For congenital thumb thumb defects or thumb hypoplasia above type IIIB, also known as floating thumb, I think the best way is to show thumbing, and this concept is recognized internationally. However, in China, based on the traditional concept, many parents always want to pursue no less than one. The floating thumb can be preserved by bone grafting, tendon transposition, flap repair, etc. If the surgery is good, it has some function, but it is impossible to be normal. The child needs to endure multiple surgeries and get scarred, and ultimately the shape and function are unlikely to be satisfactory. The child will still have a deformed thumb, which the child may not be willing to show to others, and a poorly functioning thumb, which the child may not be willing to use, and many are still used to using the middle finger to hold objects. Therefore, I think it would be better to keep those severely stunted floating thumbs, although none of them are less, but the appearance and function are not as good as the index thumb. The first case of thumb thumbing I did was in a 5 year old child, and the appearance and function of the thumb has recovered very well. The child is already going to school normally, writing and eating with the thumb thumb, just like a normal child. The following case was done at a younger age, less than 1 year and 1 month old girl. One and a half months after the operation, the child was too young to cooperate, but could hold objects. The parents were asked to encourage the child to use this thumb to hold toys more often to strengthen the activity, but then the visit was lost and the phone was stopped. Although one was missing, the whole hand was still coordinated In fact, without looking closely, it did not seem that the child was missing a finger. Added at the end of 2015, the child recently came for a review, the reconstructed thumb was pinched, but functioned well and life was not affected at all One more case, male, just reached 3 years old This one is from outside the province, I don’t know if I can have post-operative follow-up photos, huh, I hope the parents can cooperate. 2014.9 Continued: Thanks to the parents, who sent pictures 3 months after the surgery, the function recovered very well and the child has used the thumb normally.