Although floating thumb is a relatively low percentage of congenital hand deformities, there has been a significant increase in the number of cases in recent years, and parents are becoming more aware of it. This is particularly evident in the clinic, where some parents who came to the clinic a few years ago did not know about floating bunion, but now some parents can even name the three treatment options for floating bunion: index bunion, metatarsal reconstruction, and hemipalmar graft reconstruction. The more traditional treatment for floating thumb is to remove the thumb and move the index finger to the thumb position to use it as a thumb, which allows the child to have a functional thumb, but the child will only have four fingers permanently, which is difficult for most parents to accept. Is there a way to give a child a functional thumb without removing the thumb? Of course there is, and this is the second option we are going to talk about, the metatarsal reconstruction technique, which is one of the first options to preserve the thumb for floating bunions. The surgery is performed by taking part of the bone from the foot and reconstructing the first metacarpal. Although the five fingers can be preserved and have function, there is a certain chance of bone resorption and necrosis, and the damage to the foot is greater. The child needs to be weight-free for three months after the surgery, and can only lie or sit, which is very torturous for a child of this age. Nowadays, we mainly use the hemi-metacarpal bone graft reconstruction technique to treat floating bunion, which is another treatment option to preserve the fifth finger after metatarsal bone reconstruction, taking part of the bone from the second metacarpal of the affected hand to reconstruct the first metacarpal, which reduces the chance of bone resorption and necrosis. The surgery is performed on the hand only and does not affect other parts of the body, and there is no new trauma or scarring on other parts of the body. The hemi-metacarpal bone graft reconstruction surgery is done in two stages: the first stage is to move the bone to give the thumb a good shape, and the second stage is to rebuild the function of the thumb so that the thumb can move. After the two-stage surgery, functional exercises will be started to make the shape and function of the thumb more desirable.