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
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
Supply or prescribe a shoe with a rigid sole (postoperative shoe) to facilitate weight-bearing and ambulation as appropriate.
Consider crutches if weight-bearing causes significant pain.
Arrange or recommend appropriate follow-up.
Have the patient keep the dressing dry to avoid skin breakdown and change the dressing if it becomes wet.
Have the patient elevate the injured limb above the heart while seated or at rest.
Have the patient change the tape and gauze every 2 days.
Warnings and Common Errors for Buddy-Taping Toes
Do not tape toes too tightly or apply tape over joints.