This child is a typical type IIIB thumb dysplasia floating thumb. At the time, the parents did not have high expectations for their child’s recovery after the surgery, as long as the thumb could be preserved, it did not matter whether the child could move or not, but after two surgeries, the parents became more and more confident. The parents wanted to keep their child’s floating thumb, so they went around to many hospitals to inquire about the surgical method. Before they found me, the parents took their child to other hospitals to inquire about the surgical method for floating thumb, and the results they got at that time were all about thumb thumbing, which was very difficult for the parents to accept after hearing about this surgical method. But they didn’t give up and continued to look for a surgical method to preserve the thumb. At that time, more doctors were recommending them to do the thumb surgery, and there were very few doctors who could do the metatarsal reconstruction to preserve the five fingers, plus the parents were not willing to take the bones from the child’s foot, and the family attached great importance to the child, in such a situation, the parents did not give up to find a more satisfactory surgery method. The parents did not have high expectations for their child’s floating thumb surgery, and their only expectation was to be able to keep the five fingers. After the parents brought their child to my clinic, they made it clear that they did not have high expectations for their child’s floating thumb surgery, as long as the metatarsal bones on the child’s foot were not sacrificed and the thumb could be preserved, it did not matter if the hand looked intact with five fingers, it did not matter if the hand could be moved or not, preserving the five fingers was the only expectation of the parents at that time. Although I understand the parents’ feelings, from our doctor’s point of view, we always follow the principle of considering the function of the child’s thumb before the aesthetics, and if a thumb functions well, then the appearance will not be too bad. After looking at the child’s case, I told the parents that the child’s floating thumb could be preserved and that we could use the hemi-metacarpal bone graft reconstruction (SMRT floating thumb reconstruction) procedure without taking the metatarsal bone from the child’s foot, and that the child would still have five fingers after the surgery. After explaining the surgical options to the parents in detail, they decided that this was the surgical option they wanted and immediately decided to use hemi-metacarpal bone graft reconstruction to treat their child’s floating thumb. After the hemi-metacarpal bone graft reconstruction surgery, the parents became more and more confident that the function and shape of their child’s thumb would be restored After the surgical plan and surgery date were determined, we performed two surgeries on the child, the first to build the bone and the second to rebuild the function, and both surgeries were completed successfully and the results were basically the same as we predicted before the surgery. After the hemi-metacarpal bone graft reconstruction surgery, the parents were satisfied with their child’s post-operative condition, and we gave them a detailed explanation of the functional exercises. Because this child is in Wuhan, he was able to come to my clinic frequently for review, and we also gave some functional instruction exercises according to his condition. From the results of the outpatient review, the overall effect is still good, and the function of the child’s thumb is established in a very orderly way. Functional exercises are also a very important part of the post-operative period of the floating thumb. The child’s grandmother was in charge of his functional recovery process, but the whole concept of rehabilitation was in accordance with my requirements. The child’s grandmother helped the child to do very well in the process of holding large objects and holding and pinching small objects. During the recent review, we saw that the child was very flexible in holding a pen, writing, pinching objects, and opening bottle caps, and that the thumb had developed very well due to long-term functional exercise. The thumb will continue to grow. For us, it is still true that the doctor’s work is part of the job, but the parent’s help in guiding the child in functional exercises is also a very important part. As we can see from the outpatient review, the more parents pay attention to functional exercises after surgery, the better the child’s thumb and shape will recover, so after we do the floating thumb surgery, parents must actively help and guide the child to do functional exercises according to our explanation.