Goldman SB, Brininger TL, Schrader JW, Curtis R, Koceja DM. Analysis of clinical motor testing for adult patients with diagnosed ulnar neuropathy at the elbow. Arch Phys Med Rehabil 2009;90:1846-52 From the physiological standpoint , this sign is easily understandable. Adduction of the little finger is performed by the interosseous and abduction by the hypothenar muscles. Both groups of the muscles are innervated by the ulnar nerve. However, in abduction of the little finger, the extensor digiti minimi and the branch to the little finger of extensor digitorum communis also play a definite part.These both are innervated by radial nerve. If the muscles innervated by the ulnar nerve are weak, those innervated by the intact radial nerve predominate in strength and abduct the little finger. Thus it is understandable why this abduction of the little finger is best seen when extensor digitorum communis comes into action and extends the fingers and the hand. In cases with the combined palsy of ulnar nerve and radial nerve ,this sign would not be present" explains the author. A study by Goldman et al (2009) [5] adopted the technique to assess Wartenberg's Sign - The patient is placed with wrist in neutral position and forearm fully pronated and instructed to perform full extension of all the fingers. Once digits are extended patient is asked to fully abduct all fingers and then adduct all fingers. A positive sign is indicated with the observation of abduction of the 5th digit, with the inability to adduct the 5th finger when extended. Robert Wartenberg, namesake of the Wartenberg wheel, is sometimes incorrectly credited as its inventor. [3] According to Wartenberg himself, the device was in widespread use in Europe when he lived in Germany. [3] While he did not invent it, he found it "an indispensable part of the outfit for everyday neurologic practice," and recommended its use to his colleagues in the US. [3] Unlike many BDSM sex toys, using a Wartenberg Pinwheel alone is easy. If you find the right position, you can use this toy to stimulate the sensory nerves on your genitals, legs, or stomach. Use blindfolds to restrict your sense of sight for added stimulation.

As there is no general consensus regarding the aetiology of the Wartenberg's sign, managment cannot be attempted for the sign alone. Hene it would be optimal to analyse the reason for the abducted posture of the little finger and can be managed accordingly. There are few surgical procedures documented for the correction of abduction deformity of the little finger. Robert Wartenberg, M.D ;A SIGN OF ULNAR PALSY ;JAMA. 1939;112(17):1688. doi:10.1001/jama.1939.62800170002011a. Tosun N, Tuncay I, Akpinar F. Entrapment of the sensory branch of the radial nerve (Wartenberg's syndrome): an unusual cause ;Tohoku J Exp Med. 2001 Mar;193(3):251-4. Wartenberg Pinwheels are a great way of stepping into the BDSM world. How do you use a sensation wheel, wheels introduce medical vibes into your bedroom, taking your sexual experience to another level. This Wartenberg Pinwheel guide has everything you need to know before you whip these medical fetish toys out during intimacy. Carefully read the tips for a stimulating first experience with the toys.The NAD Pinwheel, which is a pinwheel neurological testing device, provides a disposable solution in aiding professionals in the diagnosing of nerve damage. David J. Magee: Orthopedic Physical Assessment: chapter 6-elbow ;sixth edition; Elsevier Health Sciences, 2008 Whipping and spanking make the skin highly sensitive. Take advantage of this to introduce your wheel for further stimulation and deep orgasm. If you do not have impact play tools, including floggers, whips, and paddles, use your hand to slap, pinch or bite your lover’s nipples to heighten sensitivity. How to Approach a Sex Worker, a Woman, a Stranger, or Anyone Else You’d Like Something From May 31, 2019 Although people focus more on whips, paddles, and floggers, the Wartenberg Pinwheels is a sensation play sex toy that is a game-changer in sensory modification. The impact of these medical fetish toys can be seen in the glowing face of the sex world. If you have always wanted to experiment with them after a stimulating experience in the hospital, this is a must-read guide for you.

