Since each hospital and each doctor has personal characteristics in handling fractures, the following postoperative instructions apply only to Dr. Shiwei’s surgical patients. Due to the special nature of children’s fractures, the most common treatment is fracture manipulation + internal fixation with Kirschner pins + external fixation with plaster, and in some cases, incisional reduction is required. The internal fixation of the Kirschner pin is not a strong internal fixation, and there may be a possibility of loosening, slipping or even bending or breaking of the Kirschner pin, or infection of the pin tract, so the postoperative review, medication change and cast change are necessary. The question of when to review for the first time. As the fracture swelling is decreasing, there may be loosening of the cast. Generally, it is necessary to come to the specialist clinic for review, cast removal, medication change and cast replacement at the pinhole or wound from the first to the second week after surgery. Because the fracture is not healed at this time, there is still a possibility of displacement of the fracture. Depending on the situation, it is necessary to remove the cast and take X-rays for possible review, in order to understand whether the fracture is displaced. Of course, if Dr. Stone feels that the fracture is less likely to be displaced, there is also the possibility of not taking X-rays. Generally speaking, the first review will be scheduled on the day of discharge by the nurse in the inpatient unit. If you are unable to make an appointment, you can come to me for an additional appointment at the time the nurse tells you. Frequency of check-ups. If the weather is hot, the child is active and sweating a lot, and the Kirschner needle is left outside the skin, Dr. Shi recommends changing the cast and changing the medication once a week. If the Kirschner needle is embedded in the skin, the cast can usually be changed once every 2 to 3 weeks. The question of when to remove the Kirschner’s needle and whether it is necessary to be admitted to the hospital to remove it Generally, children can have their Kirschner pins removed 1 month to 1.5 months after surgery, but this time varies depending on the injury, age, and healing ability. The exact time will be determined by taking x-rays to see how well the child recovers from the fracture. If the needle is buried in the skin, you will need to be admitted to the hospital to remove the needle. The need for general anesthesia depends on the ability to reach the needle on the surface of the skin and the child’s level of cooperation. If the needle is left on the outside of the skin, it can be removed in the outpatient dressing room. After removal of the needle, a cast is usually still needed for 2 weeks. After 2 weeks, the cast is removed and functional exercises are started. The question of when to fully resume joint movement. Due to the injury, age, and compliance with functional exercises, there is a large variability in rehabilitation time. If the injury is mild, the age is young, and the functional exercise is good, the recovery time will be shorter. And vice versa. In general, it may still take as long as the previous cast to restore joint movement after the cast is removed. Remember: it is definitely not the case that joint movement will be restored immediately after removal of the cast. Problems with after-effects. Any fracture (even a 100% anatomical reduction) may have sequelae. This is fully informed before surgery. A separate consultation is available if needed. At this visit, Dr. Shi will usually order the tests and treatments that need to be done at the next visit and give you an appointment for the next visit, so if you are busy and forget, you can remind me to order the next visit and make an appointment for the next visit. In order to save waiting time, you can come to Dr. Shih’s office when the child has finished taking X-rays. Dr. Shih can see the child’s X-rays on the computer, so you do not need to wait in the radiology department to pick up the X-rays. Since the presence of a cast may affect the doctor’s judgment, Dr. Shi usually requires that the cast be removed for a review of the x-ray. Of course, there are cases when the X-ray must be reviewed with the cast. Again, the above post-operative instructions apply only to Dr. Shih’s surgical patients and are not universal. Medicine is a complex discipline, not so mechanical, even the above instructions may not be the same as Dr. Shih’s actual treatment.