Here we present the results of the use of the Mangled Extremity Syndrome Index - MESI in 64 open fractures of lower limbs. The ends regarded as smashed according to MESI criteria, in a total of twenty, have been scored and represent the basis for this study. According to the scale, the 20 points limit determines whether the end should or not be preserved. Only two limbs were submitted to primary amputation (scores 15 and 20) and, 19 months later, they were resigned with the decision made, and were not wearing orthosis, ambulating with the aid of crutches. The patients presenting the most disappointing outcomes at reassessment achieved scores of 16 and 13, having their limbs spared. It was concluded that MESI criteria led to the determination of what is called as Mangled Extremity Syndrome. Injuries scoring was not easily made, and hardly reached the score of 20 points, which would determine primary amputation. In our case series, preservation of limbs scored below 20 did not mean that the decision has been the most appropriate one.
Open fractures; Amputation; Classification
