I Am A Screenwriter. My Latest Project Involves A Transradial
 
                                    
                                    
                                          
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                                           Thu, 7 Feb 2019
                                           
                                        
                                        
                                        
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                                                Thu, 7 Feb 2019
                                                
                                            
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                                            Question : I am a screenwriter. My latest project involves a transradial amputee getting his first prosthesis. I was hoping to give you a brief patient profile (details filled out in "health profile"), then a series of diagnoses that lead to amputation and I'd like to know whether you feel this is plausible. 
33 year old male diabetic, heavy smoker (2-3 packs a day, 10+ years) comes into hospital with what he thinks is a broken left arm: he was mugged and attacked. It's purple-black discoloured and in severe pain. He says that the arm had experienced some pain and numbness for a couple weeks before, but after it was broken it became unbearable. Moreover, he woke up that morning to discolouration but thought it was just an injury from a boxing sparring match the night before. Upon taking blood pressure of both his arms, we find the left has significantly lower blood pressure than the right. An ultrasound to the arm and angiogram detects a clot, a subsequent blood panel finds an infection in his bloodstream. It is at an advanced stage, and the safest way forward is amputation.
Conclusion: arterial occlussion causes gangrene, then amputation
Does this seem right to you? What strikes you as not possible, malpractice, etc.?
Thank you for your time.
                            33 year old male diabetic, heavy smoker (2-3 packs a day, 10+ years) comes into hospital with what he thinks is a broken left arm: he was mugged and attacked. It's purple-black discoloured and in severe pain. He says that the arm had experienced some pain and numbness for a couple weeks before, but after it was broken it became unbearable. Moreover, he woke up that morning to discolouration but thought it was just an injury from a boxing sparring match the night before. Upon taking blood pressure of both his arms, we find the left has significantly lower blood pressure than the right. An ultrasound to the arm and angiogram detects a clot, a subsequent blood panel finds an infection in his bloodstream. It is at an advanced stage, and the safest way forward is amputation.
Conclusion: arterial occlussion causes gangrene, then amputation
Does this seem right to you? What strikes you as not possible, malpractice, etc.?
Thank you for your time.
                                    Brief Answer:
It is usually not possible
Detailed Answer:
Hello,
If a patient has an arterial injury then it causes severe pain and it is not possible that patient can sleep over it. So it does not look right. Rarely Diabetic patient may have very less pain and so not able to recognize the symptoms in time. So, in my opinion, this gangrene is more because of Diabetes then assault.
Thanks
                                    
                            It is usually not possible
Detailed Answer:
Hello,
If a patient has an arterial injury then it causes severe pain and it is not possible that patient can sleep over it. So it does not look right. Rarely Diabetic patient may have very less pain and so not able to recognize the symptoms in time. So, in my opinion, this gangrene is more because of Diabetes then assault.
Thanks
 Above answer was peer-reviewed by :
                              
                            
                                  
                                      Dr. Chakravarthy Mazumdar
                                  
                              
                                         
 
                                    
                                    
                                Answered by
                                                    Dr. Dr. Naveen Kumar Sharma
Orthopaedic Surgeon, Joint Replacement
Practicing since :2002
Answered : 4486 Questions
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