Buddy strapping of mismatched fingers: The offset buddy strap

Abstract

Listen

Translate article

Strapping or taping one finger to an adjacent finger is indicated for several conditions. In stable proximal and middle phalangeal fractures, buddy taping allows early protected range of motion. It is also recommended for the treatment of proximal interphalangeal (PIP) joint dislocations and collateral ligament injuries after a period of immobilization. 1 The technique is also useful in the care of metacarpophalangeal joint collateral ligament injuries and for sagittal band injuries of the extensor mechanism. Buddy taping is also used for mild PIP joint stiffness where motion is desired so that the adjacent finger pulls the affected finger along with it. Finally, strapping is useful where some protection is needed by keeping the injured finger close to the normal finger and out of harm's way. A buddy strap is two layers of Velcro, each with a hook and loop piece connected near one end to create a hinge. There are two short Velcro hook tabs on one end and two longer Velcro loop straps on the other. Velcro buddy straps are available in half-inch and 1-inch widths. The half-inch straps can be used for strapping fingers together where the phalanges are evenly matched side by side. The problem occurs when taping the little finger to the ring finger, because the middle phalanx of the little finger does not match with the middle phalanx of the ring finger. For strapping the middle phalanges of the little and ring fingers, the 1-inch buddy strap can be modified as follows. The buddy strap is placed on a flat surface. The upper layer of the strap is cut down the midline longitudinally through both the long loop strip and short hook tab, leaving the hinge intact. A half-inch piece of the hook and loop is removed on the same side. The buddy strap is turned upside down and a half inch of the contralateral side is removed. The modified offset buddy strap will now have two half-inch straps that do not overlap but are adjacent, or offset. Thus there will be one portion that loops around the middle phalanx of the little finger and the other, offset portion, that fits around the middle phalanx of the ring finger (Fig. 1). An additional unmodified strap can be used around the proximal phalanges for additional support (Fig. 2). The senior author (G.R.) has used this offset buddy strap technique for several years and has been