Proximal Row Carpectomy for Stage IIIB Kienböck Disease in a 17-Year-Old Boy: A Case Report with 2 Years of Follow-Up

A 17-year-old right-hand dominant boy presented with severe, progressive wrist pain refractory to conservative treatment. Imaging confirmed Stage IIIB Kienböck disease with lunate collapse and fixed scaphoid rotation. Despite his young age and advanced stage, proximal row carpectomy was selected after shared decision-making to preserve motion and rapidly relieve pain. At the 2-year follow-up, the patient was pain-free, had full wrist motion and strength, and returned to competitive basketball.

This case highlights that, in carefully selected adolescents, proximal row carpectomy can achieve excellent outcomes, challenging traditional age-based and stage-based contraindications and emphasizing individualized, patient-centered surgical decision-making.