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A Novel Mangled Upper Extremity Injury Assessment Score.

Ira L Savetsky1, Seth Z Aschen2, Ara A Salibian1

  • 1Hansjorg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y.

Plastic and Reconstructive Surgery. Global Open
|January 17, 2020
PubMed
Summary
This summary is machine-generated.

A new scoring system, the Mangled Upper Extremity Score (MUES), reliably predicts outcomes for severe upper extremity injuries, unlike the older Mangled Extremity Severity Score (MESS). MUES correlates with complications and hospital stay.

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Area of Science:

  • Orthopedic Surgery
  • Trauma Surgery
  • Musculoskeletal System Research

Background:

  • Mangled upper extremity injuries involve multiple tissue types, complicating assessment and treatment.
  • Existing scoring systems like the Mangled Extremity Severity Score (MESS) have limitations in predicting outcomes for these complex injuries.

Purpose of the Study:

  • To develop and validate a new scoring system for mangled upper extremity injuries.
  • To compare the predictive accuracy of the new score with the existing MESS.

Main Methods:

  • Retrospective review of 76 patients with mangled upper extremities at a Level 1 trauma center.
  • Development of the Mangled Upper Extremity Score (MUES) based on injury characteristics.
  • Correlation analysis of MUES and MESS with patient outcomes (complications, hospital stay).

Main Results:

  • The MUES was created, assigning points for factors like age >40, need for fasciotomy, bony fixation, bony defect, revascularization, crush mechanism, degloving/avulsion, and large soft tissue defects.
  • MUES showed significant correlation with the number of complications (P=1.96 × 10⁻⁷) and length of hospital stay (P=3.95 × 10⁻⁷).
  • The MESS did not correlate with complications (P=0.92) or hospital stay (P=0.35).

Conclusions:

  • The Mangled Extremity Severity Score (MESS) is unreliable for predicting outcomes in mangled upper extremity injuries.
  • The newly developed Mangled Upper Extremity Score (MUES) significantly correlates with key outcome measures, offering improved predictive value for limb salvage and patient recovery.