Last Updated on February 17, 2025
Buddy wrapping is also called buddy taping or buddy strapping. In buddy wrapping, an injured or deformed digit is immobilized by being strapped to an adjacent, unaffected digit to provide alignment, support, and protection. The two attached digits move together, with the unaffected digit providing support during the range of motion.
It is used in injuries to the digits of the hand or toes of the foot.
It could be done as a temporary measure or it could be considered definitive treatment by itself.
Why Buddy Wrapping?
After an injury, immobilization of the injured part is important for rest and healing. For example in case of limb injuries, the limb is splinted by plaster splints or other types of splintage externally to provide immobilization. In buddy wrapping or strapping, the healthy digit acts as a splint, keeping the damaged one in a natural position for healing.
The method can be used for sprains, dislocations, and other injuries of digits and toes.
Reduction of the fracture or dislocation, if needed, should be done before this procedure.
Indications of Buddy Wrapping
- Finger sprain
- Small reducible avulsion fracture
- Nondisplaced stable fracture of the proximal or middle phalanx
- Proximal interphalangeal dislocations after reduction of the dislocation
Buddy wrapping should not be used in cases of unstable or displaced phalanx fractures. It cannot be used in tendon injuries like mallet fingers or in unstable dislocations.
How To Perform Buddy Wrapping
This treatment may be performed by a physician or other medical professional. Follow the following steps for buddy taping.
Determine the digits to be taped together
Typically, the index finger is buddy-wrapped to the middle finger and vice versa. Thus, these are finger buddies of each other. Similarly, the ring finger and little finger are used to support the other when it is needed.
If you flex your fingers, you will find that the index and middle fingers can move as a single unit without affecting the other two, and the same is true for the ring and little finger. This is due to the flexor tendon arrangement. So when these buddies are wrapped together, the other two fingers that are uninjured can perform the tasks better without any constraint from the taped fingers.
However, if the situation demands, the other adjacent finger may be used as well.
Padding between the digits
After identification of the injury and choosing the adjacent digit to be included, a layer of absorbent cotton or gauze is placed between the digits. This is done to prevent the breakdown of the skin due to sweat. The breakdown may cause ulcers and/or infection. The cotton absorbs the sweat and protects the skin. Ensure there are no folds in the gauze between the fingers. Ensure that padding is smooth and there is no folding of the gauze that can act as prominence later.
Wrap the digits together
After padding, the two fingers are taped together as follows
- Keep the fingers together and using an adhesive tape like dynaplast or micropore, bind the injured finger against the uninjured finger.
- One strip of tape is used at the proximal phalanx proximal to the interphalangeal joint whereas the other one is distal to interphalangeal joint on the distal phalanx.
- This allows free movement of interphalangeal joints of the fingers together
- After the procedure, check the distal sensation and capillary refill.
Be careful not to tighten the tape excessively. Only a snug rolling is required. A bandage that is too tight creates the risk of cutting off the blood flow to the digit.
This procedure should not be done in case of open injuries, tight digital compartments, or poor skin conditions that would require repeated supervision.
Follow-up after Buddy Wrapping
The patient should inspect the wrap daily to check for its effectiveness. With time, the taping may become lose and need to be removed. Wetting the wrap should be avoided as it would demand the replacement of the tape.
Any discomfort, itching or decreased sensation should be reported immediately.
