Trauma: Mangled Extremity Severity Score: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Trauma: Mangled Extremity Severity Score

Sample item

A surgeon uses the Mangled Extremity Severity Score (MESS) to decide between salvage and amputation of a severely injured leg. Which set of factors does the score include?

AFracture pattern, nerve injury, wound contamination and diabetesBSkeletal and soft tissue injury, limb ischaemia, shock and patient ageCFracture displacement, bone loss, compartment pressure and genderDMechanism of injury, plantar sensation, smoking status and BMI

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Skeletal and soft tissue injury, limb ischaemia, shock and patient age

MESS scores four variables: the energy of skeletal and soft tissue injury, limb ischaemia, shock (blood pressure) and age. A higher total points toward amputation, though no score should be used alone to make the decision. Plantar sensation is considered separately in other tools.

Option by option

A. Fracture pattern, nerve injury, wound contamination and diabetes
Nerve injury and diabetes are not scored in MESS.
B. Skeletal and soft tissue injury, limb ischaemia, shock and patient age (correct)
Correct. Injury energy, ischaemia, shock and age are the four MESS variables.
C. Fracture displacement, bone loss, compartment pressure and gender
Compartment pressure and gender are not scored.
D. Mechanism of injury, plantar sensation, smoking status and BMI
Plantar sensation, smoking and BMI are not part of the MESS variables.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is B, Skeletal and soft tissue injury, limb ischaemia, shock and patient age. MESS scores four variables: the energy of skeletal and soft tissue injury, limb ischaemia, shock (blood pressure) and age.

Why is "Fracture pattern, nerve injury, wound contamination and diabetes" not the answer?

Nerve injury and diabetes are not scored in MESS.

Why is "Fracture displacement, bone loss, compartment pressure and gender" not the answer?

Compartment pressure and gender are not scored.

Why is "Mechanism of injury, plantar sensation, smoking status and BMI" not the answer?

Plantar sensation, smoking and BMI are not part of the MESS variables.

What concept does this question test?

It tests Trauma: Mangled Extremity Severity Score in Orthopaedics. A higher total points toward amputation, though no score should be used alone to make the decision. Plantar sensation is considered separately in other tools.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Trauma: Mangled Extremity Severity Score?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.