We describe an 18-year-old man with an acute lunate dislocation treated with open reduction, ligament repair, capsulodesis, and percutaneous pinning. After pin removal and mobilization, the patient was found to have midcarpal collapse; the lateral radiographs showed a volar intercalary segment instability. We now, besides open reduction internal fixation scapholunate repair, recommend routine pinning of the lunotriquetral interval and careful evaluation of the dorsal radiocarpal ligament during repair of lunate and perilunate dislocations.