Merck Manual

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How To Buddy-Tape Toes


James Y. McCue

, MD, University of Washington

Reviewed/Revised Nov 2023

Buddy-taping a toe dynamically splints an injured toe to an adjacent, normal toe.

In buddy-taping, a digit that requires immobilization (eg, because of injury or deformity) is attached to an adjacent, unaffected digit, helping to provide alignment and some support and protection.

Indications for Buddy-Taping Toes

  • Toe sprain, dislocation, or fracture

  • Structural toe disorders (eg, hallux limitus)

Contraindications to Buddy-Taping Toes

Absolute contraindications

  • Open fracture

Relative contraindications

  • Certain fractures of the big toe (some require fixation)

Complications of Buddy-Taping Toes

  • Skin breakdown due to lack of padding and maceration between toes

  • Vascular compromise, usually due to an overly tight application

Equipment for Buddy-Taping Toes

  • Cotton or gauze for padding

  • Adhesive tape 1.25 to 2.5 cm (½ to 1 inch)

  • Sometimes commercially available toe splint

Additional Considerations for Buddy-Taping Toes

  • Dislocations should be reduced. Most toe fractures do not require reduction. Fractures of the proximal phalanx of the big toe typically require fixation; buddy-taping is inadequate.

Positioning for Buddy-Taping Toes

  • Position the patient seated in a chair or supine on an examination table.

Step-by-Step Description for Buddy-Taping Toes

  • Give the patient adequate analgesia.

  • Insert cotton padding or gauze between the toes being splinted to prevent skin maceration between the toes.

  • Apply tape around both toes to bind the injured toe against the uninjured toe.

  • Check distal sensation and capillary refill.

Aftercare for Buddy-Taping Toes

Warnings and Common Errors for Buddy-Taping Toes

  • Do not tape toes too tightly or apply tape over joints.

NOTE: This is the Professional Version. CONSUMERS: View Consumer Version
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