In buddy-taping, a digit that requires immobilization (eg, because of an injury or deformity) is attached to an adjacent, unaffected digit, helping to provide alignment as well as support and protection. The unaffected digit provides support during range of motion of the injured digit.
Minor finger sprain*
Nondisplaced stable fracture of the proximal or middle phalanx
Proximal interphalangeal (PIP) dislocations (reduced)
* Includes sprains with small avulsion fracture.
Unstable or displaced phalangeal fracture
Dislocations that remain unstable after reduction
Tendon injuries (eg, mallet finger Mallet Finger Mallet finger is a flexion deformity of the fingertip caused by avulsion of the extensor tendon, with or without fracture, from the proximal end of the distal phalanx. (See also Overview of... read more , boutonnière injury Volar dislocations Most finger dislocations occur at the proximal interphalangeal (PIP) joint; they are usually caused by hyperextension and thus are usually dorsal. Finger dislocations can be dorsal, lateral... read more )
Skin breakdown due to lack of padding between fingers
Vascular compromise, usually due to an overly tight application
Cotton or gauze for padding
Adhesive tape 1.25 cm (½ inch)
Dislocations should be reduced.
Consider a digital block before splinting if manipulation or reduction is required.
The patient should be positioned so that the operator has appropriate access to the patient's affected finger.
Step-by-Step Description of Procedure
Insert cotton padding or gauze between the fingers being splinted to prevent skin maceration between the fingers. Ensure there are no folds in the gauze between the fingers.
Apply tape around both fingers to bind the injured finger against the uninjured finger.
Use one strip of tape to bind adjacent phalanges proximally between the metacarpophalangeal and proximal interphalangeal (PIP) joints, leaving the interphalangeal joints untaped to allow them to flex and extend.
Use a second piece of tape to bind the 2 digits distally between the PIP and distal interphalangeal (DIP) joints, again leaving the interphalangeal joints untaped to allow motion of those joints.
Check distal sensation and capillary refill.
Arrange or recommend appropriate follow-up.
Patient should keep the tape and padding dry to avoid skin breakdown and change the dressing if it becomes wet.
Instruct the patient to seek further care if pain cannot be controlled with oral drugs at home.
Warnings and Common Errors
Taping too tightly can restrict circulation.
To prevent chronic deformity and loss of function, use buddy-taping only in select finger injuries.
Tips and Tricks
Instruct the patient as you apply the tape, taking care to keep the joints free, so that the patient can reapply the tape should that be necessary.