Objective: To investigate the effects of health education based on the Transtheoretical Model (TTM) on self-management and vascular crisis in patients undergoing finger replantation surgery. Methods: A total of 106 patients who underwent finger replantation surgery between January 2025 and December 2025 were randomly divided into control and intervention groups using a random number table method (control group, n = 52; intervention group, n = 54). The control group received standard perioperative nursing care, while the intervention group received TTM-based health education in addition to standard care. Self-management levels and incidence of vascular crisis were compared between the two groups. Results: After intervention, the Adult Health Self-Management Skills Rating Scale (AHSMSRS) scores in both groups increased significantly compared with baseline (control: 91.26 ± 5.49 to 116.97 ± 8.15; intervention: 90.39 ± 6.72 to 136.38 ± 9.36, p < 0.001). The intervention group showed significantly higher AHSMSRS scores than the control group (136.38 ± 9.36 vs. 116.97 ± 8.15, p < 0.001). Similarly, general self-efficacy scores increased significantly in both groups, with the intervention group demonstrating superior improvement (36.73 ± 4.78 vs. 28.49 ± 4.11, p < 0.001). The incidence of vascular crisis was significantly lower in the intervention group (5.5%) compared with the control group (19.23%, χ² = 3.421, p < 0.05). Conclusion: Health education based on the Transtheoretical Model effectively enhances self-management abilities and self-efficacy in patients undergoing finger replantation surgery, and significantly reduces the incidence of postoperative vascular crisis.