Half of patients with testicular torsion undergoing salvage surgery will develop testicular atrophy, even when intraoperatively assessed as viable, and should be counseled accordingly. Duration of pain > 1 day and sonographic heterogeneous echogenicity are predictive. Salvage rates are dismal when duration of symptoms exceeds 1 day.

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The parameters of PTS need to be further refined to improve its accuracy and minimize the undertriage rate. If a combined physiologic and anatomic scoring system such as PTS is used, other physiologic parameters such as GCS and RR may become redundant. The evaluation of the validity of PTS, GCS, and RR in predicting pediatric major trauma indicated poor reliability.