This child’s left hand appeared to have no thumb, and there was an extra small end of the finger in the area distal to the proximal interphalangeal joint of the index finger, which was also a floating thumb. In this case, it was not possible to use conventional techniques, so we used the SMRT floating thumb reconstruction. It was very challenging to reconstruct the metacarpal bone, reconstruct the full size tiger’s mouth, and provide good coverage of all the trauma. Through our relatively good design, we implemented the preoperative program in the surgery, and the overall surgical result was very satisfactory, and now this child is already doing functional exercises. In such a situation, we should not give up so easily. This child had been to many hospitals, including those in Beijing and Shanghai, and the advice they received was very unanimous: remove the floating thumb and do bunionization. However, we felt that there was still a chance to save it, so we kept it. Although this type of floating bunion surgery is really complicated, once it is preserved, for the child, the five fingers are complete, which is very significant, and the function that is preserved is not bad either. So both aesthetically and functionally, finger preservation is valuable.