This lateral view X-ray of the wrist demonstrates post-operative findings following a proximal row carpectomy (PRC). The imaging reveals the surgical absence of the proximal carpal row (scaphoid, lunate, and triquetrum). The head of the capitate is shown articulating directly with the lunate fossa of the distal radius, a hallmark of this motion-preserving procedure used to treat advanced Kienbock's disease or SLAC/SNAC wrist. A red arrow highlights the surgical site and the new radiocapitate articulation. Encasing the forearm and wrist is a radiopaque cast or splint, which creates a hazy silhouette around the anatomical structures and confirms the immediate post-operative phase. The distal radius and distal carpal row (trapezium, trapezoid, capitate, and hamate) remain visible, though their spatial relationship is altered to accommodate the shortened carpus. This diagnostic image is significant for orthopedic training in identifying salvaging procedures for chronic wrist instability and carpal collapse.

This diagnostic image is a post-operative anteroposterior (AP) view X-ray of the left wrist. The radiograph reveals significant surgical changes, specifically the absence of the proximal row carpal bones (scaphoid, lunate, and triquetrum), consistent with a proximal row carpectomy. A red arrow points to the radiolucent void created by this excision. The distal carpal row remains intact and articulates with the radius. The distal radius and ulna are visualized, as are the metacarpals and phalanges of the hand. Along the lateral aspect of the wrist, a dense, radiopaque, undulating material is visible, which represents post-surgical immobilization—likely a plaster or fiberglass cast or splint. This procedure is frequently performed as a motion-preserving salvage operation for conditions such as advanced Kienbock's disease or scaphoid nonunion advanced collapse (SNAC). The educational focus of the image is the radiological presentation of a partial carpectomy used in orthopedic surgery for chronic wrist pathology.

This posteroanterior (PA) X-ray of the right wrist demonstrates the postoperative appearance of a proximal row carpectomy (PRC). The primary diagnostic finding is the surgical absence of the scaphoid, lunate, and triquetrum. Consequently, the proximal carpal row is no longer present, and the capitate has migrated proximally to articulate directly with the lunate fossa of the distal radius. The newly formed radiocapitate articulation shows preserved joint space without significant degenerative changes or subchondral sclerosis. The distal radius and ulna remain intact, showing normal alignment and neutral ulnar variance. The distal carpal row (trapezium, trapezoid, capitate, and hamate) and the metacarpals appear structurally normal with maintained cortical thickness and trabecular density. This imaging is characteristic of a motion-preserving salvage procedure typically used for conditions like Stage III Kienböck's disease or scaphoid nonunion advanced collapse (SNAC), where the goal is to alleviate pain while maintaining functional wrist range of motion.