{"id":17810,"date":"2023-04-10T19:36:31","date_gmt":"2023-04-10T12:36:31","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=17810"},"modified":"2023-04-14T18:23:33","modified_gmt":"2023-04-14T11:23:33","slug":"co-che-chan-thuong-giai-phau-benh-trat-khop-vai","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/10\/co-che-chan-thuong-giai-phau-benh-trat-khop-vai\/","title":{"rendered":"C\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng v\u00e0 gi\u1ea3i ph\u1eabu b\u1ec7nh tr\u1eadt kh\u1edbp vai"},"content":{"rendered":"<p><strong>Trong tr\u1eadt kh\u1edbp vai ra tr\u01b0\u1edbc c\u01a1\u00a0 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng th\u01b0\u1eddng l\u00e0 gi\u00e1n ti\u1ebfp, do ng\u00e3 ch\u1ed1ng tay ho\u1eb7c ch\u1ed1ng khu\u1ef7u, c\u00e1nh tay d\u1ea1ng, m\u1edf r\u1ed9ng, xoay ngo\u00e0i t\u1ea1o ra m\u1ed9t l\u1ef1c l\u00e0m thay \u0111\u1ed5i v\u1ecb tr\u00ed gi\u1ea3i ph\u1eabu c\u1ee7a ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay. \u0110\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n tr\u1ebb th\u00ec ch\u1ea5n th\u01b0\u01a1ng th\u1ec3 thao th\u01b0\u1eddng ph\u1ed5 bi\u1ebfn, trong khi \u0111\u1ed5i v\u1edbi b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i th\u00ec t\u00e9 ng\u00e3 \u0111i\u1ec3n h\u00ecnh h\u01a1n. <\/strong><strong>Th\u00f4ng qua b\u00e0i vi\u1ebft, ch\u00fang t\u00f4i s\u1ebd tr\u00ecnh b\u00e0y v\u1ec1 c\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng v\u00e0 t\u1ed5n th\u01b0\u01a1ng gi\u1ea3i ph\u1eabu b\u1ec7nh tr\u1eadt kh\u1edbp vai<\/strong><\/p>\n<p><strong>Nh\u00f3m t\u00e1c gi\u1ea3:<\/strong> PGS. TS \u0110inh Ng\u1ecdc S\u01a1n, BS CKII V\u0169 Tr\u01b0\u1eddng Th\u1ecbnh<\/p>\n<p><strong>Ng\u00e0y ph\u00e1t h\u00e0nh<\/strong>: 30\/03\/2022<\/p>\n<h2><b>1. C\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng tr\u1eadt kh\u1edbp vai<\/b><\/h2>\n<p><b><\/b><span style=\"font-weight: 400;\">Sau l\u00e0n tr\u1eadt kh\u1edbp \u0111\u1ea7u, c\u00f3 th\u1ec3 g\u00e2y r\u00e1ch s\u1ee5n vi\u1ec1n, d\u00e2y ch\u1eb1ng, m\u1ebb b\u1edd <\/span><span style=\"font-weight: 400;\">0 <\/span><span style=\"font-weight: 400;\">ch\u1ea3o&#8230; l\u00e0m m\u1ea5t v\u1eefng kh\u1edbp. C\u00e1c t\u1ed5n th\u01b0\u01a1ng n\u00e0y n\u1ebfu kh\u00f4ng li\u1ec1n l\u1ea1i \u0111\u01b0\u1ee3c th\u00ec t\u1ed5 ch\u1ee9c x\u01a1 s\u1ee3i s\u1ebd l\u1ea5p \u0111\u1ea7y v\u00e0o \u0111\u00f3 v\u00e0 t\u1ea1o ra c\u00e1c \u0111i\u1ec3m y\u1ebfu.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Trong tr\u1eadt kh\u1edbp vai ra sau c\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng c\u0169ng th\u01b0\u1eddng l\u00e0 gi\u00e1n ti\u1ec3p, th\u00f4ng th\u01b0\u1eddng c\u00e1nh tay g\u1ea5p, kh\u00e9p, xoay trong.