Which non-surgical factors have predictive value for early digit survival after replantation or revascularization? A one-center observational study
- 1Division of Plastic Surgery, Department of Trauma Surgery, Orthopedics and Plastic Surgery, University Medical Center Göttingen
- 2East Center of Burns Treatment and Reconstructive Surgery, District Hospital Łęczna
Abstract
Background Early digit survival after replantation or revascularization may be associated with patient and injury characteristics. This study aimed to identify non-surgical factors associated with early digit survival following traumatic digit injuries. Methods This retrospective single-center observational study included patients treated for complete or subtotal digit amputations or extensive soft-tissue injuries between 2015 and 2025. The primary outcome was digit survival at hospital discharge. Associations were assessed using multivariable mixed-effects logistic regression with a patient-specific random intercept, adjusting for age, smoking status, injury mechanism, extent of vascular injury, and injury level. Sensitivity analyses excluded single-bundle injuries and separately included only complete amputations. Results Among 232 patients with 363 injured digits, replantation or revascularization was attempted in 217 digits. Overall, 155 digits survived (71.4%). Survival was 92.9% after single-bundle injuries, 81.5% after two-bundle injuries, and 53.2% after complete amputations. Extent of vascular injury was associated with survival in the adjusted model (global p = 0.026). Complete amputation was associated with lower odds of survival than single-bundle injury (OR 0.015, 95% CI 0.001–0.327; p = 0.008). This association persisted after excluding single-bundle injuries (OR 0.055, 95% CI 0.004–0.663; p = 0.022). No statistically significant adjusted associations were identified for injury mechanism, injury level, smoking, or age, either in the primary model or among complete amputations alone. Conclusions The extent of vascular injury was the only evaluated factor significantly associated with early digit survival in the adjusted model. Complete amputations had lower odds of survival than injuries retaining tissue continuity. These findings concern survival at hospital discharge and should not be extrapolated to long-term functional outcomes.
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BibTeX
@article{stepniewski2026which,
title = {{Which non-surgical factors have predictive value for early digit survival after replantation or revascularization? A one-center observational study}},
author = {Adam Stepniewski and Adrian Bartoszek and Adrian Hunek and Jakub Grzybowski and Anna Gajdosz and Aleksandra Winiarska and Aleksandra Barbachowska and Paweł Aleksandrowicz and Alperen Sabri Bingoel and Gunther Felmerer and Hubert Opaliński and Joanna Piszczek and Tomasz Korzeniowski},
journal = {European Journal of Medical Research},
year = {2026},
month = oct,
doi = {10.1186/s40001-026-05365-x},
url = {https://doi.org/10.1186/s40001-026-05365-x},
note = {CC BY},
}
RIS
TY - JOUR
TI - Which non-surgical factors have predictive value for early digit survival after replantation or revascularization? A one-center observational study
AU - Adam Stepniewski
AU - Adrian Bartoszek
AU - Adrian Hunek
AU - Jakub Grzybowski
AU - Anna Gajdosz
AU - Aleksandra Winiarska
AU - Aleksandra Barbachowska
AU - Paweł Aleksandrowicz
AU - Alperen Sabri Bingoel
AU - Gunther Felmerer
AU - Hubert Opaliński
AU - Joanna Piszczek
AU - Tomasz Korzeniowski
PY - 2026
DA - 2026/10/25
JO - European Journal of Medical Research
DO - 10.1186/s40001-026-05365-x
UR - https://doi.org/10.1186/s40001-026-05365-x
AB - Background Early digit survival after replantation or revascularization may be associated with patient and injury characteristics. This study aimed to identify non-surgical factors associated with early digit survival following traumatic digit injuries. Methods This retrospective single-center observational study included patients treated for complete or subtotal digit amputations or extensive soft-tissue injuries between 2015 and 2025. The primary outcome was digit survival at hospital discharge. Associations were assessed using multivariable mixed-effects logistic regression with a patient-specific random intercept, adjusting for age, smoking status, injury mechanism, extent of vascular injury, and injury level. Sensitivity analyses excluded single-bundle injuries and separately included only complete amputations. Results Among 232 patients with 363 injured digits, replantation or revascularization was attempted in 217 digits. Overall, 155 digits survived (71.4%). Survival was 92.9% after single-bundle injuries, 81.5% after two-bundle injuries, and 53.2% after complete amputations. Extent of vascular injury was associated with survival in the adjusted model (global p = 0.026). Complete amputation was associated with lower odds of survival than single-bundle injury (OR 0.015, 95% CI 0.001–0.327; p = 0.008). This association persisted after excluding single-bundle injuries (OR 0.055, 95% CI 0.004–0.663; p = 0.022). No statistically significant adjusted associations were identified for injury mechanism, injury level, smoking, or age, either in the primary model or among complete amputations alone. Conclusions The extent of vascular injury was the only evaluated factor significantly associated with early digit survival in the adjusted model. Complete amputations had lower odds of survival than injuries retaining tissue continuity. These findings concern survival at hospital discharge and should not be extrapolated to long-term functional outcomes.
SN - 2047-783X
ER -