The ligamentous injury of the metacarpophalangeal joint of the thumb occurs more to the ulnar collateral ligament by the incidence about 90%. Radial collateral ligament, dorsal capsule and volar plate may sustain injury. The diagnosis depends on the stress test either clinical or radiological. Surgical treatment for acute injury type by ligament repair and for the chronic type by ligament reconstruction .With failure of ligament reconstruction arthrodesis or arthroplasty can take place.