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Purpose: Ischemic time is a key factor in satisfactory functional results after forearm replantation. In this study, we provide a detailed description of our surgical technique, the temporary screw plate fixation technique, which aims to reduce ischemic time. Methods: From June 2007 to June 2017, we performed a retrospective study of 20 patients who underwent forearm replantation. Eighteen cases involved male patients, and their mean age was 46 years. The mechanism of injury was roller injuries in 5 cases, power saw injuries in 3 cases, traffic accident in 7 cases, rope injuries in 2 cases, machinery injuries in 2 cases, and crushing injuries by rebar beam in 1 case. Results: A total of 20 replantation patients survived. According to injury level, there were 3 cases of the proximal type, 11 cases of the middle type, and 6 cases of the distal type. The average time to revascularization was 331 min. The total operation time was, on average, 5.73 h. In the rest of the 18 cases, the temporary screw plate fixation technique was performed, and the average time required for bone shortening and plate fixation was 38.3 min. Conclusions: To reduce ischemic time, we need a plan that progressively reduces time at each stage. Among our tips, temporary screw plate fixation can reduce the initial bone surgical operation to < 40 min, does not have many complications, and can be used as definitive surgery. This method for bone fixation should be considered as a strategy to actively reduce operation time during forearm replantation. Level of evidence: Retrospective study, Level III. [ABSTRACT FROM AUTHOR]

Background: Segmental fractures often result from high-energy or indirect trauma that causes bending or torsional forces with axial loading. We evaluated surgical outcomes of patients with forearm segmental diaphyseal fractures. Methods: We retrospectively analyzed data from patients with forearm segmental fractures for which they underwent surgery at the Pusan National University Trauma Center from March 2013 to March 2022. We also analyzed accompanying injuries, injury severity score (ISS), injury mechanism, occurrence of open fracture, surgical technique, and treatment results. Results: Fifteen patients were identified, one with bilateral segmental diaphyseal forearm bone fracture, for a total of 16 cases. Nine of the patients were male. The overall mean age was 50 years, and the mean follow-up period was 16.2 months. Six cases who underwent surgery using plate osteosynthesis achieved bone union without length deformity at final follow-up. Three of seven patients who underwent intramedullary nailing alone underwent reoperation due to nonunion. Six cases achieved bone union at final follow-up, three of which showed length deformity. Three patients underwent surgery using a hybrid method of IM nailing, plates, and mini cables. One patient who underwent surgery with a plate and one patient who underwent surgery with IM nailing alone showed nonunion and were lost to follow-up. Conclusion: Plate osteosynthesis is considered the gold standard for treatment of adult forearm diaphyseal segmental fractures. In this study, IM nailing was associated with high rates of non-union and length deformity. However, the combination of IM nailing and a plate-cable system may be an acceptable alternative in segmental diaphyseal forearm fracture, achieving a union rate similar to that provided by plate fixation. [ABSTRACT FROM AUTHOR]