question-icon

I am a screenwriter. My latest project involves a transradial

default
Posted on Wed, 27 Feb 2019
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.
doctor
Answered by Dr. Naveen Kumar Sharma (39 minutes later)
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
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Naveen Kumar Sharma

Orthopaedic Surgeon, Joint Replacement

Practicing since :2002

Answered : 4486 Questions

premium_optimized

The User accepted the expert's answer

Share on
I am a screenwriter. My latest project involves a transradial

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