If two people are facing off, then you can call out a challenge every time a certain finger or color (or one of each) comes up.  This is a good way to make a drinking game out of it.  Consider every middle finger called out being time to take a drink.  Go an extra step and have the drink being drank decided by the color (red=wine, blue=water, yellow=beer, and green=hard liquor.)  If you want a more singular drinking act, have a 'rock paper scissors' playoff with the other hand at each challenge, and the loser has to drink while continuing with the Twisted Fingers game.  

If you happen to have a box of trivia nearby, let the challenge be answering questions for 'points'.  If you want to use this for a learning game for kids, have the challenge be spelling a word of a vocab list, or answering a question from a test quiz.  

If you laminate the card, you could have fun making a mess with some like-colored finger paint on each color circle.  After 5 spins/rolls, each person has to press their fingers to a piece of paper, creating a chain of ever-devolving color fingerprints.  Watch the primary turn to secondary turn to mud!