Dysplastic thumb floating finger, can be improved by surgery, for the hand, the thumb occupies 50% of the function, so we can improve the function and shape of the child’s thumb through surgery. Nowadays, we use Semi Metacarpal Bone Graft Reconstruction (SMRT), which is the best surgical procedure for treating floating fingers. This advanced surgical procedure avoids some of the effects of bunionization and metatarsal reconstruction of the thumb, and the surgery is performed only on the child’s hand, which preserves the integrity of the fingers and does not affect the rest of the child’s body at the same time. After years of outpatient review and follow-up investigation, we have found that the function and appearance of the child’s thumb have improved very well. The child’s ability to write, draw, hold chopsticks, button, and hold small objects is not affected, and many of the children had the surgery done when they were small, so there is no psychological impact after they go to school.