Trans-scaphoid perilunate fracture dislocation is a complex carpal dislocation causing marked disruption of the carpal structures. Open treatment has been accepted as standard for this injury. We have used arthroscopically assisted percutaneous screw fixation and bone grafting to treat this injury in four patients. The functional outcome was good. All patients achieved solid union without nonunion or malunion. The complication and morbidity was relatively low; all patients had proper alignment and there was no evidence of instability or avascular necrosis or midcarpal arthritis.
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