Perilunate dislocations and fracture dislocations are most often a result of high-energy trauma, exerting an axial load with hyperextension and ulnar deviation of the wrist, along with intercarpal supination. Early treatment of perilunate injuries is necessary to optimize the clinical outcome. Although closed management has been the more commonly reported treatment for perilunate injuries, the current consensus is that anatomic restoration of carpal alignment has better results. The combined dorsal-volar approach offers the advantages of both approaches and is the preferred choice for the authors since it allows assessment of all the injured structures. The surgical techniques to restore carpal alignment and repair the scapholunate interosseous ligament are discussed. Current literature regarding treatment and prognosis is also included.
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