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MESS Score (Mangled Extremity Severity Score)

These diagrams and illustrations have been designed to help you learn, memorise and recall key information.

Skeletal / soft-tissue injury 
     Low energy (stab; simple fracture; pistol gunshot wound): 1 
     Medium energy (open or multiple fractures, dislocation): 2 
     High energy (high speed MVA or rifle GSW): 3 
     Very high energy (high speed trauma + gross contamination): 4 
Limb ischemia 
     Pulse reduced or absent but perfusion normal: 1* 
     Pulseless; paresthesias, diminished capillary refill: 2 
     Cool, paralyzed, insensate, numb: 3* 
     Systolic BP always > 90 mm Hg: 0 
     Hypotensive transiently: 1 
     Persistent hypotension: 2 
Age (years) 
     < 30: 0 
     30-50: 1 
     > 50: 2 

* Score doubled for ischemia > 6 hours 


Mangled Extremity Severity Score
Mangled Extremity Severity Score
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