[Clinical significance of MESS scoring system in the treatment of fractures of lower limb combined with vascular injuries].
OBJECTIVE
To study the clinical significance of MESS scoring system in the treatment of fractures of lower limb combined with vascular injuries, and to evaluate its reliance.


METHODS
From March 2006 to March 2008, 28 patients with fractures of lower limb combined with vascular injuries were graded by MESS scoring system. There were 17 patients were male and 11 patients were female, ranging in age from 23 to 53 years, averaged 38 years. Seventeen patients had fractures at the superior segment of tibia and fibia, 7 patients had fractures at the inferior segment of femur, and other 4 patients had dislocation of knee joint. Among the patients, 18 patients had MESS scores more than 7.0 point, in which 13 patients were treated with one-stage amputation, 5 patients were treated with two-stage amputation; the other 10 patients had the MESS scores less than 7.0 point, and were treated with open reduction and internal fixation, in which 8 patients were treated with transplantation of great saphenous vein to repair blood vessles, and 2 patients were treated with vascular end to end anastomosis.


RESULTS
Among the patients, including 18 patients whose MESS scores more than 7.0 point were treated with one-stage or two-stage amputation, and 10 patients whose MESS scores less than 7.0 point were treated with limb salvage operations, all the limbs survived. During the follow-up period (ranged from 0.5 to 1 year, the movement and sensory function of the limbs recovered well.


CONCLUSIONS
MESS is a simple and reliable tool to determine the proper strategy for the patients suffering from vascular injuries with fractures.
Zhou
Fei-Ya
FY
Department of Orthopaedics, Second Hospital Affiliated to Wenzhou Medical College, Wenzhou 325027, Zhejiang, China.
Guo
Xiao-Shan
XS
Gao
Wei-Yang
WY
Chen
Xing-Long
XL
Li
Zhi-Jie
ZJ
Jiang
Liang-Fu
LF
D000328:Adult; D000671:Amputation, Surgical; D001808:Blood Vessels / Q000293:injuries; D005260:Female; D005592:Fracture Fixation / Q000379:methods*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D015599:Trauma Severity Indices; D014656:Vascular Surgical Procedures