Finger and hand injuries are very common in rugby.1
Buddy strapping for dislocations, subluxations, or interphalangeal joint sprains is the mainstay of treatment.2
Strapping and taping of body joints represent the second most common form of protective equipment used by rugby players, second only to mouthguard usage.3
These techniques can prevent injury and protect the athlete from reinjury when returning to sport. Taping of fingers, and in particular buddy strapping, is used to protect an unstable joint where the uninjured finger acts as a splint to protect an injured joint on an adjacent finger. However, finger taping is not without its problems, as illustrated by Rashid et al
, who reported on a case of fingertip necrosis following buddy strapping.4
One of the main tenets of healthcare provision is ‘primum non nocere’ (first, do no harm), and it is vital that as healthcare professionals we use the correct equipment and, more importantly, advise athletes as to the correct equipment to use to protect themselves from injury. In most circumstances, players will use the tape most readily available for buddy strapping, which is commonly electric insulating tape used for sock and boot taping. Electrical insulating tape is made from polyvinyl chloride material that is coated with rubber pressure-sensitive adhesive. The tape is water resistant, very adhesive and cheap, which make it an ideal taping material for everyday use. However, the tape has a sharp edge and is capable of incising through skin, particularly when the skin is moist.
There are a number of more appropriate strapping materials available; they range from self-adhesive tape, to Tegaderm, to commercially available straps.5,6
However, the most common taping material used in practice is zinc oxide tape. It is usually white, although sometimes tan or brown, in colour, non-elastic and sticky. It derives its name from the adhesive glue found on the tape, which contains zinc oxide. It comes in a variety of widths and is easy to tear to the appropriate length required. Its non-elastic properties make it the ideal tape for limiting range of movement of joints or for splint application.
In this case report, the mechanism of injury and direction of pull of the fingers caused significant stress across the third web space and put the skin under considerable tension. We believe the injury was exacerbated by the creation of a lead point in the web space by the sharp edge of the electrical insulating tape, which allowed the skin to tear as a result of the forces applied. The edge of the electrical insulating tape was found stuck into the skin of the web space directly at the point of the laceration. Had another, more appropriate material been used, it is doubtful that the injury would have been so extensive if it had occurred at all.
- This case illustrates the potential for serious injury when using electrical insulating tape.
- Appropriate taping material (eg, zinc oxide tape) should be available for buddy strapping.
- All athletes and members of the coaching staff, including the medical staff, should be strongly advised against the use of electrical insulating tape for the taping of fingers.