A 72-year-old male tripped and fell, dislocating his non-dominant left-ring finger’s proximal interphalangeal joint (Figures 1 and 2). The dislocation was reduced under ring block anaesthesia and the joint immediately mobilised using a simple method of ‘buddy strapping’ using elasticated bandages (Figures 3–6). This enabled the patient to play 18 holes of golf the following week with minimal swelling, controlled flexion and abduction of the digit and with adequate functional support!
Figure 1: Dislocated PIP LD4.
Figure 2: Xray showing fracture dislocation of PIP joint LD4.
Figure 3: Elasticated self-adherent strapping roll.
Figure 4: Tailoring the strapping.
Figure 5: Application of strapping as single digit to control joint and swelling.
Figure 6a: Application for use a buddy strap for the injured digit to the middle finger.
Figure 6b: Use of easily retained gauze to separate the digits in buddy strapping.
Figure 7: Ring finger elasticated bandage support and buddy strap
have been temporarily removed for ease of hand washing.
Tips
There are distinct advantages of using this customised, elasticated, self-adherent tape for buddy strapping digits over the more commonly used ‘above and below’ joint application of ‘inch pink’ Elastoplast and gauze dressings. These are:
- There is less restriction on active and passive mobilisation of the affected joint.
- The strapping is easily self-applied.
- The elasticated strapping can be separately applied for a controlled pressure over the affected joint to help reduce and control soft tissue swelling.
- Single-digit application can be omitted or used in combination with distal joint buddy strapping (Figure 6a).
- ‘Inch pink’ Elastoplast is non-compliant, and difficult to self-apply over gauze dressings. Gauze can easily be applied underneath the elasticated strapping and changed without necessarily removing the strapping (Figure 6b).
- Using single-digit strapping to control swelling also removes the need to use gauze between the digits normally used to prevent excoriation.
- The strappings are easily removed intact (Figure 7) and because they are self-adherent and have been effectively pre-moulded, they can be easily reapplied after showering, digit cleaning and massage of the affected digit.
- The strapping is cheap and effective, allowing early return of function to the hand.
- Elastoplast can be difficult and uncomfortable to remove when ‘stuck’ on the skin of the affected digit.
- A caution of Elastoplast is related to adhesive skin allergy in atopic individuals, although allergy to rubber needs to be excluded for use of the elasticated strapping.
Declaration of competing interests: None declared.
