Perilunate injuries cause a severe derangement of wrist anatomy prone to ma
jor dysfunction. Early surgery employing dual dorsal and volar exposures fo
r precise repair of each component of injury affords the optimal means of r
estoring wrist stability and achieving a highly favorable recovery. This ar
ticle provides an overview of the characteristic features of perilunate inj
uries. The effectiveness of primary surgery employing dual dorsal and volar
exposures for precision repair of the multicomponent perilunate injury is
emphasized.