Mommsen et al. Journal of Orthopaedic Surgery and Research 2010, 5:25 RESEARCH ARTICLE Research article Open Access Traumatic extremity arterial injury in children: Epidemiology, diagnostics, treatment and prognostic value of Mangled Extremity Severity Score Philipp Mommsen*1, Christian Zeckey1, Frank Hildebrand1, Michael Frink1, Nawid Khaladj2, Nadine Lange1, Christian Krettek1 and Christian Probst1 Abstract Background: Traumatic paediatric arterial injuries are a great challenge due to low incidence and specific characteristics of paediatric anatomy and physiology. The aim of the present study was to investigate their epidemiology, diagnostic and therapeutic options and complications. Furthermore, the prognostic value of the Mangled Extremity Severity Score (MESS) was evaluated. Methods: In. | Mommsen et al. Journal of Orthopaedic Surgery and Research 2010 5 25 http content 5 1 25 éHMÌ JOURNAL OF ORTHOPAEDIC MBs SURGERY AND RESEARCH RESEARCH ARTICLE Open Access Traumatic extremity arterial injury in children Epidemiology diagnostics treatment and prognostic value of Mangled Extremity Severity Score Philipp Mommsen 1 Christian Zeckey1 Frank Hildebrand1 Michael Frink1 Nawid Khaladj2 Nadine Lange1 Christian Krettek1 and Christian Probst1 Abstract Background Traumatic paediatric arterial injuries are a great challenge due to low incidence and specific characteristics of paediatric anatomy and physiology. The aim of the present study was to investigate their epidemiology diagnostic and therapeutic options and complications. Furthermore the prognostic value of the Mangled Extremity Severity Score MESS was evaluated. Methods In a retrospective clinical study 44 children aged years treated for traumatic extremity arterial lesions in our Level I trauma center between 1971 and 2006 were enrolled. Exclusion criteria were age 14 venous and iatrogenic vascular injury. Demographic data mechanism of injury severity of arterial lesions by Vollmar and MESS diagnostic and therapeutic management complications and outcome were evaluated. Results The most commonly injured vessel was the femoral artery 25 followed by the brachial artery . The mechanism of injury was penetrating isolated severe blunt extremity trauma multiple trauma 25 and humeral supracondylar fractures . In no specific vascular diagnostic procedure was performed in favour of emergency surgery. Surgical reconstructive strategies were preferred . A MESS 7 was associated with initial p and definite limb salvage p of the lower extremity. Conclusions Traumatic paediatric vascular injuries are very rare. The most common situations of vascular lesions in childhood were penetrating injuries and fractures of the extremities either as isolated .
