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We undertook a prospective study of 50 cases who met the criteria of mangled lower extremities in our hospital from Jan. 1994. Thirty-five cases were imb-saved while fifteen cases were amputated. The average length of follow-up was 18.5 months. The infection rate of salvage group was 20%, and nonunion rate was 14.3%. We concluded that both the sensitivity (91.4%) and the specificity (93.3%) were high when using the Mangled Extremity Severity Score (MESS) points 6 as crete-ria. However, many mangled extremities around the ankle could be saved even with MESS points higher than 7, which also had satisfactory results.

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