Relevance of mangled extremity severity score to compartment syndromes

Abstract

This study investigated the relevance of a mangled extremity severity score (MESS) to the evaluation of intracompartmental pressure in injured patients. We measured intracompartmental pressures with a modification of the Whitesides method and compared these values with MESS in 27 patients after trauma. For 5 of them fasciotomy was necessary to relieve high intracompartmental pressures. In our series MESS seemed to correlate with intracompartmental pressure values (r = 0.733, P < 0.05). We conclude that the MESS system provides objective criteria in determining the risk of a compartment syndrome.

Assessment and diagnosis of acute limb compartment syndrome: A literature review

“…The majority (n=9) of studies were based on retrospective design (Blakemore et al, 2000;Blick et al, 1986;Cascio et al, 2005;Ferlic et al, 2012;Mithofer et al, 2004;Park et al, 2009;Uslu et al, 1995;Vaillancourt et al, 2004). Seven studies used a prospective design (Al-Dadah et al, 2008;Frink et al, 2007;Janzing & Broos, 2001;Katz et al, 2008;Kosir et al, 2007;, including one randomized control trial of continuous pressure monitoring versus usual care (Harris et al, 2006).…”

Clinical practice guidelines for the management of acute limb compartment syndrome following trauma

“…Compartment pressures have been shown to rise for at least 24 h post‐injury, 9,10 and hence it is recommended that high‐risk patients be monitored during this period. A number of authors have reported that patients with high‐grade injuries are at increased risk of developing compartment syndrome 2,7,8,11 . McQueen and colleagues also identified young males with forearm or tibial fractures and young males with limb injuries and a high likelihood of bleeding as being at high risk 2 .…”

The right team at the right time – Multidisciplinary approach to multi-trauma patient with orthopedic injuries

“…The mangled extremity can be quickly assessed and temporized. [1718] Diminished or absent pulses in an injured extremity require immediate attention as early reduction and/or repositioning and immobilization can often restore blood flow and subsequently minimize disability and potentially avoid amputation. [19] Specific injuries such as posterior knee dislocations and unstable pelvic fractures elevate concern in the emergency physician's mind for concomitant vascular injury and may require further testing such as angiography.…”

“…[2324] In addition to all these diagnostic and therapeutic interventions, the emergency traumatologists are also trained in prompt recognition of other limb-threatening phenomena such as the compartment syndrome. [17]…”