The patient, a 40-year-old male from Hebei, was crushed by a truck carrying 40 tons, resulting in severe disfigurement of his right forearm. On admission, the patient was pale due to excessive blood loss. The examination revealed that the skin of his right forearm from the elbow joint to the metacarpophalangeal joint was completely peeled off, the forearm muscles were severely shredded, and due to the crushing of the truck, some of the shredded muscles of the forearm were squeezed into the subcutaneous part of the hand, the median nerve and ulnar nerve were torn in a rat tail shape and long segment defect, the ulnar and radial arteries were broken and long segment defect, the ulnar and radial bones and the elbow joint were rubbed against the ground, and the flesh was bloody and miserable. The patient was sent to Beijing from Hebei by his family, and was told by several hospitals to have his limbs amputated, so he came to our hospital with a ray of hope. Due to the complexity of the injury, Zhao Dongsheng’s team of doctors examined the patient and made a detailed surgical plan, and contacted the operating room, where Dr. Zhao Dongsheng, chief physician, Yan Baoshan, Tang Jiayi and other physicians performed overnight forearm clearing vascular nerve exploration anastomosis, free posterior tibial vascular flap graft to repair forearm trauma and bridge the radial artery, and artificial skin membrane to cover the trauma, finally preserving the limb on the verge of amputation.