Question: I am a screenwriter, My current project involves a transradial amputee received their first prosthetic arm and I'm trying to think of a diagnosis that leads to amputation. I've read that PVD can lead to lower limb amputations. Despite its rarity in arms, I'm wondering if there's a possible instance in which it could lead to an upper extremity amputation.

So I have a few questions:

what are some symptoms of a severe case of PVD in the upper extremities? Moreover, at what point would treatments or something like a vascular reconstructive procedure not be an option? At said point, would amputation be the only way to assure the patient's safety?

The details filled out below in the health profile will be that of my character/patient

So is this to say that the only case in which PVD leads to upper extremity amputation is when the arm turns gangrenous? Moreover, how severe must the gangrene be? Can gangrene be treated?

I am having trouble finding reference pictures of mild cases of gangrene. I guess what I'd like to know is how quickly it's physical symptoms can develop and whether a person could perceivably ignore it for a day or two.

Thank you for obliging me. I'm sure these are odd requests by any standard, but it's important that the medical aspects of the project are sound.

Last one. Just to wrap this up, I'd like to summarize what I think could happen to the character and I'd love to know if you think this is possible.

33 year old male diabetic, heavy smoker (2-3 packs a day) comes into hospital with a broken left arm: it's purple-black discoloured and in severe pain. He says that the arm had experienced some pain and numbnes for a couple weeks before, but after it was broken it became unbearable. 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 blood panel finds an infection in his bloodstream. It is at an advanced stage, and the safest way forward is amputation.

Does this seem right to you? What strikes you as not possible, malpractice, etc.?

Thank you again for your time. Is there a way I can write a comment or commendation on your behalf? I'm new to the site and am unsure of how I can show my appreciation.

One last thing: he woke up with discolouration in the arm, but said he thought it was an injury sustained in a boxing match the night before.

Thank you Dr. Christensen, I'll be sure to give a rating.