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb b\u00e1n tr\u1eadt t\u00e1i ph\u00e1t ho\u1eb7c tr\u1eadt kh\u1edbp \u0111a h\u01b0\u1edbng th\u00ec c\u01a1 ch\u1ebf g\u00e2y tr\u1eadt kh\u1edbp c\u00f3 th\u1ec3 ho\u00e0n to\u00e0n kh\u00f4ng do ch\u1ea5n th\u01b0\u01a1ng (atraumatic) ho\u1eb7c l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a m\u1ed9t vi ch\u1ea5n th\u01b0\u01a1ng l\u1eb7p \u0111i l\u1eb7p l\u1ea1i.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Trong b\u1ec7nh l\u00fd th\u1ea7n kinh c\u01a1 (nghi\u1ec7n r\u01b0\u1ee3u, co gi\u1eadt, \u0111i\u1ec7n gi\u1eadt&#8230;) chi\u1ebfm kho\u1ea3ng 30% c\u1ee7a t\u1ea5t c\u1ea3 tr\u1eadt kh\u1edbp ra sau, v\u00e0 d\u1eabn \u0111\u1ebfn tr\u1eadt kh\u1edbp th\u00f4ng qua s\u1ef1 co c\u01a1 qu\u00e1 m\u1ea1nh (xoay trong c\u1ee7a c\u01a1 ng\u1ef1c l\u1edbn, c\u01a1 d\u01b0\u1edbi vai \u00e1p \u0111\u1ea3o so <\/span><span style=\"font-weight: 400;\">v\u1edbi xoay ngo\u00e0i c\u1ee7a c\u01a1 tr\u00f2n b\u00e9, c\u01a1 d\u01b0\u1edbi gai).<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Trong tr\u1eadt kh\u1edbp vai thu\u1ea7n t\u00fay xu\u1ed1ng d\u01b0\u1edbi th\u00ec c\u01a1 ch\u1ebf l\u00e0 khi c\u00e1nh tay d\u1ea1ng h\u1ebft m\u1ee9c trong \u0111\u00f3 \u0111\u1ea7u g\u1ea7n x\u01b0\u01a1ng c\u00e1nh tay nh\u01b0 \u0111\u00f2n b\u1ea9y ch\u1ed1ng l\u1ea1i m\u1ecfm c\u00f9ng vai v\u00e0 g\u00e2y tr\u1eadt<\/span><span style=\"font-weight: 400;\">kh\u1edbp.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Tr\u1eadt kh\u1edbp n\u00e0y th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn g\u00e3y m\u1ea5u \u0111\u1ed9ng l\u1edbn ho\u1eb7c r\u00e1ch ch\u00f3p xoay.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Tr\u1eadt kh\u1edbp l\u00ean tr\u00ean c\u1ef1c k\u1ef3 hi\u1ebfm g\u1eb7p, nh\u01b0ng c\u00f3 th\u1ec3 x\u1ea3y ra v\u1edbi m\u1ed9t l\u1ef1c c\u1ef1c m\u1ea1nh t\u1eeb d\u01b0\u1edbi l\u00ean khi c\u00e1nh tay d\u1ea1ng.<\/span><\/p>\n<h2>2. T\u1ed5n th\u01b0\u01a1ng gi\u1ea3i ph\u1eabu b\u1ec7nh<\/h2>\n<p><b>2.1 S\u1ee5n vi\u1ec1n, bao kh\u1edbp v\u00e0 d\u00e2y ch\u1eb1ng<\/b><\/p>\n<ul>\n<li><strong>T\u1ed5n th\u01b0\u01a1ng Bankari<\/strong>\n<p><figure id=\"attachment_17813\" aria-describedby=\"caption-attachment-17813\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-17813\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-10-luc-18.27.59-300x177.png\" alt=\"T\u1ed5n th\u01b0\u01a1ng Bankari\" width=\"300\" height=\"177\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-10-luc-18.27.59-300x177.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-10-luc-18.27.59-768x453.