This little girl was born with a congenital floating bunion, which is a little different from the floating bunion that we usually see, and this is a very special type of floating bunion. Her left hand does not appear to have a bunion, but has an extra small end joint in the proximal interphalangeal joint of the index finger, which is also a floating bunion. What can be done about this little girl’s floating thumb, which is difficult to resolve with conventional surgery? This child had been to many hospitals before, including hospitals in Beijing and Shanghai, and the advice they received was very unanimous: the floating thumb should be removed and a bunionization surgery should be performed, which would mean that the child would only have four fingers forever, which was unacceptable to the parents, who hoped that their child’s hand would at least look intact after the surgery. In this case, the conventional approach is not very good because it is difficult to solve the problem of floating bunions when you want to preserve all five fingers. After looking at the child’s condition, we felt that there was still a chance of saving the child’s thumb, so we used the Semicarpal Bone Graft Reconstruction (SMRT Floating Bunion Reconstruction), which not only saved the child’s floating bunion, but also operated only on the child’s hand without affecting the child’s other parts of the body. The surgery was complex but the overall surgical result was very satisfactory During the surgery, we have to reconstruct the metacarpal bone of the child, reconstruct a complete tiger’s mouth, and also provide good coverage of all the wounds, which is a very challenging process. When faced with a situation like this, we first don’t give up easily. Although this child’s floating bunion surgery was relatively complicated, through our relatively good design, we implemented the preoperative design plan relatively completely during the surgery, and the overall surgical result was very satisfactory. The overall result was very satisfactory. We were able to preserve the thumb and improve the function and appearance of the thumb, and the child’s parents were satisfied with the surgery. The child is now doing functional exercises, and we explained to the parents that they must pay attention to their child’s postoperative functional exercises, which are just as important as the floating thumb surgery. Parents can guide the child to grasp some fine things, such as letting the child to grasp glass balls, red beans, green beans and other small things, and then slowly guide the child to do some grasping of large objects, you can also buy your child’s favorite toys for her to play with, we must let the child’s thumb to get exercise, and only in this way the child’s thumb function will recover more and more well. We are looking forward to more surprises from this child when she comes for her next review. The significance of preserving the five fingers is very great, but we have to be careful in choosing the treatment plan. This particular type of floating thumb is not uncommon, and we have seen fewer of them, but we have seen more of them. Although this type of floating thumb surgery is indeed more complicated, once the floating thumb is preserved, the five fingers of the child are complete, which is of great significance, and the function of the thumb is not bad at all. The function of the preserved thumb is not bad either. Therefore, for children with the special type of floating bunion, preserving the child’s five fingers is valuable both from an aesthetic and functional point of view, only that we need to put in more effort during the operation, but the child’s hand is intact after the operation and the end result is worthwhile. If you come across a similar situation again, you have to be more careful, it is a matter of the child’s health and life, or you have to be very careful to choose the treatment program.