Patients with Kienbock disease in the 16–20-year age range form a distinct prognostic group. Clinical evidence supports separating this cohort from other age groups, as their expected disease course and response to management differ meaningfully.
This protocol addresses Kienbock disease specifically in patients aged 16 to 20 years. Because this age group carries a different prognosis, it is evaluated and managed independently from older or younger populations. This distinction shapes which interventions are considered first.
For this age group, the structured first-line approach is nonoperative. Management begins with a strategy centred on wrist immobilization — the specific regimen, its duration, and the criteria for moving to further intervention are detailed in the full protocol.
The complete structured regimen, including the decision points and escalation criteria, is available via the link below.
DOI: 10.1055/s-0037-1604137
A2 16–20 years: Trial of nonoperative management.
As these are different prognostic groups, we have separated them from the start.
The juvenile group was also treated with immobilization, however, 30% had progression and required a joint leveling procedure.
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