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-10-luc-18.27.59.png 974w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-17813\" class=\"wp-caption-text\">T\u1ed5n th\u01b0\u01a1ng Bankari trong tr\u1eadt kh\u1edbp vai<\/figcaption><\/figure><\/li>\n<\/ul>\n<p><b><i><\/i><\/b><span style=\"font-weight: 400;\">T\u1ed5n th\u01b0\u01a1ng Bankart l\u00e0 s\u1ef1 b\u00f3c t\u00e1ch ph\u1ee9c h\u1ee3p \u0111\u00e2y ch\u1eb1ng &#8211; s\u1ee5n vi\u1ec1n tr\u01b0\u1edbc d\u01b0\u1edbi, m\u00e0 ch\u1ee7 y\u1ebfu l\u00e0 d\u00e2y ch\u00e0ng \u1ed1 ch\u1ea3o c\u00e1nh tay d\u01b0\u1edbi ra kh\u1edfi b\u1edd x\u01b0\u01a1ng \u1ed5 ch\u1ea3o. S\u1ef1 t\u00e1ch r\u1eddi n\u00e0y r\u1ea5t quan tr\u1ecdng trong s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n v\u00ec v\u1ecb tr\u00ed n\u00e0y l\u00e0 ch\u1ed7 b\u00e1m c\u1ee7a to\u00e0n b\u1ed9 d\u00e2y ch\u1eb1ng \u1ed5<\/span><span style=\"font-weight: 400;\"> ch\u1ea3o c\u00e1nh tay d\u01b0\u1edbi, d\u00e2y c<b><\/b><\/span><span style=\"font-weight: 400;\">h\u1eb1ng n\u00e0y ch\u00ednh l\u00e0 th\u00e0nh ph\u1ea7n c\u01a1 <\/span><span style=\"font-weight: 400;\">b\u1ea3n trong ch\u1ed1ng s\u1ef1 d\u1ecbch chuy\u1ec3n ra tr\u01b0\u1edbc v\u00e0 xu\u1ed1ng d\u01b0\u1edbi c\u1ee7a ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay khi c\u00e1nh tay d\u1ea1ng v\u00e0 xoay ngo\u00e0i. N\u1ebfu d\u00e2y ch\u00e0ng \u1ed5 ch\u1ea3o c\u00e1nh tay d\u01b0\u1edbi t\u00e1ch ra c\u00f9ng v\u1edbi m\u1ed9t m\u1ea3nh x\u01b0\u01a1ng nh\u1ecf c\u1ee7a \u1ed5 ch\u1ea3o th\u00ec g\u1ecdi l\u00e0 Bankart x\u01b0\u01a1ng. Ngo\u00e0i ra b\u1ec7nh l\u00fd s\u1ee5n vi\u1ec1n ph\u00eda sau c\u0169ng \u0111\u01b0\u1ee3c ghi nh\u1eadn trong tr\u1eadt kh\u1edbp vai ra sau, r\u00e1ch ho\u1eb7c m\u00f2n s\u1ee5n vi\u1ec1n \u1ed5 ch\u1ea3o trong tr\u1eadt kh\u1edbp vai \u0111a h\u01b0\u1edbng.<\/span><\/p>\n<p><strong>2.1.2<\/strong> <b><i><\/i><\/b><b><i>T\u1ed5n th\u01b0\u01a1ng bong tr\u00f3c s\u1ee5n vi\u1ec1n d\u00e2y ch\u1eb1ng ph\u00eda tr\u01b0\u1edbc ki\u1ec3u s\u1eafn tay \u00e1o (ALPSA: Anterior Labral Ligamentous Periostea Sleeve Avulsion)<\/i><\/b><\/p>\n<p><span style=\"font-weight: 400;\">T\u1ed1n th\u01b0\u01a1ng ALPSA (bi\u1ebfn th\u1ec3 c\u1ee7a t\u1ed5n th\u01b0\u01a1ng Bankart) v\u1edbi \u0111\u1eb7c \u0111i\u1ec3m:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">S\u1ee5n vi\u1ec1n v\u00e0 d\u00e2y ch\u1eb1ng <\/span><span style=\"font-weight: 400;\">0<\/span><span style=\"font-weight: 400;\"> ch\u00e1o c\u00e1nh tay d\u01b0\u1edbi l\u1ea3ch kh\u1ecfi \u1ed1 ch\u1ea3o<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">M\u00e0ng x\u01b0\u01a1ng \u00f4 ch\u1ea3o c\u00f2n nguy\u00ean v\u1eb9n<\/span><\/li>\n<\/ul>\n<p><strong>2.1.3<\/strong> <b><i><\/i><\/b><b><i>T\u1ed5n th\u01b0\u01a1ng s\u1ee5n vi\u1ec1n ph\u00eda tr\u00ean (SLAP: Superior Labrum Anterior Posterior Tears)<\/i><\/b><\/p>\n<p><span style=\"font-weight: 400;\">T\u1ed5n th\u01b0\u01a1ng SLAP \u0111\u01b0\u1ee3c Snyder v\u00e0 c\u1ed9ng s\u1ef1 m\u00f4 t\u1ea3 l\u00e0 t\u1ea3n th\u01b0\u01a1ng r\u00e1ch s\u1ee5n vi\u1ec1n tr\u00ean t\u1eeb tr\u01b0\u1edbc ra sau, c\u00f3 th\u1ec3<\/span><span style=\"font-weight: 400;\">k\u00e8m theo b\u00f3c t\u00e1ch c\u1ee7a \u0111\u1ea7u d\u00e0i g\u00e2n nh\u1ecb \u0111\u1ea7u, t\u1ed5n th\u01b0\u01a1ng n\u00e0y th\u01b0\u1eddng th\u1ea5y trong nh\u1eefng ch\u1ea5n th\u01b0\u1edbng n\u0103ng l\u01b0\u1ee3ng l\u1edbn v\u00e0 l\u00e0m m\u1ea5t v\u1eefng kh\u1edbp vai.