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 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". There are also chrome-plated iron and plastic Wartenberg Pinwheels in the market. Chrome-plated iron Wartenberg Pinwheels are relatively cheaper than the stainless-steel models. However, these devices may rust after some days of use, increasing infection risks. For that reason, avoid chrome-plated iron models or be extra careful when using them to avoid causing harm to your lover. Plastic Wartenberg Pinwheels are also cheaper than stainless steel variants. Plastic pinwheels come in various colors, allowing you to choose what fits the session’s mood or your outfit. However, they are not as durable as other types. Sterilizing them is also challenging; hence not ideal for group sex. When it comes to pinwheel material, your safety should take precedence. Then, you can consider the budget and durability of the toy. 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.

Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc. David J. Magee: Orthopedic Physical Assessment: chapter 6-elbow ;sixth edition; Elsevier Health Sciences, 2008 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. 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.

8. Blindfolds

Sensory play is slowly becoming a new normal in many romantic relationships. Couples are looking for new ways to add pleasure to their sex lives. If you are among these couples, then the Wartenberg Pinwheel BDSM sex toy guide will be great and add to your sex toys collection. The history of this toy is quite interesting and its impact is mind-blowing. It can take your sensational and bondage play to the next level. How to Approach a Sex Worker, a Woman, a Stranger, or Anyone Else You’d Like Something From May 31, 2019 The NAD Pinwheel, which is a pinwheel neurological testing device, provides a disposable solution in aiding professionals in the diagnosing of nerve damage. A cadaveric study [8] investigated the impact of the radialization of the extensor digiti minimi (EDM) at the level of the fifth metacarpophalangeal (MCP) joint and reroutes it from the fifth to fourth extensor compartment. The study was done in 16 freshly frozen cadaver hands sectioned at mid-forearm.The authors concluded that the key to correct abduction deformity of the little finger is radialization of the EDM, which can be done through a solitary incision at the level of the MCP joint. Rerouting alone does not correct the abduction deformity, and in combination with radialization it does not predictably enhance the correction. 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.

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. 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. 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. 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.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.