Floating finger is a subtype of thumb dysplasia, which belongs to the congenital hand and foot deformity disease. It is often manifested as a short thumb, which is in a floating state, only the skin tip is connected to the palm, and the function of the fingers is missing, which can only be thrown by the swing of the hand, and it also affects the aesthetics of the hand, so we need to improve the floating finger of the child through surgery. Currently, there are three surgical procedures to treat floating fingers: bunionization, metatarsal reconstruction, and semimetacarpal bone graft reconstruction (SMRT floating thumb reconstruction). Bunionectomy is a surgical procedure that many parents and children in China are reluctant to choose, because after the surgery, the child will only have four fingers forever, and many parents think that the child’s fingers will still be crippled after the surgery, so they usually can’t accept this type of surgery. Metatarsal reconstruction is a traditional surgery, which requires taking the metatarsal bone from the child’s foot and transplanting it into the hand to rebuild the first metacarpal bone and the first carpometacarpal joint. After the surgery, the child’s foot has to be put in a plaster cast, and the child can’t put the foot on the ground for at least three months, which makes the postoperative care more complicated; at the same time there is a certain risk of resorption and necrosis of the grafted bone, and the surgical scars will be left in the foot after the surgery. Semi-metacarpal Bone Graft Reconstruction (SMRT Floating Bunion Reconstruction) is currently the most advanced surgical procedure, which is to reconstruct the first metacarpal bone from the second metacarpal bone of the child. The whole surgery is performed on the child’s hand only, so the child’s foot will not be affected in any way, and the chances of bone resorption and necrosis will be greatly reduced, and the child doesn’t need to be in a plaster cast after the surgery, and what’s more important, the child can be admitted to the surgery between the ages of 6 months and 1 year. More importantly, the surgery can be performed between the ages of 6 months and 1 year, which can help the child to establish thumb function at an earlier age. After years of research and clinical practice, we have found that SMRT floating bunion reconstruction has multiple advantages in solving children’s floating bunion problems, does not affect the growth and development of the child’s second metacarpal bone, avoids some of the impacts caused by bunionization of the demonstrated finger and metatarsal reconstruction, and the post-operative care is relatively simple. After years of postoperative surveys, the function and appearance of the child’s thumb have improved nicely after surgery compared to before surgery. Therefore, more and more parents are now willing to choose this most advanced surgical method to treat their children’s floating bunions. Before Floating Bunion After Floating Bunion