How To Buddy-Tape Toes

• Toe sprain, dislocation, or fracture

• Structural toe disorders (eg, hallux limitus)

Absolute contraindications

• Open fracture

Relative contraindications

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

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

• Vascular compromise, usually due to an overly tight application

• Cotton or gauze for padding

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

• Sometimes commercially available toe splint

• 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.

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

• 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.

• 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.

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