Arch Hand Microsurg 2019; 24(1): 68-73  
Predictors of Survival Rate in Fingertip Replantation
Tae-Kyung Lee, Jin-Hee Choi, Tae-Yeong Yang, Sang Hyun Woo
W Institute for Hand and Reconstructive Microsurgery, W General Hospital, Daegu, Korea
Correspondence to: Sang Hyun Woo
W Institute for Hand and Reconstructive Microsurgery, W General Hospital, 1632 Dalgubeol-daero, Dalseo-gu, Daegu 42642, Korea
TEL: +82-53-550-5000, FAX: +82-53-552-4000, E-mail:
Received: December 18, 2018; Revised: December 27, 2018; Accepted: January 7, 2019; Published online: March 1, 2019.
© Korean Society for Surgery of the Hand, Korean Society for Microsurgery, and Korean Society for Surgery of the Peripheral Nerve. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: To evaluate the variable factors affecting the survival rate in fingertip replantation.
Methods: We have performed 640 replantation cases of amputation distal to the distal interphalangeal joint between January 2010 to June 2018. Retrospectively, patients were analyzed about variable factors (age, sex, injury mechanism, amputation level according to Ishikawa subzone, ischemic time, surgical experience, vein anastomosis, vein graft) affecting the survival rate of fingertip replantation.
Results: The overall survival rate was 76.9% (492 of 640). Male patients were more than female (511 of 640, 79.8%), but survival rate of female was higher than male (80.6%). The mean age of patients was 45.3 years old (15 months to 76 years). In the level of injury, amputation of distal phalanx was most frequently occurred at Ishikawa subzone I (167 of 640). Survival rate of subzone I (80.8%) and II (85.8%) was higher than subzone III (72.4%) and IV (66.8%). In the type of injury, local crushing injury (345 of 640) was most common cause of amputation. And severe crushing injury (66.5%) was the lowest survival rate than others; guillotine (87.0%) and local crushing (80.3%). Total ischemic time was 631 minutes. Ischemic time was not statistically significant. There was a higher survival rate for vein anastomosis group (77.9%) than salvage group (66.4%) in Ishikawa subzone III and IV. The success rate of fingertip replantation is getting higher with experience of hand surgeons.
Conclusion: The factors of age, sex, and ischemic times do not affect the survival rate of fingertip replantation. The level of injury, injury mechanism, vein anastomosis, vein graft, surgical experience of the surgeons are statistically significant factors for the survival rate of fingertip replantation.
Keywords: Replantation, Survival rate

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