Buddy Taping as a Treatment Option for Salter-Harris II and Juxta-Physeal Fractures of the Proximal and Middle Phalanx: A Systematic Review.

Abstract

Salter-Harris II (SH2) proximal/middle phalanx fractures are common injuries in children and heal well with immobilization. We conducted a systematic review of nonsurgical treatments for SH2 proximal/middle phalanx fractures. The constructed search strategy used descriptors that included synonyms for "phalanx fracture," "proximal/middle phalanx," and "fracture treatment." All steps of the process were performed by 2 independent reviewers. Articles of any study design that included children treated for SH2 proximal/middle phalanx fractures were included. Results were analyzed for summary statistics and interobserver agreement. Findings were reported in keeping with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The initial search yielded 3511 studies. Five studies met the final criteria: 1 randomized controlled trial (RCT), 3 prospective studies, and 1 retrospective study. Three studies employed a combination of taping and splinting strategies. All fractures healed with no reported complications. At the final follow-up, all studies reported full or nearly full range of motion and high rates of patient comfort and satisfaction. The RCT found lower rates of secondary displacement in the taping (6%) versus splinting (23%) group. Due to small sample sizes and heterogeneous study designs, conclusive recommendations cannot be drawn. More research is needed to determine the feasibility, compliance, safety, and effectiveness of taping these injuries.