Most surgeons make their decision to amputate or perform limb salvage of a mangled extremity based on scoring systems and grading of acute ischemic limb. We report on a child in whom limb salvage was achieved in spite of a clinical picture of irreversible ischemia with high mangled severity scores. Attempts to revascularize the mangled extremity of children are recommended, regardless of their severity scores and condition of the foot.
KrettekC, SeekampA, KontoppH, TscherneH. Hannover Fracture Scale ‘98 – re-evaluation and new perspectives of an established extremity salvage score.Injury2001; 32: 317-28
2.
HelfetDL, HoweyT, SandersR, JohansenK. Limb salvage versus amputation. Preliminary results of the mangled extremity severity score.Clin Orthop Relat Res1990; 256: 80-6
3.
DurhamRM, MistryBM, MazuskiJE, ShapiroM, JacobsD. Outcome and utility of scoring systems in the management of the mangled extremity.Am J Surg1996; 172: 569-73
4.
RutherfordRB. Clinical staging of acute limb ischemia as the basis for choice of revascularization method: when and how to intervene.Semin Vase Surg2009; 22: 5-9
5.
MommsenP, ZeckeyC, HildebrandF. Traumatic extremity arterial injury in children: epidemiology, diagnostics, treatment and prognostic value of Mangled Extremity Severity Score.J Orthop Surg Res2010; 5: 25
KumarMK, BadoleC, PatondK. Salvage versus amputation: Utility of mangled extremity severity score in severely injured lower limbs.Indian J Orthop2007; 41: 183-7
8.
ElsharawyMA. Arterial reconstruction after mangled extremity: injury severity scoring systems are not predictive of limb salvage.Vascular2005; 13: 114-9
9.
LyTV, TravisonTG, CastilloRC, BosseMJ, MacKenzieEJ LEAP Study Group. Ability of lower-extremity injury severity scores to predict functional outcome after limb salvage.J Bone Joint Surg Am2008; 90: 1738-43
10.
BosseMJ, MacKenzieEJ, KellamJF. A prospective evaluation of the clinical utility of the lower-extremity injury-severity scores.J Bone Joint Surg Am2001; 83: 3-14
KorompiliasAV, BerisAE, LykissasMG, VekrisMD, KontogeorgakosVA, SoucacosPN. The mangled extremity and attempt for limb salvage.J Orthop Surg Res2009; 4: 4
13.
BondurantFJ, CoderHB, BuckleR, Miller–CrotchettP, BrownerBD. The medical and economic impact of severely injured lower extremities.J Trauma1988; 28: 1270-3
14.
DickinsonBP, JimenezJC, LawrencePF, DerubertisBG. Functional limb salvage following muscle rigor in a pediatric patient.Vasc Endovasc Surg2010; 44: 315-8