At present, there are three surgical procedures to treat floating fingers: bunionization, metatarsal bone reconstruction, and semimetacarpal bone graft reconstruction (SMRT floating thumb reconstruction). 1. Bunionization: This is a type of surgery that many parents and children in China are reluctant to choose, because after the surgery, the child will only have four fingers forever, so this type of surgery is usually unacceptable. 2. Metatarsal reconstruction: This is a traditional surgery, which requires taking metatarsal bones from the child’s feet and transplanting them to the hand to reconstruct the first metacarpal bone and the first carpometacarpal joint, and the child will not be able to land on the ground for at least three months, and there is a certain risk of resorption and necrosis of the transplanted bone. 3. Semi-metacarpal bone graft reconstruction (SMRT floating bunion reconstruction): A portion of the child’s second metacarpal bone is taken to reconstruct the first metacarpal bone. The entire surgery is performed on the child’s hand only, and the child’s foot will not be affected in any way, and the risk of bone resorption and necrosis will be greatly reduced, and there is no need to wear a plaster cast after the surgery. What’s more, children can undergo the surgery between the ages of 6 months and 1 year, which can help them establish thumb function earlier. SMRT floating thumb reconstruction has multiple advantages in solving the problem of floating thumb in children. It does not affect the growth and development of the second metacarpal bone, avoids some of the effects caused by bunionization and metatarsal reconstruction of the finger, and the post-operative care is relatively simple. To sum up, the floating thumb reconstruction technique is the most commonly used surgery in clinical practice, which will cause the least damage to the child. Parents are advised to actively cooperate with the doctor in order to avoid affecting the growth and development of the child.