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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]

Replantation of multilevel amputation of the hand requires considerable hospital resources, and the surgical outcomes in older adults have not been described in detail. Thus, replantation for this injury was mostly confined to young patients. Here, we describe the case of a 63-year-old patient with multilevel amputation of the hand in whom replantation surgery was successful with grasp and pinch functions by the last follow-up. We report the clinical, functional, and patient-reported outcomes and discuss the indications. As the patient transfer system and communication technology develops, more patients will arrive at hospitals in a critical time for replantation. Accordingly, hand surgeons should consider offering replantation option for multilevel amputation after evaluating the indications. [ABSTRACT FROM AUTHOR]