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Journal of Hand Surgery (British and European Volume)
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Articles

The Role of Allopurinol in Digital Replantation

S. WAIKAKUL
A. UNNANANTANA
V. VANADURONGWAN

From the Department of Orthopaedic Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand

Correspondence: S. Waikakul MD, Department of Orthopaedic Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. E-mail: rawwk{at}mahidol.ac.th

The clinical effects of allopurinol on the attenuation of reperfusion injury in thumb replantations after prolonged ischaemic time were studied in a randomized control trial with a 2-year follow-up. There were 60 patients, in the trial group, and 38 patients in the control group. All were young, healthy labourers who had sharp or locally crushed amputations of the thumb at the proximal phalanx with a total ischaemic time of more than 10 hours. The standard management for thumb replantation was used in these patients, except that 300 mg allopurinol was given orally in the trial group on admission and a further 300 mg for another 5 days. After operation, the trial group had a lower infection rate, and less postoperative pain and chronic swelling than the control group. Recovery of sensation was also better in the trial group.

Journal of Hand Surgery (British and European Volume), Vol. 24, No. 3, 325-327 (1999)
DOI: 10.1054/JHSB.1998.0215
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