Pressure

AAST Rectal Injury Scale

Injury Severity Score

Revised Trauma Score

Predictive Salvage Index

AAST Bowel Injury Scale

Resuscitative Thoracotomy Indications

Injury Severity Score — Age-adjusted

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