Some parents say that their babies were born with congenital thumb deformity floating thumb with no metacarpal bone and only a very thin tube of skin connected to the palm of the hand, and ask what to do? To save the floating thumb, we need to reconstruct the first metacarpal bone. What kind of metacarpal is needed? One, it has to be able to continue to grow at this stage, two, it has to have a proper articulating surface, and three, it has to have a relatively good exercise strength. In the beginning, we take the metatarsal bone, which is the bone in the foot. After removing the metatarsal bone, the baby cannot walk for three to four months and cannot go down to the ground at all, which is painful for the baby and inconvenient for the parents to take care of. In addition, there are other problems associated with metatarsal bone removal, such as resorption and necrosis of the grafted bone. Nowadays, the SMRT floating bunion reconstruction is used, what does this mean? It means that a portion of bone is taken from the baby’s second metacarpal bone to reconstruct the first metacarpal bone, hence the name Semi Metacarpal Bone Graft Reconstruction (SMRT). This procedure does not involve the baby’s foot, which makes it easier to care for, and the chances of bone resorption and necrosis are greatly reduced. So how far can you recover after surgery? Our requirement is that the baby can pinch a pen to write, hold chopsticks to eat, and also be able to grasp some small things, such as red beans, green beans, rice grains, etc., and can also unscrew bottle caps. From the follow-up, babies who do well in functional exercises have pretty good thumb function after surgery.