A knuckle is a joint connecting the bones of the hand and fingers. Wrapping an injured knuckle, particularly through the use of buddy taping, can provide temporary stabilization and pain relief for a suspected fracture. This technique uses an adjacent, healthy finger as a splint to restrict motion and prevent further damage to the site. Wrapping is a first-aid measure only and is not a substitute for professional medical care, which is required for any suspected bone break.
Recognizing a Knuckle Injury
A severe, persistent pain that does not lessen with rest is often the first indicator of a broken knuckle, which is a fracture of one of the metacarpal bones. Significant swelling around the injured area usually develops quickly, sometimes spreading to adjacent fingers and the back of the hand. Bruising may appear rapidly, and the injured finger may be difficult or impossible to move. A visibly misshapen finger or a “sunken” appearance where the knuckle should be are strong signs of a displaced fracture.
Immediate first aid should focus on limiting swelling and pain before wrapping. The injured person must stop all activity immediately to prevent movement of the finger and hand. Applying a cold pack wrapped in a cloth helps minimize inflammation and discomfort. The hand should also be kept elevated above the level of the heart to encourage fluid drainage and reduce swelling.
Materials and Preparation for Wrapping
The buddy taping method requires a few basic supplies for effective temporary stabilization. You will need medical cloth tape, which is easily torn or cut to size, and a soft padding material like cotton or gauze. Scissors will be necessary to cut the tape and padding accurately. If the skin is broken, antiseptic wipes should be used to clean the area first.
Preparation protects the skin and ensures the tape adheres correctly. The hand and fingers must be clean and completely dry before application to prevent skin irritation. Place a small piece of gauze or cotton between the injured finger and the adjacent uninjured finger that will serve as the splint. This padding prevents skin-to-skin contact, which can lead to chafing and breakdown when taped together.
The Buddy Taping Technique
The buddy taping technique uses the neighboring finger to restrict the movement of the injured one, providing dynamic support. First, position the injured finger next to its uninjured partner, ensuring the padding is correctly situated between them. The uninjured finger should be as close in length to the injured finger as possible for optimal stabilization.
You will apply two separate strips of tape around both fingers, avoiding wrapping directly over the knuckle joints. The first strip should be applied near the base of the fingers, between the main knuckle (metacarpophalangeal joint) and the next joint. The second strip should be placed toward the fingertip end, between the middle knuckle (proximal interphalangeal joint) and the tip joint (distal interphalangeal joint). Taping only in the sections between the joints allows the fingers to retain some ability to flex and extend slightly.
The tape should be applied with gentle pressure, snug enough to hold the fingers together as a single unit, but not so tight that it constricts blood flow. Check circulation by pressing lightly on the nail bed of the injured finger. If the color does not return within two seconds, the tape is too tight and must be removed and reapplied more loosely. Leaving the fingertips uncovered allows monitoring for changes in color or temperature, which could indicate a circulation problem.
When to Seek Professional Treatment
Buddy taping is a temporary measure designed to stabilize a potential fracture until a medical professional can be seen. Any suspected broken knuckle requires a medical evaluation to confirm the diagnosis and receive definitive treatment. A doctor will typically order an X-ray to determine the exact location and type of fracture, such as a stable, non-displaced fracture or a more complex, displaced break.
Immediate medical care is necessary if certain warning signs are present. These include an open wound where the bone may have broken through the skin, severe deformity, or a loss of sensation in the finger. Pale or blue fingertips and extreme swelling that does not lessen with elevation are also urgent indicators, as they suggest compromised circulation or nerve damage.
Delaying treatment, especially for a fracture with rotational misalignment, can seriously affect the long-term function and appearance of the hand. Treatment may involve closed reduction, where the bones are manually realigned without surgery, followed by casting or splinting. More severe or unstable fractures may necessitate surgical intervention, using pins, screws, or plates to stabilize the bone fragments for proper healing. The goal of professional treatment is to restore the bone’s alignment and ensure full hand function returns after the recovery period.