<\/span><\/p>\n<p><strong>2.1.4 B<\/strong><b><strong>o<\/strong>ng \u0111i\u1ec3m b\u00e1m d\u00e2y ch\u1eb3ng \u1ed5 ch\u1ea3o c\u1ea3nh tay (HAGL: Humeral Avulsion of Glenohumeral Ligaments)<\/b><\/p>\n<p><b><i><\/i><\/b><span style=\"font-weight: 400;\">T\u1ed5n th\u01b0\u01a1ng UAGL l\u00e0 t\u1ed5n th\u01b0\u01a1ng bong \u0111i\u1ebfm b\u00e1m c\u1ee7a to\u00e0n b\u1ed9 d\u00e2y ch\u1eb1ng \u1ed5 <\/span><span style=\"font-weight: 400;\">ch\u1ea3o c\u00e1nh tay d\u01b0\u1edbi t\u1ea1i \u0111i\u1ec3m b\u00e1m \u1edf \u0111\u1ea7u tr\u00ean x\u01b0\u01a1ng c\u00e1nh tay. \u0110\u1eb7c tr\u01b0ng c\u1ee7a t\u1ed5n th\u01b0\u01a1ng HAGL l\u00e0 n\u00f3 x\u1ea3y ra khi c\u00e1nh tay qu\u00e1 d\u1ea1ng v\u00e0 xoay ngo\u00e0i v\u00e0 th\u01b0\u1eddng d\u1eabn \u0111\u1ebfn tr\u1eadt kh\u1edbp. G\u1ed3m c\u00f3 06 t\u1ed5n <b><\/b><\/span><span style=\"font-weight: 400;\">th\u01b0\u01a1ng \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3:<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">T\u1ed5n th\u01b0\u01a1ng b\u00f3 tr\u01b0\u1edbc: 90%<\/span><\/li>\n<li><span style=\"font-weight: 400;\">T\u1ed5n th\u01b0\u01a1ng b\u00f3 tr\u01b0\u1edbc k\u00e8m theo bong m\u1ea3nh x\u01b0\u01a1ng <\/span><\/li>\n<li><span style=\"font-weight: 400;\">T\u1ed5n th\u01b0\u01a1ng b\u00f3 tr\u01b0\u1edbc \u0111\u1ed3ng th\u1eddi bong c\u1ea3 \u0111i\u1ec3m b\u00e1m s\u1ee5n vi\u1ec1n (\u201cfloating anterior HAGL\u201d)<\/span><\/li>\n<li><span style=\"font-weight: 400;\">T\u1ed5n th\u01b0\u01a1ng b\u00f3 sau: hi\u1ebfm g\u1eb7p<\/span><\/li>\n<li>T\u1ed5n th\u01b0\u01a1ng b\u00f3 sau k\u00e8m theo bong m\u1ea3nh x\u01b0\u01a1ng<\/li>\n<li>T\u1ed5n th\u01b0\u01a1ng b\u00f3 sau \u0111\u1ed3ng th\u1eddi bong c\u1ea3 \u0111i\u1ec3m b\u00e1m s\u1ee5n vi\u1ec1n (\u201cfloating posterior HAGL\u201d)<\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Ngo\u00e0i ra, c\u00e1c t\u1ed5n th\u01b0\u01a1ng gi\u1ea3i ph\u1eabu b\u1ec7nh c\u1ee7a bao kh\u1edbp kh\u00e1c nh\u01b0: r\u00e1ch ho\u1eb7c k\u00e9o gi\u00e3n bao kh\u1edbp, ph\u1ed3ng bao kh\u1edbp ho\u1eb7c r\u00e1ch bao kh\u1edbp do c\u00e1c vi ch\u1ea5n th\u01b0\u01a1ng l\u1eb7p \u0111i l\u1eadp l\u1ea1i,&#8230;<\/span><\/p>\n<p><strong>2.2 Ch\u00f3p xoay<\/strong><\/p>\n<p><span style=\"font-weight: 400;\">R\u00e1ch ch\u00f3p xoay kh\u00f4ng ph\u1ed5 bi\u1ec3n \u1edf b\u1ec7nh nh\u00e2n d\u01b0\u1edbi 40 tu\u1ed5i c\u00f3 t\u00ecnh tr\u1ea1ng tr\u1eadt kh\u1edbp vai nh\u01b0ng c\u00f3 th\u1ec3 g\u1eb7p trong nh\u1eefng ch\u1ea5n th\u01b0\u01a1ng n\u0103ng l\u01b0\u1ee3ng cao. R\u00e1ch c\u01a1 tr\u00ean gai v\u00e0 c\u01a1 d\u01b0\u1edbi vai l\u00e0 ph\u1ed5 bi\u1ebfn nh\u1ea5t.