Severe lower limb trauma

Severe trauma to the lower limbs, with major skin loss and the compromise of vital struc­ tures, is often difficult to treat. A combination of several factors such as ability and effort made to distinguish lesion severity – that is, to differentiate recoverable traumas from those that will inevitably progress to amputation – plays an important role. Therefore, indices were developed to facilitate the stratification of injury severity and prediction of the need for amputation, such as the Mangled Extremity Severity Score (MESS). In this article, we report a case of severe trauma to the lower limb, where reconstruction was performed based on the MESS index with multiple muscle flaps, and a good functional outcome was achieved.