Pediatric and adult trigger thumbs represent different entities requiring different treatment approaches. Despite some controversy, pediatric trigger thumb is considered an acquired condition caused by unique anatomic abnormalities.17 Among the estimated 0.05% of all children diagnosed with trigger digits, 90% occur in the thumb, most commonly presenting at 2 years of age.7 Previous studies report a spontaneous resolution rate ranging from zero to 66%.1
According to a 2010 Kaiser Family Foundation study, 85% of 15- to 18-year-olds own a personal cell phone, an increase of nearly 30% from just 5 years earlier.10 In a typical day, 46% of 8- to 18-year-olds reported sending text messages, with those who text estimated to send an average of 118 messages in a typical day.10 Fifteen- through 18-year-olds spent the largest amount of time engaged in sending and receiving texts at 1 hour 51 minutes daily.10
In our report, we present the unique case of a 16-year-old female patient with no risk factors for the development of stenosing tenosynovitis other than her substantial texting. Though the aforementioned studies report occurrences of tendonitis or tenosynovitis due to text messaging, nearly all reports are related to dorsoradial pathology, such as in De Quervain tenosynovitis. In addition, studies using electrogonimetry and ultrasound also focused on this region of pathology, suggesting that tenosynovitis involving the flexor aspect of the thumb is rarely appreciated.1516 To our knowledge, this is the first report of stenosing tenosynovitis in a teenager that resulted in clinically disabling triggering of the thumb and ultimately required surgery. As the use of mobile devices increases while technology continues to progress, this rare clinical phenomenon may be of increasing importance in the near future. Thus, it is warranted to examine precipitating factors in our presented case in an effort to shed light on potential risk factors or preventative measures that may be implemented.
Based on the previously mentioned values from the Kaiser Family Foundation study, a typical teenager who uses text messaging services would average roughly 3,500 texts per month.10 According to Table 1, our patient sent 7,085 texts per month at her lowest point and 13,487 at her peak prior to her initial visit in November 2012. Therefore, she was texting an average of 2 to 3.7 times more than the average texting teenager when her symptoms developed. In addition, she used a cell phone with depressible buttons instead of a touch screen (Fig. 2), which likely increased the amount of muscle activity needed to enter a text message.
Babies and children begin sucking their thumbs as a reflex, making them feel secure and safe. The behavior may extend into adulthood for similar reasons. Adults may suck their thumbs as a response to stress or anxiety.
Many babies and young children suck their thumbs, but most stop by the age of 4. However, some people will continue to suck their thumb into adulthood. Vigorous thumb sucking can cause blisters, calluses, and dental problems.
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Reviewed by: Hit the Road Deborah Stevenson Cooney, Caroline B. Hit the Road. Delacorte, 2006 [176p] Library ed. ISBN 0-385-90174-7$17.99 Trade ed. ISBN 0-385-72944-8$15.95 Reviewed from galleys R Gr. 6-10 Brit's expectations of a quiet stay with her grandmother evaporate when it turns out that eighty-six-year-old Nannie is planning to take advantage of her watchful daughter's absence, drive a rented van out to pick up her old college buddies, and attend her college reunion. Since Nannie is every bit as unsafe a driver as Brit's mother had thought, novice driver Brit ends up at the wheel, fearfully tackling motoring challenges such as interstate traffic and car ferries. Soon, though, driving is the least of Brit's worries: she, Nannie, and Nannie's old college dormmates Flo and Aurelia are trying to elude Aurelia's villainous money-grubbing son, who had his mother committed to a nursing home under false pretenses, and who has made it clear he will stop at very little to get his mother and her money back under his thumb. As usual, Cooney provides a breezy, easily digestible narrative peppered with sarcastic wit and subtly flavored with thought-provoking reflection. There's an entertainingly madcap story in Brit's taking it on the lam with the trio of old ladies, known as \"the girls,\" and getting periodic telephonic advice from the boy she's crushing on. Underlying that story is Brit's growing realization that a teenager's blossoming possibilities are the reverse of old age's increasing curtailments (\"As fast as I climb into adulthood,\" she thinks as she realizes that the women have all been stripped of their cars and credit cards, \"the girls are shoved away\"), and that the decisions she's just being allowed to make are those that the old ladies are expected to surrender. It's a telling point, made in a way particularly understandable to teen readers, but it doesn't overpower the adventure story. The end is a little disappointingly abrupt (Brit gets her boy and maybe an extra, but we don't see the villain's comeuppance), but it's otherwise an enjoyably frenetic road trip with some surprising and reflective touches.
Brett \"Ice\" Grady finds single parenting a precocious 16-year-old daughter more challenging than his position as president of the Regulators MC. Keeping tabs on Brooke requires technological subterfuge, so when she doesn't check in at the expected time, he uses said technology to track her and her friend Madyson down at a wild teenage house party. It's quite the scene when Ice and two of his tough, intimidating MC brothers arrive at the party to collect Brooke and her friend. When Ice demands Madyson's address so she can be safely seen home, they land on her the doorstep of her sister Morgan, who greets Ice with a can of pepper spray in her hand.
\"This one belong to you\" the rugged-looking stranger gruffly asks me as he points his thumb over his shoulder, obviously pissed. There is another man with him. His vest has a patch that says \"Hammer\" and a teen girl is shifting nervously beside him.
What sets Ice apart from many MC romances is that it isn't about club rivalries or relationship difficulties related to the interpersonal dynamics between those living in the MC subculture. Ice is a complex story about heroism and exposes inhumane treatment of women captured for exploitation by human traffickers and how it's sometimes necessary to step outside the law to catch those involved in these heinous crimes and rescue the victims. The authors don't hold back in depicting graphic scenes of brutal violence. That said, the dialogue and introspection are peppered with dry wit and sarcasm, enabling the story's multidimensional characters to share more than a few laughs with readers. Brooke is delightful. Her teenage hijinks and interactions with her father and his MC brethren are a riot. I wondered how the authors would create a believable relationship between a tough motorcycle-riding alpha male and a virginal investment broker. 59ce067264