Buddy Taping for Non-Displaced 3rd Metacarpophalangeal (MCP) Fracture
Buddy taping is appropriate and effective for treating a non-displaced 3rd metacarpophalangeal (MCP) fracture, providing good functional outcomes while allowing early mobilization.
Assessment and Indications for Buddy Taping
- Buddy taping is suitable for minimally displaced fractures (<2-3mm displacement) of the metacarpals 1
- Non-displaced metacarpal fractures can be effectively treated with conservative management rather than surgical intervention 2, 3
- Radiographic assessment with at least 2 views (PA and lateral) should be performed initially to confirm the non-displaced nature of the fracture 1
Benefits of Buddy Taping vs. Cast Immobilization
- Buddy taping allows immediate active protected mobilization, leading to faster functional recovery compared to cast immobilization 2, 4
- Studies show significantly lower disability scores (DASH) at 3 weeks for patients treated with buddy taping versus cast immobilization 4
- Buddy taping results in higher patient comfort and lower treatment costs compared to splint immobilization 5
- Return to work is approximately 28 days sooner with buddy taping compared to cast treatment 4
Technique for Proper Buddy Taping
- The injured 3rd finger should be taped to an adjacent uninjured finger (typically the 2nd or 4th digit) 3, 6
- Tape should be applied around both fingers at multiple points, allowing for interphalangeal joint movement while stabilizing the fracture 2
- A barrier (such as gauze) should be placed between the fingers to prevent skin maceration and potential complications 6
- Each application of tape should be limited to periods of 20 minutes to prevent cold injury 7
Monitoring and Follow-up
- Clinical and radiographic assessments should be performed at approximately day 15 and then at 1 and 2 months post-fracture 2
- Complete fracture healing can be expected in most cases by 2 months 2
- Range of motion should be comparable to the contralateral side in approximately 90% of cases after 2 months 2
Potential Complications and Precautions
- Common complications include skin injuries at the adhesive area (45%) and between the taped fingers (45%) 6
- Patient compliance can be an issue, with studies reporting up to 65% low compliance rates 6
- To prevent skin complications, place gauze between fingers and ensure tape is not too tight 6
- Secondary displacement occurs in a small percentage of cases (approximately 11%), but functional results remain good even with some displacement 2, 3
Special Considerations
- For fractures with significant displacement (>3mm) or involving more than one-third of the articular surface, surgical management should be considered instead of buddy taping 1
- Buddy taping may be less effective for displaced fractures that require reduction, particularly in the little finger 5
- If there are signs of malrotation, buddy taping alone may be insufficient and additional immobilization or surgical intervention may be necessary 3