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How To Buddy-Tape Toes

By

James Y. McCue

, MD, University of California San Francisco - Fresno

Last full review/revision Apr 2021| Content last modified Apr 2021
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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

  • Toe sprain, dislocation, or fracture

  • Structural toe disorders (eg, hallux limitus)

Contraindications

Absolute contraindications

  • Open fracture

Relative contraindications

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

Complications

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

  • Vascular compromise, usually due to an overly tight application

Equipment

  • Cotton or gauze for padding

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

  • Sometimes commercially available toe splint

Additional Considerations

  • 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

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

Step-by-Step Description of Procedure

  • 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

  • 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.

  • Tell the patient to apply ice as needed.

Warnings and Common Errors

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

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NOTE: This is the Professional Version. CONSUMERS: Click here for the Consumer Version
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