The thumb appears to be floating, which would be a type 4 bunion dysplasia, also known as floating bunion. We recommend treatment for floating thumbs. Although children can write with their left hand through exercise, as long as they are strong enough and don’t care about what their classmates think, it won’t affect them too much during their school years. However, the child still has a long way to go in the future, and he or she will have to find a job, get a date, and get married, which will definitely affect him or her to a certain extent. Therefore, we suggest that you should get the surgery done while your child is still young. At this time, his own healing ability is stronger, and the result after the surgery is definitely better than doing it when he is an adult. There are various treatment options for floating bunions, but we mainly use the hemi-metacarpal bone grafting technique, which can preserve the five fingers and take care of the function, and has advantages in terms of the age of the operation and post-operative care. The earliest age for hemi-metacarpal grafting is around 6 months to 1 year of age, which is when the child’s thumb function is being established, and the advantage of doing the surgery at this time is that the child’s thumb function is more smoothly established. The technique of hemi-metacarpal bone graft reconstruction involves reconstructing the first metacarpal bone from the second metacarpal bone of the affected hand. The entire surgery is performed on the hand only, with no additional trauma to other parts of the hand, so it is relatively easy to take care of the patient after the surgery. The surgery is divided into two phases, the first phase is to move the bone and the second phase is to establish the function. Functional exercises should be performed about 3-4 weeks after the second phase of the surgery is done. You can try to hold some objects with your thumb, as small as a grain of rice or as big as a stuffed animal, and as long as you are diligent in your exercises, you will get better and better in both function and appearance.