Objective: The volar scapholunate interosseous ligament is an important stabilizer of the wrist. In 2015, Kampen et al. described the technique for reconstruction of an isolated palmar injury using the long radiolunate ligament in the subacute or chronic setting, however its use has not been described in the acute, traumatic setting. Methods: The patient is 22-year-old male who presented with a traumatic right open trans-radial/ulnar wrist disarticulation with underlying bony, tendinous, ligamentous, and neurovascular injuries secondary to a motor vehicle accident. The volar scapholunate ligament was found to be completely disrupted at the time of surgery with appreciable gapping. As described by Kampen, the long radiolunate (LRL) ligament was identified. An L shaped incision was made within the ligament, releasing the radial attachment, and then extending the cut in line with the transverse fibers, dividing the ligament in half. The scapholunate joint was manually reduced under direct visualization. The strip of LRL was rotated distally toward the scaphoid, tensioned, and attached to the proximal pole of the scaphoid with a suture anchor. The remainder of the volar capsule was then repaired. Intra-operative repair also included six-strand repair in a M-tang fashion of flexor pollicis longus (FPL), flexor digitorum superficialis (FDS) to index and middle, flexor carpi radialis (FCR), extensor pollicis brevis (EPB) and abductor pollicis longus (APL). The lacerated median nerve was trimmed back to healthy fascicular architecture, mobilized, primarily repaired without undue tension, and wrapped with a nerve protector. Results: At 3 months post-operatively, the patient had improved range of motion, specifically with wrist flexion and radial deviation. Pronation and supination were near equivalent compared to the uninjured wrist. Currently, the patient reports no pain and has a recovering Tinel sign at the distal palmar crease. On radiographic analysis, patient had normal scapholunate (SL) angle at 59.6° and no SL gap. Patient also reports ability to hold and swing a baseball bat. Conclusion: The volar scapholunate interosseous ligament is an important stabilizer of the wrist. A strip of the long radiolunate ligament can be used to reconstruct the volar scapholunate ligament in the acute, subacute, or chronic setting. This technique is a useful tool for the hand surgeon faced with an isolated palmar scapholunate injury in the acute traumatic hand. Corresponding Author: Olivia Means, 100 Michigan St NE, Suite A601, Grand Rapids, MI 49503, [email protected], (202) 258 - 0130