How To Buddy-Tape Fingers

• Minor finger sprain*

• Nondisplaced stable fracture of the proximal or middle phalanx

• Proximal interphalangeal (PIP) dislocations (reduced)

* Includes sprains with small avulsion fracture.

Absolute contraindications

• Unstable or displaced phalangeal fracture

• Dislocations that remain unstable after reduction

• Tendon injuries (eg, mallet finger, boutonnière injury)

• Open fracture

Relative contraindications

• None

• 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.

• 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 medications at home.

• Taping too tightly can restrict circulation.

• To prevent chronic deformity and loss of function, use buddy-taping only in select finger injuries.

• 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.