The floating thumb generally works best when the procedure is done between six months and one year of age. Why is this the best time? Because floating thumb is not functional at all, while normal children start to build up their thumb function at six months of age, slowly moving from simple grasping to fine motor skills, which takes a process and does not happen overnight. What we need to do is to provide the foundation of thumb function when the child starts to establish it, so that it will not have a big impact on the use of the thumb in the future. Is it possible that if we miss this time, the surgery will be less effective? Nowadays, we use the hemi-metacarpal bone grafting method to treat floating thumb, which means that a portion of the child’s second metacarpal bone is taken to rebuild the first metacarpal bone. From a growth perspective, there is no doubt that the younger the child is, the easier it will be for the bone graft and the donor bone to recover. Some children are older and parents are asking if the surgery is not as effective as it should be. This is not the case, because older children can understand exactly what their parents are saying and can cooperate better when performing post-operative functional exercises.