{"id":18113,"date":"2023-04-11T00:31:34","date_gmt":"2023-04-10T17:31:34","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=18113"},"modified":"2023-04-11T12:19:22","modified_gmt":"2023-04-11T05:19:22","slug":"lam-sang-va-chan-doan-gay-loi-cau-ngoai-xuong-canh-tay-o-tre-em","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/11\/lam-sang-va-chan-doan-gay-loi-cau-ngoai-xuong-canh-tay-o-tre-em\/","title":{"rendered":"L\u00e2m s\u00e0ng v\u00e0 ch\u1ea9n \u0111o\u00e1n g\u00e3y l\u1ed3i c\u1ea7u ngo\u00e0i x\u01b0\u01a1ng c\u00e1nh tay \u1edf tr\u1ebb em"},"content":{"rendered":"<p><strong>G\u00e3y l\u1ed3i c\u1ea7u ngo\u00e0i x\u01b0\u01a1ng c\u00e1nh tay \u1edf tr\u1ebb em l\u00e0 g\u00e3y \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng c\u00e1nh tay, \u0111\u01b0\u1eddng g\u00e3y n\u1eb1m t\u1eeb m\u1ecfm tr\u00ean l\u1ed3i c\u1ea7u \u0111\u1ebfn r\u00f2ng r\u1ecdc x\u01b0\u01a1ng c\u00e1nh tay. G\u00e3y l\u1ed3i c\u1ea7u ngo\u00e0i x\u01b0\u01a1ng c\u00e1nh tay l\u00e0 g\u00e3y x\u01b0\u01a1ng th\u01b0\u1eddng g\u1eb7p, \u0111\u1ee9ng th\u1ee9 hai sau trong c\u00e1c g\u00e3y x\u01b0\u01a1ng v\u00f9ng khu\u1ef7u \u1edf tr\u1ebb em, chi\u1ebfm t\u1eeb 10-20%. L\u00e0 m\u1ed9t g\u00e3y n\u1ed9i kh\u1edbp, type II ho\u1eb7c IV theo ph\u00e2n lo\u1ea1i c\u1ee7a Salter v\u00e0 Harris g\u00e2y t\u1ed5n th\u01b0\u01a1ng \u0111\u1ebfn hai c\u1ea5u tr\u00fac quan tr\u1ecdng c\u1ee7a \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng c\u00e1nh tay l\u00e0 s\u1ee5n ph\u00e1t tri\u1ec3n v\u00e0 s\u1ee5n kh\u1edbp. G\u00e3y l\u1ed3i c\u1ea7u ngo\u00e0i x\u01b0\u01a1ng c\u00e1nh tay c\u00f3 th\u1ec3 k\u00e8m: tr\u1eadt kh\u1edbp khu\u1ef7u, g\u00e3y m\u1ecfm khu\u1ef7u, g\u00e3y \u0111\u1ea7u tr\u00ean x\u01b0\u01a1ng quay.<\/strong><\/p>\n<p><strong>Nh\u00f3m t\u00e1c gi\u1ea3: <\/strong>PGS. TS. Tr\u1ea7n Trung D\u0169ng, ThS. BS. Tr\u1ea7n Qu\u1ed1c L\u00e2m, BS. Ph\u1ea1m Xu\u00e2n H\u01b0ng<\/p>\n<h2>1. C\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng g\u00e3y l\u1ed3i c\u1ea7u ngo\u00e0i x\u01b0\u01a1ng c\u00e1nh tay<\/h2>\n<p>Th\u01b0\u1eddng g\u1eb7p trong tr\u01b0\u1eddng h\u1ee3p ng\u00e3 ch\u1ed1ng tay xu\u1ed1ng n\u1ec1n c\u1ee9ng.