Mangled extremity--case report, literature review and borderline cases guidelines proposal.

نویسندگان

  • Bore Bakota
  • Mario Kopljar
  • Zoran Jurjević
  • Mario Staresinić
  • Ivan Cvjetko
  • Ivan Dobrić
  • Diarmuid De Faoite
چکیده

Treatment of a mangled lower extremity represents a major challenge. The decision whether to amputate or attempt reconstruction is currently based upon surgical evaluation. The aim of this paper is to propose a new approach to surgical evaluation based on scoring systems, local clinical status of the patient as well as comorbidities, mechanism of trauma and hospital resources. Available literature regarding this topic was evaluated and a case of patient with mangled extremity is presented. Based on current literature guidelines and evidence-based medicine, management for borderline cases is proposed to aid clinical decision making in these situations. We describe a 44-year old male patient who presented with mangled lower left leg. Despite a borderline Mangled Extremity Severity Score (MESS), due to the overall health status of the patient and local clinical status with preserved plantar sensitivity and satisfactory capillary perfusion, reconstruction was attempted. After 6 months of treatment, all wounds healed completely with no pain, and satisfactory motor and sensory function was achieved. In conclusion, the treatment of mangled extremity treatment should be based on evidence based literature along with a clinical evaluation of every individual patient. Scores are helpful, but should not be taken as the sole indication for amputation.

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عنوان ژورنال:
  • Collegium antropologicum

دوره 36 4  شماره 

صفحات  -

تاریخ انتشار 2012