Because polydactyly is a much higher percentage of congenital hand deformities than floating bunion, and because it is a relatively simple procedure, many parents who do not find a suitable treatment for floating bunion choose to perform the two procedures separately, having the polydactyly removed first and then considering floating bunion surgery. This is sometimes a very unfortunate approach. Why is this so? In the case of floating thumb, we now use a hemi-metacarpal bone grafting technique to reconstruct the first metacarpal bone from the second metacarpal of the affected hand. If the patient also has polydactyly, it is possible to see if the two surgeries can be done together, depending on the situation. If it is possible, the operation can make full use of the polydactyly finger bones and use the extra finger bones to reconstruct the metacarpal bone of the floating thumb with minimal surgical trauma. This approach to surgery will be more difficult, but it makes sense in the long run.