Examination of the Factors Affecting the Survival Rate after Digital Replantation

Abstract

This study evaluated the factors affecting the survival of digital replants using univariate and multivariate analyses. A cohort of 49 patients with 63 digital replants ( mean age : 46.8 years ; range, 18-81 years ) were enrolled in this study. The data collected included information about age, sex, smoking history, the injury zone, preoperative time, the amputated digit, the mechanism of injury, the level of surgical expertise, the method and number of anastomosed vessels, and the bone fixation technique. The survival rate of the replanted digits was 76%. The univariate analysis showed that avulsion injuries and a greater number of anastomosed arteries have significant negative impacts on the survival rate of digital replants. The multivariate analysis revealed that avulsion injuries ( odds ratio [OR], 73.7 ; 95% confidence interval [CI], 7.19-756 ) and zone I injuries ( according to Tamai's classification ) ( OR, 24.9; 95% CI, 1.29-480 ) significantly reduce the survival rate of amputated digital replants. A zone I injury indicates a technical problem, whereas a greater number of anastomosed arteries is primarily attributed to the extent of damage of the amputated digit. Therefore, these results suggest that avulsion injuries might be the main risk factor for replantation failure.