The threat of  lower limb loss is seen commonly in severe crush injury, cancer

 ablation, diabetes, peripheral vascular disease and neuropathy. The primary goal

of limb salvage is to restore and maintain stability and ambulation. Reconstructive

strategies differ in each condition such as: Meticulous debridement and  skeletal

stabilization early coverage in trauma, , improving vascularity in ischaemic leg. e a

borderline Mangled Extremity Severity Score in some cases reconstruction can be

attempted considering the overall health status of the patient and local clinical

status, with preserved plantar sensitivity and satisfactory capillary perfusion .In

conclusion, management of mangled extremity treatment should refer to evidence–

based literature in correlation with clinical evaluation of every individual patient.

Scores are helpful but should not be taken as a sole Indication for amputation.

Mangled extremity is a consequence of high Energy trauma which result in

combined bone and soft tissue injury associated with severe bone and soft tissue

loss or destruction (1).Treatment of a mangled lower extremity represents a major

challenge decision whether to amputate or attempt reconstruction is currently

based upon surgical evaluation (1)