Without the thumb, we would have half the function of our hand. Floating finger not only affects the function of your child’s hand, but also affects the aesthetics of the hand, so surgery is needed to improve your child’s thumb. In the past, we would use surgical procedures of demonstrative bunionization and metatarsal reconstruction to treat a child’s floating thumb, but one is unacceptable to the parents and the child, and the other is a traditional treatment, neither of which is the best option for treating floating thumb. We now have a more advanced surgical procedure that allows us to treat children’s floating fingers with semimetacarpal bone graft reconstruction (SMRT Floating Bunion Reconstruction), which avoids some of the effects caused by bunionization and metatarsal reconstruction of the digit. The SMRT procedure is performed on the child’s hand only and does not affect other parts of the body. It does not affect the growth and development of the second metacarpal bone and does not require a cast after the procedure. The procedure has also been successful in advancing the age of surgery to between 6 months and 1 year, allowing the child to receive the surgery at a younger age, which will help the child to establish thumb function at an earlier age.