Floating bunions are really difficult to correct. It is characterized by severe bunion hypoplasia, in which not only the deformed thumb loses its function completely, but also the first metacarpal bone is missing, and there is only a tiny dermatome connecting the thumb to the metacarpal bone, which has a great impact on the life of the patient. I have been working in hand surgery for many years and have seen many floating thumb babies. Many parents ask me, can my baby’s hand look like normal? What I always say is that we should work together in this direction. A deformed finger lacks functionality, and a relatively functional thumb after correction is of great value to the hand. For the treatment of floating bunions, many foreign countries advocate the reconstruction of the thumb function through thumb bunionization, but there is no unified treatment plan in China. The first correction that can save the thumb is half metatarsal reconstruction, which is transplanting half of the third or fourth metatarsal bone from the foot to the affected hand to reconstruct the first metacarpal bone and the first carpometacarpal joint. However, the patient is not allowed to put weight on the foot for three months after the correction, and the grafted bone will be absorbed and will have a chance of necrosis. Many parents are reluctant to accept the removal of the metatarsal bone from the foot, and as doctors we are always looking for better treatment options to minimize the trauma while preserving the thumb. After many years of research and clinical practice, we have realized the use of semimetacarpal bone graft reconstruction (SMRT floating bunion reconstruction) to reconstruct the first metacarpal with a portion of the second metacarpal bone. What’s more, the surgery can be performed on children between the ages of 6 months and 1 year, which can help children to establish the function of the bunion at an earlier age. When this child’s parents came to see me, they said that they had been to a lot of places, and most of the doctors had recommended that they have a bunionization of the demonstrated finger. This was not acceptable to them and they came to me hoping that I could save their child’s five fingers. I looked at the child’s condition and diagnosed him with a Type IIIB bunion, which can be corrected with Semi Metacarpal Bone Graft Reconstruction (SMRT Bunion Reconstruction). After hearing about the program, the parents indicated that this was the approach they had been looking for. The child underwent a two-stage surgery, and the parents also cooperated correctly in guiding the child’s finger function exercise. From the results of the outpatient review, the overall effect was still good, and the child’s thumb function was established in a very orderly manner. The child is now able to write normally. The corrective effect of floating bunion is related to the functional exercise, so parents must pay attention to the functional exercise in order to let the finger function recover better.