Peripheral Artery Disease (PAD) of the upper extremities is common. It is most often asymptomatic but may cause exertional pains, ischemic pains, gangrene or ulceration. The risk factors for PAD are smoking, obesity, hypertension, diabetes, hypercholesterolemia and end stage renal disease. Here the authors reported a case of 45-year-old male patient, presenting with severe aching type of pain associated with paraesthesia and numbness and blue, cold and gangrenous right forearm which was amputated below the elbow. After amputation, the condition advanced and led to weakness of the right upper arm with bone necrosis and surrounding skin was hyperaemic and oedematous with differential warmth, therefore the patient undergone amputation of the right upper arm and was managed postoperatively with antibiotics and the wound was closed with non absorbable sutures and was on oral anticoagulant therapy and after complete recovery, patient was discharged. On follow-up, removal of sutures was done and patient was referred for physiotherapy for muscle strengthening and prosthesis fitment.
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