Objective To analyze the effect of predictive risk nursing on aesthetic satisfaction, digital replantation survival rate and joint function in patients after digital replantation. Methods A total of 82 patients undergoing digital replantation in the Department of Orthopedics, Suining TCM Hospital from January 2023 to December 2024 were selected as the research subjects, and they were divided into the control group and the study group by the random number table method, with 41 patients in each group. The control group received conventional nursing, and the study group received predictive risk nursing. The aesthetic satisfaction (BIS score), digital replantation survival rate, joint function, objective sensation (2PD), scar status (VSS score), psychological state (HAD score) and pain degree (VAS score) were compared between the two groups. Results The aesthetic satisfaction of the study group (92.68%) was higher than that of the control group (78.05%) (P <0.05). The digital replantation survival rate and excellent and good rate of joint function in the study group at 4 weeks after nursing were higher than those in the control group (P <0.05). The 2PD, VSS score and HAD score in the study group at 4 and 12 weeks after nursing were lower than those in the control group (P <0.05). The VAS score in the study group at 7 days after nursing was lower than that in the control group (P <0.05). Conclusion Predictive risk nursing has a good effect in the nursing of patients undergoing digital replantation, which can improve postoperative aesthetic satisfaction and digital replantation survival rate, promote the recovery of finger joint function, improve the sensory function of the affected finger, scar status and patients' mentality, reduce pain, and is worthy of clinical application.