It is possible to diagnose trans× scaphoid perilunar dislocation(TSPD) with simple anteraposterior and lateral roentgenograms, But, there are many cases in which we make a wrong diagnosis as simple scaphoid fracture or perilunar dislocation. Most of the 7 cases among the 11 cases who visited Seoul National University Hospital from 1981 to 1.987 were delayed 3 or more weeks because they were misdiagnosed as simple fracture, sprain or dislocation. It is important to identify the relationship of scaphoid with capitate or radius with simple lateral roentgerogran and we must suspect accompanying perilunar dislocation if there is rotationary deformity in scaphoid fracture. We consider open reduction and internal fixation is better than closed reduction as treatment of TSPD because scaphoid fracture is easy to displace due to instability of fracture fragments in most cases. And we also suggest it is better to try open reduction and internal fixation first than salvage operation as initral tratment of old fractures, if there is no osteoporosis and resorption of scaphoid fragment.