<\/p>\n<ul>\n<li>Ng\u00e3 trong t\u01b0 th\u1ebf du\u1ed7i khu\u1ef7u, b\u1edd ngo\u00e0i m\u1ecfm khu\u1ef7u \u0111\u1eadp v\u00e0o r\u00f2ng r\u1ecdc, l\u00e0m v\u1ee1 l\u1ed3i c\u1ea7u ngo\u00e0i.<\/li>\n<li>Ng\u00e3 trong t\u01b0 th\u1ebf g\u1ea5p khu\u1ef7u: ch\u1ecfm quay th\u00fac v\u00e0o ch\u1ecfm con, g\u00e2y v\u1ee1 l\u1ed3i c\u1ea7u ngo\u00e0i.<\/li>\n<\/ul>\n<h2>2. Gi\u1ea3i ph\u1eabu l\u1ed3i c\u1ea7u ngo\u00e0i x\u01b0\u01a1ng c\u00e1nh tay \u1edf tr\u1ebb em<\/h2>\n<p>\u0110\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng c\u00e1nh tay (XCT) d\u1eb9t v\u00e0 b\u00e8 ngang sang hai b\u00ean, \u0111\u01b0\u1ee3c c\u1ea5u t\u1ea1o ch\u1ee7 y\u1ebfu b\u1edfi m\u1ed9t kh\u1ed1i c\u00e1c di\u1ec7n kh\u1edbp v\u00e0 c\u00e1c h\u1ed1, c\u00e1c m\u1ecfm \u0111i k\u00e8m.<\/p>\n<ul>\n<li>R\u00f2ng r\u1ecdc XCT: l\u00e0 di\u1ec7n kh\u1edbp \u0111\u1ea7u d\u01b0\u1edbi XCT ti\u1ebfp kh\u1edbp v\u1edbi di\u1ec7n kh\u1edbp \u0111\u1ea7u tr\u00ean x\u01b0\u01a1ng tr\u1ee5. \u1ede ph\u00eda sau c\u1ee7a r\u00f2ng r\u1ecdc r\u1ed9ng h\u01a1n \u1edf ph\u00eda tr\u01b0\u1edbc, s\u01b0\u1eddn trong d\u00e0i h\u01a1n s\u01b0\u1eddn ngo\u00e0i, gi\u1eefa hai s\u01b0\u1eddn l\u00e0 m\u1ed9t ch\u1ed7 th\u1eaft \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 nh\u01b0 m\u1ed9t \u0111\u01b0\u1eddng xo\u1eafn \u1ed1c.Tr\u00ean r\u00f2ng r\u1ecdc, \u1edf ph\u00eda sau l\u00e0 h\u1ed1 khu\u1ef7u, ph\u00eda tr\u01b0\u1edbc l\u00e0 h\u1ed1 v\u1eb9t.<\/li>\n<li>L\u1ed3i c\u1ea7u ngo\u00e0i (LCN) XCT: L\u00e0 di\u1ec7n kh\u1edbp \u0111\u1ea7u d\u01b0\u1edbi XCT ti\u1ebfp kh\u1edbp v\u1edbi \u0111\u00e0i quay, M\u1ed9t m\u1ecfm x\u01b0\u01a1ng h\u00ecnh c\u1ea7u h\u01b0\u1edbng xu\u1ed1ng d\u01b0\u1edbi v\u00e0 ra tr\u01b0\u1edbc, c\u00f3 tr\u1ee5c th\u1eb3ng \u0111\u1ee9ng l\u1edbn h\u01a1n tr\u1ee5c ngang. Ph\u00eda tr\u01b0\u1edbc v\u00e0 ngay tr\u00ean l\u1ed3i c\u1ea7u l\u00e0 h\u1ed1 tr\u00ean l\u1ed3i c\u1ea7u (h\u1ed1 quay).