Objective  To analyze the related influencing factors for survival rate of replantation of distal thumb amputation.

  Methods  The clinical materials of 106 patients with unilateral complete distal thumb amputation undergoing replantation of severed fingers in authors' hospital from 2014 to 2020 were retrospectively analyzed. At the follow-up of 6 months after operation, the nail length of replanted thumb, range of motion of interphalangeal joint and two-point discrimination of fingertip were evaluated. Related influencing factors for the success rate of replantation were analyzed.

  Results  At 6 months after operation, the length of fingernail of replanted distal thumb was (10.4±1.7) mm, the range of motion of interphalangeal joint was (59.3±5.2)°, and the two-point discrimination distance of fingertip was (5.8±0.9) mm. The survival rate of replantation in 106 patients was 84.9%. Univariate analysis showed that age, operation time, warm ischemia time and sharp cutting injury were the related factors affecting the success rate of replantation (P < 0.05). Multivariate binary Logistic regression analysis showed that age ≥ 45 years old, operation time ≥ 2.8 h, warm ischemia time ≥ 6 h and non-sharp cutting injury were the independent risk factors for survival rate of replantation (P < 0.05 or P < 0.01).

  Conclusion  Age ≥ 45 years old, operation time ≥ 2.8 h, warm ischemia time ≥ 6 h and non-sharp cutting injury are the independent risk factors for survival rate of replantation. Therefore, a targeted treatment plan should be adopted when dealing with distal thumb amputation.