The Wartenberg Wheel was created to test nerve sensitivity in patients who might have brain damage. If your toes curled in one direction or another or not at all as the spikey little pinwheel rolled across the bottom of your foot, the examinier could discern what might be going on with your body. It didn’t take very long at all for tailors, hedonists, sadists, and sensualists of various persuasions to arm themselves with this very same tool.It is seen that the author (Robert Wartenberg) had not prescribed a specific technique to assess the sign. The literature describes few techniques of assessment based on the explanation given by the author. Clothing pattern-making can use a version of the Wartenberg wheel, called a pounce wheel, to transfer markings from paper to fabric. Pounce wheels resemble standard Wartenberg wheels in shape but have wooden or plastic handles. There is an assortment of professionals that could benefit from the use of such a device. The Wartenberg Pinwheel saw widespread use in Germany before being accepted into the United States by chiropractors, orthopedists, neurosurgeons, neurologists, physical therapists, and more. A Wartenberg Pinwheel is a medical fetish sex toy with a rotating spiked wheel that glides on the skin to stimulate nerve endings. The Pinwheel was invented as a medical tool for testing nerve sensitivity. This invention slowly found its way into the sexual arena and is used in sensational plays. The evenly-spaced wheels on this tool provide different sensations when running on various body parts. Sensation’s intensity depends on the number of wheels and the pressure you apply when using the toy. If you are a beginner, start with a one-wheeled Pinwheel and upgrade to models with a row of wheels with experience. More wheels produce intense sensations over a large area, which might be overwhelming to some first-timers. Kilgus M , Burg D, Loss M, Weishaupt D, Meyer VE.: Wartenberg's Sign of Ulnar Nerve Lesion. A Contribution to Pathophysiology and to the Differential Diagnosis; Handchir Mikrochir Plast Chir. 2003 Jul;35(4):2518.

A Wartenberg wheel, also called a Wartenberg pinwheel or Wartenberg neurowheel, is a medical device for neurological use. The wheel was designed to test nerve reactions ( sensitivity) as it rolled systematically across the skin. [1] A Wartenberg wheel is generally made of stainless steel with a handle of approximately 18 centimetres (7in) in length. The wheel, which has evenly spaced radiating sharp pins, rotates as it is rolled across the flesh. A disposable plastic version is available. Because of hygienic concerns, these devices are rarely used for medical purposes. [2] The Wartenberg Pinwheel has a simple yet powerful design that leaves your sensory nerves excited. The frontal part of this device is made up of a wheel with evenly distributed spikes. In action, the pins provide uniform sensations that can make your lover melt in front of you. Connected to the spiked wheels is an ergonomically designed handle that allows easy use of the toy to torture the submissive with the intended pain or pleasure. The first literature regarding this sign appears to be the Letter to the Editor By Robert Wartenberg himself at 1939. In this ,he emphasize the diagnostic importance of this sign in ulnar nerve neuropathy which is not documented. The author further describes "this sign consists of position of abduction assumed by the little finger. Sometimes the fourth finger too has a tendency to assume a position of abduction, but usually it is only the little that is found in abnormal position. It was found to be most conspicuous when the patient was asked to extend his finger at the proximal joints. The importance of this sign has become increasingly evident from numerous experiences which indicate that this tendency of the little finger to be abducted may constitute an early (in some cases the first) and also a late sign of ulnar palsy". This is where stainless steel Wartenberg Pinwheels gain an advantage over plastic and chrome-plated iron Pinwheels. To experiment, heat the metal pinwheel in warm water or cool it in the freezer. After heating or cooling the wheel, test it on your body to confirm if the temperatures are manageable. Once you are ready, run the hot or cold toy on your lover’s sensitive spots and watch them moan in pleasure.So, here’s to tiny little pokey things that make us both giggle and squeal; I hope you have fun playing with the simple and delightful Wartenberg Wheel!

The mere presence of this sign doesn’t warrant ulnar neuropathy as the various studies reported abducted posture of little finger in patients without ulnar nerve involvement or even without neurological involvement. A study by Kilgus et al (2003) [7] analysed the aetiology of the Wartenberg sign. In this study five cases suffering from bothersome permanent abduction of the small finger and referred under the diagnosis of ulnar nerve paresis are presented. The authors commented that the Clinical, electrodiagnostic and imaging evaluation of three neurogenic cases disclosed a lesion of the ramus profundus distal to the branches innervating hypothenar muscles in one case, ulnar nerve injury with neuromuscular hyperactivity of the abductor digiti minimi muscle following split repair in another case and syringomyelia in the third case. Two patients revealed an abduction posture of the little finger of nonneurogenic origin. One of them showed closed ligament injuries. The other patient revealed necrosis, scarring and contracture of hypothenar muscles and atrophy of the third palmar interosseous muscle following compression in a tight cast.A Wartenberg Pinwheel can leave an itching effect after the play. For that reason, always have an anti-itching cream before using a Pinwheel. If the play causes a little bloodshed, clean and wipes the scene with an alcohol swab to prevent infections. Sterilize the wheel after use for safety and hygiene purposes.