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">R\u00e1ch c\u01a1 d\u01b0\u1edbi <\/span>vai <span style=\"font-weight: 400;\">hay b\u1ecb b\u1ecf s\u00f3t, tuy <\/span><span style=\"font-weight: 400;\">nhi\u00ean ph\u1ea3i lu\u00f4n \u0111\u00e1nh gi\u00e1 sau th\u1ea5t b\u1ea1i c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p l\u00e0m \u1ed5n \u0111\u1ecbnh kh\u1edbp, \u0111\u1eb7c bi\u1ec7t l\u00e0 sau khi ph\u1eabu thu\u1eadt s\u1eeda ch\u1eefa. M\u1eb7c d\u00f9 r\u00e1ch c\u01a1 tr\u00ean gai l\u00e0m gi\u1ea3m t\u00ednh \u1ed5n \u0111\u1ecbnh \u0111\u1ed9ng c\u1ee7a kh\u1edbp, nh\u01b0ng s\u1ef1 thi\u1ebfu h\u1ee5t c\u01a1 d\u01b0\u1edbi vai \u0111\u00f3ng vai l\u1edbn h\u01a1n r\u1ea5t nhi\u1ec1u tr\u1ecdng m\u1ea5t v\u1eefng kh\u1edbp v\u1edbi vi\u1ec7c b\u1ecf qua s\u1eeda ch\u1eefa l\u1ea1i g\u00e2n (kh\u00e2u l\u1ea1i g\u00e2n).<\/span><\/p>\n<p><strong>2. 3 X\u01b0\u01a1ng<\/strong><\/p>\n<p><strong>2.3.1 \u1ed4\u00a0ch\u1ea3o x\u01b0\u01a1ng vai<\/strong><\/p>\n<ul>\n<li aria-level=\"1\"><span style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Thi\u1ec3u s\u1ea3n \u1ed5 ch\u1ea3o l\u00e0 ki\u1ec3u bi\u1ebfn \u0111\u1ed5i c\u00f3 th\u1ec3 x\u1ea3y ra, nh\u01b0ng kh\u00f4ng ph\u1ea3i lu\u00f4n lu\u00f4n d\u1eabn \u0111\u1ebfn tr\u1eadt kh\u1edbp. Kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t r\u00f5 r\u00e0ng trong thi\u1ec3u s\u1ea3n \u00f4 ch\u1ea3o gi\u1eefa nh\u1eefng ng\u01b0\u1eddi b\u1ecb tr\u1eadt kh\u1edbp vai ra tr\u01b0\u1edbc v\u00e0 ng\u01b0\u1eddi b\u00ecnh th\u01b0\u1eddng <\/span><\/span>m\u1eb7c d\u00f9 h\u1ea7u h\u1ebft tr\u1eadt kh\u1edbp vai ra tr\u01b0\u1edbc l\u00e0 do ch\u1ea5n th\u01b0\u01a1ng. Tuy nhi\u00ean \u1edf m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 g\u1eb7p b\u1ec7nh thi\u1ec3u s\u1ea3n \u1ed5 ch\u00e1o ph\u00eda sau d\u1eabn \u0111\u1ebfn tr\u1eadt kh\u1edbp t\u00e1i di\u1ec5n ra sau. G\u00e3y vi\u1ec1n \u1ed5 ch\u1ea3o ph\u00eda sau ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng x\u01b0\u01a1ng m\u1ea1n t\u00ednh \u0111\u00f4i khi l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y m\u1ea5t v\u1eefng ph\u00eda sau.<\/li>\n<\/ul>\n<ul>\n<li aria-level=\"1\"><span style=\"font-weight: 400;\">T\u1ed5n th\u01b0\u01a1ng gi\u1ea3i ph\u1eabu b\u1ec7nh trong m\u1ea5t v\u1eefng kh\u1edbp vai ph\u00eda tr\u01b0\u1edbc th\u01b0\u1eddng l\u00e0 khuy\u1ebft x\u01b0\u01a1ng c\u1ee7a b\u1edd tr\u01b0\u1edbc &#8211; d\u01b0\u1edbi \u1ed5 ch\u00e0o ho\u1eb7c t\u1eeb m\u1ed9t g\u00e3y x\u01b0\u01a1ng c\u1ea5p t\u00ednh\/ Bankart x\u01b0\u01a1ng ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng x\u01b0\u01a1ng m\u1ea1n t\u00ednh t\u1eeb nhi\u1ec1u l\u1ea7n tr\u1eadt kh\u1edbp.