Case Overview: We present the case of a man with 90° Dupuytren contractures in both the right small and ring finger at both the metacarpophalangeal and proximal interphalangeal joints.

Technique: With the patient in supine position with the hand on an arm board, a digital blockade is performed. An Agee digit widget guide is placed over the middle phalanx of the small finger. The guide is positioned via fluoroscopic guidance to ensure adequate space and alignment away from the joint. Under fluoroscopy, Kirschner wires are then advanced to the second cortex. The K-wires are then subsequentially removed, and the threaded pins for the jig are slowly advanced. The Agee digit coupler is applied and tightened. The wrist sleeve portion is placed on the patient, and two light bands are placed to each finger.

Results: This patient demonstrated near-full recovery after the two-stage process. The slow process of proximal interphalangeal extension via the Agee digit widget has shown promise over fasciectomy and checkrein releases. In a case series by Craft et al, the investigators found that the soft-tissue distraction via the use of a digit widget showed greater correction than standard open procedures alone. This technique remains relatively novel in comparison with prior open techniques alone.

Summary: The digit widget is an easy supplement for a staged release of a severely contracted or recurrent retracted proximal interphalangeal joint secondary to Dupuytren contracture. We have found that this external fixation system has reduced neurologic injuries and the need for skin-grafting procedures.