This child had type IIIC bunion dysplasia, also known as floating bunion. When the parents brought their child to the doctor, I was not the first one they found, but a local doctor. At that time, the plan given to them was metatarsal bone reconstruction, which means taking the bone from the foot, and the parents were reluctant to do this, thinking that the child already had problems with his hands, and they didn’t want to let the child have any more problems with his feet. Parent’s request: Don’t touch other parts of the body, just cut on the hand The child’s parents realized that I had been doing the floating bunion surgery, and at that time, my plan of metacarpal bone grafting reconstruction had already been put forward, so they hadn’t accepted other surgeries and waited for me, and they talked with me for a long time after they found me and asked if this metacarpal reconstruction is possible or not, and I was very certain that I could do it. I told him with certainty that it could be done, and that we had already done several cases of this kind. After I explained the surgical plan to them, they felt that it would work, and said that this was the surgical plan they wanted, and that since they had a problem with their hands, they would go under the knife on their hands. The parents’ request at that time was to try not to move other parts of the body and not to remove the bones in the foot. At that time, the child was more than one year old, which was the age of mobility. If the bone in the foot was removed, the child could not go down to the ground for three months, and it was impossible to let him lie down or hold him for three months without letting him go down to the ground, and the parents of this child were very busy at work and did not have the means to take care of him, which was a very realistic problem. For a variety of reasons, we ended up using the surgical plan of hemimetacarpal bone graft reconstruction for him. Exercise is very important after surgery for floating bunions, and it’s not advisable to do a free-range exercise. At that time, my surgery schedule was already very full, and they came back to see me about four or five months later for the surgery. After the two surgeries, the parents thought the results were good, but I didn’t think they were what I wanted. Because this child was a free-range exerciser, the child played as much as he or she wanted to play, plus it was an elderly person who brought him or her up, and there was no deliberate effort to cultivate and exercise the child’s thumb function. When he came to the outpatient clinic for review, we found that this child’s grasping and gripping ability was very good, but his ability to grasp small objects was not demonstrated. In fact, what we observed is that the first thing that a child with a floating bunion can do after surgery is to grasp something small, but he is not capable of grasping something big. This child, on the contrary, has a strong grip on something big, but due to the lack of exercise, he does not have the ability to grasp small things. As they were far away from Wuhan, I could only supervise his exercise through WeChat. Postoperative follow-up, the child’s thumb function and shape is getting better and better After the surgery, we found through three to four years of follow-up, with the growth of the child’s reconstruction of the metacarpal bone thickness has reached about 90% of the normal metacarpal bone thickness, and at the same time, its donor area has also been very well restored, and the metacarpal bone length and width is almost the same as that of our normal compared to the current situation. At present, the child’s thumb function and shape are getting better and better, his hand strength is good, and his fine motor movements have recovered relatively well. The child’s parents are relatively satisfied and hope that he can recover even better through further exercises. When is the best time to do postoperative fine motor exercises? We believe that the sooner the fine exercises are done after bunion surgery, the better. The children who come to the clinic for follow-up are basically able to start the functional exercises soon after the second bunion surgery when the Gerber’s needle is removed. The child has a sense of self-protection. After the floating bunion surgery, he knows that his hand has been injured, so he is reluctant to grasp things. At this time, parents have to encourage the child and guide him to grasp some small things, and when he knows that his hand is able to grasp things and there is no injury to him, slowly he will be willing to do some grasping movements, so this is a very important step, and it is crucial to make the breakthrough from zero to one. This is the first time that many parents experience their child’s post-surgical exercises after floating bunion surgery, and sometimes they don’t know how to help their child with functional exercises. However, it is very common for our surgeons to help their children with their first exercises after surgery, and many parents go to help their children with grasping motions under the guidance of our surgeons, so as long as this breakthrough has been made, it will be good for their children’s exercises at home in the future. The best way to recover from floating bunion surgery is to exercise gradually. In the beginning, we can use small paper balls and cotton swabs to let the child practice grasping, for example, letting the child use the hand that has undergone surgery to transfer the small paper ball from one place to another, and grasping a few more times the child will know that his hand can be grasped. Parents must actively help the child with the exercise until the child can be skilled at grasping and pinching small red and green beans and other small things. With continuous practice, the child’s refinement exercise is also done well, usually at this time the child’s thumb function and appearance will be restored better.