<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-level=\"1\"><span style=\"font-weight: 400;\">\u0110\u1ed9 l\u00f5m v\u00e0 di\u1ec7n t\u00edch b\u1ec1 m\u1eb7t <\/span>c\u1ee7a <span style=\"font-weight: 400;\">\u1ed5 ch\u1ea3o gi\u1ea3m s\u1ebd d\u1eabn \u0111\u1ebfn t\u00ecnh tr\u1ea1ng l\u00e0m gi\u1ea3m l\u1ef1c c\u00f3 th\u1ec3 g\u00e2y tr\u1eadt kh\u1edbp. Gerber v\u00e0 Nyffler ch\u1ec9 ra r\u1eb1ng n\u1ebfu chi\u1ec1u d\u00e0i c\u1ee7a khuy\u1ebft x\u01b0\u01a1ng l\u1edbn h\u01a1n b\u00e1n k\u00ednh c\u1ee7a \u0111\u01b0\u1eddng tr\u00f2n ph\u00f9 h\u1ee3p nh\u1ea5t \u1edb ph\u1ea7n d\u01b0\u1edbi c\u1ee7a \u1ed5 ch\u00e0o 2-3 l\u1ea7n th\u00ec l\u1ef1c g\u00e2y n\u00ean tr\u1eadt kh\u1edbp gi\u1ea3m 70%.<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-level=\"1\"><span style=\"font-weight: 400;\">C\u00e1c <\/span><strong>nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng <\/strong><span style=\"font-weight: 400;\">v\u00e0 c\u01a1 sinh h\u1ecdc ch\u1ec9 ra r\u1eb1ng ph\u1eabu thu\u1eadt n\u1ed9i soi s\u1eeda ch\u1eefa ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u1edbi m\u1ea5t x\u01b0\u01a1ng l\u1edbn h\u01a1n 25% v\u00ec t\u1ef7 l\u1ec7 th\u1ea5t b\u1ea1i cao.<\/span><\/li>\n<\/ul>\n<p><strong>2.3.2<\/strong> <b><i><\/i><\/b><b><i>Ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay: T\u1ed5n th\u01b0\u01a1ng Hill &#8211; Sachs<\/i><\/b><\/p>\n<ul>\n<li aria-level=\"1\"><span style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">T\u1ed1n th\u01b0\u01a1ng Hill &#8211; Sachs l\u00e0 m\u1ed9t t\u1ed5n th\u01b0\u01a1ng l\u00fan x\u01b0\u01a1ng c\u1ee7a v\u00f9ng sau tr\u00ean ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay x\u1ea3y ra khi kh\u1edbp vai b\u1ecb tr\u1eadt ra tr\u01b0\u1edbc. N\u0103m 1940, Hin v\u00e0 Sachs \u0111\u00e3 m\u00f4 t\u1ea3 t\u1ed5n th\u01b0\u01a1ng n\u00e0y l\u00e0 m\u1ed9t \u0111\u01b0\u1eddng \u0111\u1eadm tr\u00ean X-quang vai t\u01b0 th\u1ec3 xoay trong. Nguy\u00ean nh\u00e2n g\u00e2y ra \u0111\u01b0\u1eddng t\u1ed5n th\u01b0\u01a1ng n\u00e0y l\u00e0 do va ch\u1ea1m c\u01a1 h\u1ecdc c\u1ee7a ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay l\u00ean b\u1edd tr\u01b0\u1edbc c\u1ee7a \u1ed5 ch\u1ea3o trong tr\u1eadt <b><\/b><\/span><\/span><b><\/b><span style=\"font-weight: 400;\">kh\u1edbp vai ra tr\u01b0\u1edbc t\u00e1i di\u1ec5n nhi\u1ec1u l\u1ea7n.