Abstract
Abstract The decision to amputate rather than reconstruct a severely injured limb (‘mangled extremity’) has historically been one of the most difficult choices faced by a trauma surgeon. The surgeon’s responsibility is heightened by the knowledge that delayed or incorrect decision-making may lead to worse outcomes. Unfortunately, hard data upon which to base reliable decisions remain elusive. A prospective analysis of the use of scoring systems including the Limb Salvage Index, the Predictive Salvage Index, the Hanover Fracture Scale, and the NISSSA (Nerve injury, Ischaemia, Soft-tissue contamination, Skeletal damage, Shock, Age) and MESS (Mangled Extremity Severity Score) scores did not validate the clinical utility of any of the scoring algorithms.
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