Management of the Mangled Extremity


Patients with mangled extremities remain a significant management challenge. A thoughtful approach to the management has the potential to optimize outcome after these injuries. The algorithm above represents the efforts of the Western Trauma Association Critical Decisions in Trauma Ad Hoc Committee based on best evidence available and expert opinion. Prospective validation of this algorithm is advised.

The Western Trauma Association (WTA) develops algorithms to provide guidance and recommendations for particular practice areas but does not establish the standard of care. The WTA develops algorithm based on the evidence available in the literature and the expert opinion of the task force in the recent timeframe of the publication. The WTA considers use of the algorithm to be voluntary. This tool may, however, prove a useful discussion tool for multidisciplinary review of institutional protocols. The ultimate determination regarding its application is to be made by the treating physician and health care professionals with full consideration of the individual patient’s clinical status and available institutional resources and is not intended to take the place of health care providers’ judgment in diagnosing and treating particular patients.