<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-level=\"1\"><span style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Trong tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n, t\u1ed5n th\u01b0\u01a1ng Hill &#8211; Sacli v\u1edbi khuy\u1ebft x\u01b0\u01a1ng nh\u1ecf th\u01b0\u1eddng kh\u00f4ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb. Tuy nhi\u00ean, v\u1edbi t\u1ed5n th\u01b0\u01a1ng r\u1ea5t l\u1edbn, t\u1ed5n th\u01b0\u01a1ng m\u1edf r\u1ed9ng d\u1ea7n v\u1edbi tr\u1eadt kh\u1edbp t\u00e1i di\u1ec5n th\u01b0\u1eddng xuy\u00ean, ho\u1eb7c v\u1edbi khuy\u1ebft x\u01b0\u01a1ng \u1ed5 ch\u1ea3o \u0111\u1ed3ng th\u1eddi, th\u00ec s\u1ef1 li\u00ean quan c\u1ee7a t\u1ed5n th\u01b0\u01a1ng <\/span><\/span>Hill &#8211; Sach ng\u00e0y c\u00e0ng tr\u1edf n\u00ean quan tr\u1ecdng trong t\u1ed5n th\u01b0\u01a1ng gi\u1ea3i ph\u1eabu b\u1ec7nh c\u1ee7a b\u1ec7nh l\u00fd m\u1ea5t v\u1eefng kh\u1edbp vai. \u0110i\u1ec1u th\u00fa v\u1ecb l\u00e0 t\u1ed5n th\u01b0\u01a1ng Hill &#8211; Sach th\u01b0\u1eddng kh\u00f4ng th\u1ea5y \u1edf b\u1ec7nh l\u00fd m\u1ea5t v\u1eefng kh\u1edbp vai kh\u00f4ng do ch\u1ea5n th\u01b0\u01a1ng (atraumatic).<\/li>\n<li aria-level=\"1\"><b><\/b><span style=\"font-weight: 400;\">T\u1ed5n th\u01b0\u01a1ng Hill &#8211; Sachs: \u201cEngaging\u201d v\u00e0 \u201cNon-Engaging\u201d<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Engaging: l\u00e0 t\u1ed5n th\u01b0\u01a1ng khi m\u00e0 c\u00e1nh tay d\u1ea1ng v\u00e0 xoay ngo\u00e0i, t\u1ed5n th\u01b0\u01a1ng Hill &#8211; Sach song song v\u1edbi b\u1edd tr\u01b0\u1edbc \u1ed1 ch\u1ea3o, do \u0111\u00f3 x\u1ea3y ra hi\u1ec7n t\u01b0\u1ee3ng \u201c\u0103n kh\u1edbp\u201d (Engaging), l\u00e0m tr\u1eadt kh\u1edbp vai.<\/span><\/li>\n<li aria-level=\"1\"><span style=\"font-weight: 400;\">Noti-Engaging: !\u00e0 t\u1ed5n th\u01b0\u01a1ng khi m\u00e0 c\u00e1nh tay d\u1ea1ng v\u00e0 xoay ngo\u00e0i, t\u1ed5n th\u01b0\u01a1ng Hill &#8211; Sach v\u00e0 b\u1edd tr\u01b0\u1edbc \u1ed5 ch\u1ea3o kh\u00f4ng c\u00f9ng h\u01b0\u1edbng, do \u0111\u00f3 kh\u00f4ng x\u1ea3y ra hi\u1ec7n t\u01b0\u1ee3ng \u201c\u0103n kh\u1edbp\u201d (Non-Engaging).<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-level=\"1\"><span style=\"font-weight: 400;\">T\u1ed5n th\u01b0\u01a1ng Hill &#8211; Sachs: \u201cOn track\u201d v\u00e0 \u201cOfftrack\u201d (theo Burkhart)<\/span><\/li>\n<\/ul>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u201cOn track\u201d: khi xoay ngo\u00e0i t\u1ed1i \u0111a th\u00ec t\u1ed5n th\u01b0\u01a1ng Hill &#8211; Sachs v\u1eabn\u00a0<\/span><span style=\"font-weight: 400;\">kh\u00f4ng v\u01b0\u1ee3t qu\u00e1 b\u1edd tr\u01b0\u1edbc \u1ed5 ch\u1ea3o (t\u01b0\u01a1ng t\u1ef1 \u201cNon &#8211; Engaging\u201d)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u201cOff track\u201d: khi xoay ngo\u00e0i t\u1ed1i \u0111a th\u00ec t\u1ed3n th\u01b0\u01a1ng Hill &#8211; Sachs v\u01b0\u1ee3t qu\u00e1 b\u1edd tr\u01b0\u1edbc \u1ed5 ch\u1ea3o (t\u01b0\u01a1ng t\u1ef1 \u201cEngaging\u201d)<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<figure id=\"attachment_17870\" aria-describedby=\"caption-attachment-17870\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-17870\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-10-luc-19.27.39-300x97.png\" alt=\"T\u1ed5n th\u01b0\u01a1ng Hill - Sachs: \u201cOn track\u201d v\u00e0 \u201cOfftrack\u201d\" width=\"300\" height=\"97\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-10-luc-19.27.39-300x97.