Once again, we are seeing this type of hand deformity once again. This child came to my clinic last week with problems in both hands. At first glance, it looks more like syndactyly or split hands, but if you probe with your hands, you’ll see that it’s not that simple. …… Loss of Thumb Function, Playing with Toys by Clamping In order to check the function of the fingers, I always have some small toys for children to play with in my clinic. This child is over one year old, just the age when he likes to play, holding one in one hand and playing alone. In the process of the child’s play, we found that the child’s posture with toys is very wrong, he has no thumb function, playing with toys mainly rely on the fingers to pinch, so the grip is not very stable, and will often fall. This situation is very similar to one of our previous babies. After some examination, we can finally determine that this child’s hand, although it looks like a syndactyly and split hand, is in fact a more specific type of high floating bunion. Although the child’s two-fingered hands were both high floating bunions, there were actually some differences. Through the x-ray, we can observe that the child’s left hand has one less joint than the right hand, so it will be more troublesome, and the postoperative function can be slightly worse than the left and right hands. There are various surgical options, parents need to consider carefully The parents also went to other cities before they came to me, and at that time the doctor gave them the option of bunionization of the finger. This is indeed a surgical option, and the operation is relatively simple. The floating thumb is removed directly, and then the index finger is moved to the thumb position to be used as a thumb. Although the purpose of having a functional thumb can be achieved, the cost is relatively high, and the child will have a permanent fourth finger after the operation. Considering the drawbacks of bunionization surgery, two treatment options for preserving the five fingers have since emerged. The first, the reconstruction of the first metacarpal bone from the foot, also known as the metatarsal reconstruction technique, preserves all five fingers and still allows the thumb to be functional. However, the postoperative care will be more cumbersome, the child needs to be bedridden for about three months, no weight bearing on the foot, which is difficult for active children, because after all, the bone is taken from the foot, so even if the operation is healed, the child can not do too strenuous movements, so as not to cause fractures. The second option is to reconstruct the first metacarpal bone from the second metacarpal bone of the affected hand, which is also known as hemi-metacarpal bone grafting reconstruction technique, which can achieve the purpose of preserving the child’s thumb and will not hurt other parts of the child’s body, and it is one of the surgical options that we mainly use nowadays. All three surgical options can achieve the purpose of correcting the thumb and are an option, but because everyone’s needs are different, parents need to consider carefully when choosing one.