With the continuous development of technology and the improvement of people’s living standards, cell phones are becoming more and more essential to the public. However, excessive use of smartphones can also lead to a series of injuries, such as Blackberry thumb (Blackberry thumb), a disease of the finger joints caused by the use of Blackberry phones. (It occurs when excessive use of Blackberry phones to send and receive e-mails and text messages, resulting in repetitive strain injuries to the fingers). Gilman et al. from Naval Medical Center San Diego, USA, presented a case of thumb extensor tendon rupture due to excessive use of smartphone games, published in a recent issue of JAMA Internal Medicine. Case presentation: The patient, a 29-year-old male with a right lipped hand, presented with persistent pain and limited motion in his left thumb. According to the patient, he had been playing a video game with his smartphone almost all day for 6-8 weeks prior to the onset of this symptom. The patient was accustomed to playing with his left hand while doing other tasks with his right hand. While playing, the patient did not feel any discomfort, and according to the patient, “the game was secondary, but necessary, and the hand could not be stopped”. The patient had no previous injuries or surgeries on both hands, and no history of inflammatory arthritis, quinolone use, or other conditions that would trigger tendon rupture. On examination: the left long thumb extensor tendon was not palpable, and no tendon movement was seen when the wrist tendon was fixed. The range of motion of the metacarpophalangeal joint of the left thumb was 10°-80°, and the range of motion of the interphalangeal joint was 30°-70°. These conditions were not present in the right thumb, leading to the diagnosis of a left long thumb extensor tendon rupture. The patient’s treatment plan was to graft the index extensor muscle (one of the two extensor tendons of the index finger) to the long thumb extensor tendon. Intraoperatively, a rupture of the long thumb extensor tendon between the metacarpophalangeal and carpal joints was seen. The players in the video game that this patient was addicted to were connected to each other through social networking software and smartphones via the Internet. Players can call their friends to join them through social networking software, and several features of these mobile video games make them popular: a virtual world unrestricted by the surrounding environment, an in-game achievement system, and mass entertainment. The surprising stimulation experienced by players in the game together with a series of physiological reactions stimulates the hypothalamic-pituitary-adrenal axis, leading to a rapid heartbeat, increased blood pressure and sympathetic excitement. The game process suppresses pain perception in children with burns, distraction by what they see in front of them and neurosecretion of the hypothalamic-pituitary-adrenal axis may be the reason why this patient did not feel discomfort during the game. Because no discomfort was felt in the finger during play, the patient chose to continue playing, which led to tendon thinning and subsequent tendon rupture. Unlike a high-energy injury where the tendon is at its thinnest point or in close proximity to the bone, in this case the tendon was ruptured in the middle. Tip: This is an extreme example, but cases of finger arthritis, tendonitis, elbow and shoulder pain caused by playing with cell phones are common.