Hand Biomechanics Lab

Digit Widget

  • A surgical device created to aid in the treatment of PIP flexion contractures
  • Extension torque, transmitted to the joint by bone pins in the middle phalanx, “grows” all contracted palmar tissues back towards normal length
  • Can be used on multiple digits
  • Accommodates soft tissue procedures
  • Optimal torque controlled by the surgeon and hand therapist
  • Avoids skin pressure limitations of conventional splints and casts
  • Minimal restriction of hand function during soft tissue growth

It is important to remember that while the Digit Widget is very effective in reversing PIP contractures, maintenance of active joint extension requires identification and treatment of the underlying cause of the each patient’s PIP joint contracture.

Illustrative Case

Treatment of PIP Flexion Contractures

Patient is diagnosed with recurrent Dupuytren’s Contracture.

Patient following 3 weeks of extension torque

Two Digit Widgets were applied pre-fasciectomy to reverse the contracture:  two small incisions were made to divide bands on the little finger with one incision adequate for the ring finger.

The Digit Widget needs to be worn full time. The dynamic portion of the device can be “clicked off” the finger for bathing and active flexion exercises.

Patient at 6 weeks

After six weeks of wearing the Digit Widgets, the patient’s extension had plateaued. He was scheduled for the fasciectomy.

Restoration of extension, as a function of time, varies with the etiology of the contracture (i.e. torque imbalance) and the biomechanical properties of the contracted tissues. In Dupuytren’s, a gain of 10 to 20 degrees per week is typical.

Patient at 11 weeks

Following two months of extension torque, the patient gained almost full PIP extension. Surgical excision of the diseased tissue was followed by continued extension torque at three weeks post op.

The device’s skeletal pins should not be removed until voluntary “active” PIP extension demonstrates maintenance of the improved “arc” of motion.

Patient at 23 weeks

The patient’s “widgets” were removed following four months of extension torque.

Night splinting for six to nine months following device removal helps maintain active finger extension.

Digit Widget Sterile Pack A Contains:

  • Proximal and Distal Pre-drills
  • Proximal and Distal Bone Pins
  • Pin Block
  • Drill Guide
  • Hex Wrench (5/64″)
  • Sterile Condensed Surgical Guide (Not shown)

Digit Widget Non-Sterile Pack B Contains:

  • Two sizes of Hand Cuffs
  • Connector Assembly
  • Three weights of Elastic Bands
  • Extra Hex Wrench (5/64″) for Removal
  • MP Flexion Strap
  • Condensed Assembly Guide (Not shown)

PIP flexion contractures result from a torque imbalance across the joint. Either there is not enough extensor force, too much flexor force, or a combination of the two.

The Digit Widget reverses these contractures by utilizing the principle that gentle force applied over time will stimulate growth of contracted soft tissues.

The Digit Widget applies extension torque to reverse the contracture, instead of joint traction used by other methods. The Digit Widget does not prohibit finger flexion. The patient remains more active during treatment thereby minimizing joint stiffness.

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