From the Research
Buddy taping is the preferred method for managing proximal phalanx fractures, especially for stable, non-displaced or minimally displaced fractures, as it allows for early controlled motion and provides adequate stability, promoting better functional outcomes and preventing stiffness. This method involves securing the injured finger to an adjacent uninjured finger using tape with gauze padding between the digits to prevent skin maceration. The tape should be changed regularly and continued for 3-4 weeks depending on healing progress 1.
Key Considerations
- Fracture characteristics, stability, and patient factors should guide the choice between buddy taping and splinting.
- Splinting is more appropriate for unstable or significantly displaced fractures, or when greater immobilization is needed, and typically involves aluminum-foam splints or custom thermoplastic splints applied to maintain the finger in a functional position (slight flexion of the MCP joint) for 2-3 weeks.
- Early consultation with a hand specialist is recommended for complex or unstable fractures that may require surgical intervention.
- Recent studies, such as the one published in 2021, support the use of early active motion postoperatively for patients with proximal phalangeal fractures treated by percutaneous, antegrade pinning, as it allows for earlier return to work and potentially better functional outcomes 2.
Comparison of Methods
- Buddy taping allows for early controlled motion, which helps prevent stiffness and promotes better functional outcomes.
- Splinting provides greater immobilization, which may be necessary for unstable or significantly displaced fractures.
- The choice between buddy taping and splinting should be based on individual patient factors and fracture characteristics.
Evidence-Based Recommendations
- The most recent and highest quality study, published in 2021, supports the use of buddy taping for stable, non-displaced or minimally displaced proximal phalanx fractures 2.
- Other studies, such as those published in 2014 and 2009, also support the use of buddy taping and early controlled motion for managing proximal phalanx fractures 1, 3.