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-10-luc-19.27.39-1024x330.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-10-luc-19.27.39-768x247.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-10-luc-19.27.39.png 1298w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-17870\" class=\"wp-caption-text\">T\u1ed5n th\u01b0\u01a1ng Hill &#8211; Sachs: \u201cOn track\u201d v\u00e0 \u201cOfftrack\u201d<\/figcaption><\/figure>\n<p><span style=\"font-weight: 400;\">T\u1ed5n th\u01b0\u01a1ng Hill &#8211; Sachs ng\u01b0\u1ee3c c\u0169ng \u0111\u00e3 \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 \u1edb nh\u1eefng b\u1ec7nh nh\u00e2n tr\u1eadt kh\u1edbp vai sau.<\/span><\/li>\n<\/ul>\n<p>\u0110\u1ec3 \u0111\u1eb7t l\u1ecbch kh\u00e1m t\u1ea1i vi\u1ec7n, Qu\u00fd kh\u00e1ch vui l\u00f2ng b\u1ea5m s\u1ed1\u00a0<strong>HOTLINE<\/strong>\u00a0ho\u1eb7c \u0111\u1eb7t l\u1ecbch tr\u1ef1c ti\u1ebfp\u00a0<strong>T\u1ea0I \u0110\u00c2Y<\/strong>. T\u1ea3i v\u00e0 \u0111\u1eb7t l\u1ecbch kh\u00e1m t\u1ef1 \u0111\u1ed9ng tr\u00ean\u00a0<a href=\"https:\/\/www.vinmec.com\/myvinmec\/\">\u1ee9ng d\u1ee5ng MyVinmec<\/a> \u0111\u1ec3 qu\u1ea3n l\u00fd, theo d\u00f5i l\u1ecbch v\u00e0 \u0111\u1eb7t h\u1eb9n m\u1ecdi l\u00fac m\u1ecdi n\u01a1i ngay tr\u00ean \u1ee9ng d\u1ee5ng.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Trong tr\u1eadt kh\u1edbp vai ra tr\u01b0\u1edbc c\u01a1\u00a0 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng th\u01b0\u1eddng l\u00e0 gi\u00e1n ti\u1ebfp, do ng\u00e3 ch\u1ed1ng tay ho\u1eb7c ch\u1ed1ng khu\u1ef7u, c\u00e1nh tay d\u1ea1ng, m\u1edf r\u1ed9ng, xoay ngo\u00e0i t\u1ea1o ra m\u1ed9t l\u1ef1c l\u00e0m thay \u0111\u1ed5i v\u1ecb tr\u00ed gi\u1ea3i ph\u1eabu c\u1ee7a ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay. \u0110\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n tr\u1ebb th\u00ec ch\u1ea5n th\u01b0\u01a1ng th\u1ec3 thao th\u01b0\u1eddng [&hellip;]<\/p>\n","protected":false},"author":49,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[75,40],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>C\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng v\u00e0 gi\u1ea3i ph\u1eabu b\u1ec7nh tr\u1eadt kh\u1edbp vai - Vinmec<\/title>\n<meta name=\"description\" content=\"C\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng th\u01b0\u1eddng l\u00e0 gi\u00e1n ti\u1ebfp do ng\u00e3 ch\u1ed1ng tay ho\u1eb7c ch\u1ed1ng khu\u1ef7u. 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