30-176
Predicción de amputación mediante MESS (Mangled Extremity Severity Score) en pacientes con lesión traumática vascular grave
Prediction of limb amputation by mess (mangled extremity severity score) applied to patients with severe vascular injury
A. D. DELGADO MARTÍNEZ*, E. C. RODRÍGUEZ MERCHAN*, A. HERNÁNDEZ DÍAZ** y R. BALLESTEROS MASSO* * Servicio de Traumatología y Cirugía Ortopédica. ** Servicio de Cirugía Vascular. Hospital «La Paz». Madrid.
Recepción:
06/11/2008
Aceptación:
06/11/2008
Publicación:
06/11/2008
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Resumen (ES)
60 patients (63 limbs) suffering from a severe vascular injury of the lower extremities
between 1978-1992 have been retrospectively reviewed. Those cases wherein vascular injury
was located above the hip level or under the ankle level were not included. The aim of this study
was to investígate whether the Mangled Extremity Severity Score (MESS) is a useful test to decide
between limb salvage or early amputation in this type of patients. Among 36 amputated limbs. 34
had a score equal or greater than 7, the rate of sensitivity of the test was 94,4%. Among 27 salvaged
limbs, 22 had a score equal or lower than 6, showing a rate of specificity of 81,4%. The MESS
seems to be a very useful test for prediction of limb salvage versus amputation with severe vascular
injury, although it is not totally reliable. It seems better when applied to patients with vascular injury,
rather than to those with mangled extremity, with or without vascular injury.
between 1978-1992 have been retrospectively reviewed. Those cases wherein vascular injury
was located above the hip level or under the ankle level were not included. The aim of this study
was to investígate whether the Mangled Extremity Severity Score (MESS) is a useful test to decide
between limb salvage or early amputation in this type of patients. Among 36 amputated limbs. 34
had a score equal or greater than 7, the rate of sensitivity of the test was 94,4%. Among 27 salvaged
limbs, 22 had a score equal or lower than 6, showing a rate of specificity of 81,4%. The MESS
seems to be a very useful test for prediction of limb salvage versus amputation with severe vascular
injury, although it is not totally reliable. It seems better when applied to patients with vascular injury,
rather than to those with mangled extremity, with or without vascular injury.
Palabras clave (ES):
Grave
Fractura
Compleja
Conminuta
Abierta
Tibia
Complicación
Aplastamiento
Predicción
Amputación
MESS
Mangled
Lesión
Traumática
Vascular
Resumen (EN)
60 patients (63 limbs) suffering from a severe vascular injury of the lower extremities
between 1978-1992 have been retrospectively reviewed. Those cases wherein vascular injury
was located above the hip level or under the ankle level were not included. The aim of this study
was to investígate whether the Mangled Extremity Severity Score (MESS) is a useful test to decide
between limb salvage or early amputation in this type of patients. Among 36 amputated limbs. 34
had a score equal or greater than 7, the rate of sensitivity of the test was 94,4%. Among 27 salvaged
limbs, 22 had a score equal or lower than 6, showing a rate of specificity of 81,4%. The MESS
seems to be a very useful test for prediction of limb salvage versus amputation with severe vascular
injury, although it is not totally reliable. It seems better when applied to patients with vascular injury,
rather than to those with mangled extremity, with or without vascular injury.
between 1978-1992 have been retrospectively reviewed. Those cases wherein vascular injury
was located above the hip level or under the ankle level were not included. The aim of this study
was to investígate whether the Mangled Extremity Severity Score (MESS) is a useful test to decide
between limb salvage or early amputation in this type of patients. Among 36 amputated limbs. 34
had a score equal or greater than 7, the rate of sensitivity of the test was 94,4%. Among 27 salvaged
limbs, 22 had a score equal or lower than 6, showing a rate of specificity of 81,4%. The MESS
seems to be a very useful test for prediction of limb salvage versus amputation with severe vascular
injury, although it is not totally reliable. It seems better when applied to patients with vascular injury,
rather than to those with mangled extremity, with or without vascular injury.
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