A finger dislocation occurs when the bones that form a joint are forced out of their normal alignment, often tearing the surrounding ligaments. This painful injury causes immediate swelling, bruising, and a visible deformity where the finger may appear crooked or bent at an abnormal angle. While the ultimate treatment requires a medical professional to realign the bones, buddy taping offers a temporary method of stabilization. Buddy taping involves securing the injured finger to an adjacent, healthy finger, providing support during transport to a clinic or emergency room. This improvised splinting method is not a substitute for professional diagnosis and treatment, which is necessary to prevent long-term complications like decreased mobility or chronic stiffness.
Essential Immediate Care Before Stabilization
The priority immediately following a suspected finger dislocation is to minimize further harm and manage initial symptoms. Check for any rings or jewelry on the injured finger and remove them immediately, as swelling begins rapidly and can quickly compromise circulation. Next, visually assess the injury for severe signs such as an open wound, the bone protruding through the skin, or extreme, unnatural angulation. If any of these conditions are present, do not attempt to move the finger, and seek emergency care right away.
Never attempt to reduce the dislocation by forcefully pushing or pulling the joint back into place. This action risks causing irreversible damage to the delicate blood vessels, nerves, and tendons that surround the joint. To help control swelling and pain, apply a cold pack or ice wrapped in a thin towel to the injured area for 15 to 20 minutes. Keep the hand elevated above the level of the heart, using pillows for support, which assists gravity in reducing fluid accumulation in the tissues.
Step-by-Step Guide to Proper Buddy Taping
The goal of buddy taping is to harness the strength of a healthy finger to protect the injured one, allowing the two digits to move together as a unit. Begin by selecting the adjacent finger that is closest in length to act as the “buddy,” which is typically the finger immediately next to the injured one. The materials required are simple: a roll of medical cloth tape, preferably one half to one inch wide, and a thin piece of soft padding, such as cotton gauze or a small piece of foam.
Before applying any tape, a crucial step is to place the padding between the injured finger and its buddy. This layer acts as a physical barrier to prevent skin-on-skin friction and moisture buildup, which can lead to chafing, blisters, and skin maceration. Ensure the padding is flat and smooth, paying particular attention to the web space between the fingers where skin breakdown is common.
With the padding in place, secure the two fingers together using two separate strips of tape. The first strip should be applied proximally, meaning closer to the palm, in the mid-shaft area between the main knuckle joint and the middle joint. Apply the second strip distally, toward the fingertip, in the space between the middle joint and the joint closest to the nail.
It is essential that both strips of tape are placed only on the bone shafts, completely avoiding the knuckles or finger joints themselves. Leaving the joints uncovered allows for limited, protected motion, which helps prevent long-term stiffness, a common consequence of prolonged immobilization.
The tape should be applied firmly enough to hold the fingers securely together but not so tight that it pinches the skin or causes any throbbing sensation. Once the tape is applied, the two fingers should move simultaneously without any independent motion.
Monitoring Circulation and Knowing When to Remove Tape
After the buddy tape is applied, it is necessary to immediately assess the fingers for signs of compromised circulation. The tape’s application should not impede blood flow, which is best checked using the Capillary Refill Test (CRT). To perform this assessment, gently press on the soft pad of the injured finger until the skin turns pale, indicating the blood has been pushed out of the small capillaries.
Upon releasing the pressure, the color should return to the finger pad within three seconds. A longer return time suggests that the tape may be too tight and is restricting blood flow, which necessitates immediate loosening or removal. Beyond the CRT, continuously monitor for other signs of poor circulation, including a pale or bluish discoloration, increased swelling, or a feeling of numbness or tingling in the fingertip.
If the pain increases significantly, or if the finger feels cool to the touch or develops persistent numbness, the tape should be removed right away. Buddy taping is a temporary measure used solely to stabilize the finger until a medical professional can perform a proper reduction. The tape should remain in place only during transport and initial management, and any long-term splinting or taping regimen should be determined and demonstrated by a healthcare provider.