<\/li>\n<li>R\u00e3nh li\u00ean l\u1ed3i c\u1ea7u &#8211; r\u00f2ng r\u1ecdc: l\u00e0 r\u00e3nh gi\u1eefa l\u1ed3i c\u1ea7u v\u00e0 r\u00f2ng r\u1ecdc, c\u00f3 s\u01b0\u1eddn ngo\u00e0i l\u00e0 ph\u1ea7n trong c\u1ee7a l\u1ed3i c\u1ea7u v\u00e0 s\u01b0\u1eddn trong c\u0169ng ch\u00ednh l\u00e0 b\u1edd ngo\u00e0i c\u1ee7a r\u00f2ng r\u1ecdc, \u0111\u01b0\u1ee3c m\u00e0i v\u1eb9t theo m\u1ed9t b\u00ecnh di\u1ec7n ch\u00e9o t\u1eeb trong ra ngo\u00e0i, t\u1eeb d\u01b0\u1edbi l\u00ean tr\u00ean.<\/li>\n<li>M\u1ecfm tr\u00ean r\u00f2ng r\u1ecdc v\u00e0 m\u1ecfm tr\u00ean l\u1ed3i c\u1ea7u: l\u00e0 hai kh\u1ed1i x\u01b0\u01a1ng n\u1eb1m \u1edf ph\u00eda tr\u00ean c\u1ee7a c\u00e1c di\u1ec7n kh\u1edbp (r\u00f2ng r\u1ecdc v\u00e0 l\u1ed3i c\u1ea7u), \u1edf \u0111\u00f3 c\u00f3 c\u00e1c kh\u1ed1i c\u01a1 b\u00e1m v\u00e0o. C\u00e1c nh\u00e0 ph\u1eabu thu\u1eadt c\u00f2n chia \u0111\u1ea7u d\u01b0\u1edbi XCT l\u00e0m hai kh\u1ed1i, \u0111\u00f3 l\u00e0 kh\u1ed1i LCN v\u00e0 kh\u1ed1i l\u1ed3i c\u1ea7u trong.<\/li>\n<li>Kh\u1ed1i l\u1ed3i c\u1ea7u ngo\u00e0i l\u00e0 m\u1ed9t kh\u1ed1i x\u01b0\u01a1ng bao g\u1ed3m l\u1ed3i c\u1ea7u, m\u1ecfm tr\u00ean l\u1ed3i c\u1ea7u v\u00e0 n\u1eeda ngo\u00e0i c\u1ee7a r\u00f2ng r\u1ecdc.<\/li>\n<li>Kh\u1ed1i l\u1ed3i c\u1ea7u trong l\u00e0 m\u1ed9t kh\u1ed1i x\u01b0\u01a1ng bao g\u1ed3m m\u1ecfm tr\u00ean r\u00f2ng r\u1ecdc v\u00e0 n\u1eeda trong c\u1ee7a r\u00f2ng r\u1ecdc.<\/li>\n<\/ul>\n<p>\u0110\u1ea7u d\u01b0\u1edbi XCT ng\u1ea3 v\u1ec1 tr\u01b0\u1edbc so v\u1edbi th\u00e2n x\u01b0\u01a1ng. G\u00f3c xi\u00ean t\u1ea1o b\u1edfi tr\u1ee5c c\u1ee7a th\u00e2n XCT v\u00e0 tr\u1ee5c \u0111\u1ea7u d\u01b0\u1edbi XCT b\u1eb1ng 45\u00b0 (g\u00f3c g\u1ea5p tr\u01b0\u1edbc 45\u00b0).<\/p>\n<p>\u0110\u01b0\u1ee3c t\u00e1ch ra t\u1eeb \u0111\u1ea7u x\u01b0\u01a1ng nh\u1edd b\u1ea3n x\u01b0\u01a1ng, chia th\u00e0nh 4 khu v\u1ef1c.<\/p>\n<ul>\n<li>Khu v\u1ef1c th\u1ee9 nh\u1ea5t: g\u1ed3m c\u00e1c t\u1ebf b\u00e0o m\u1ea9m n\u1eb1m s\u00e1t v\u1edbi b\u1ea3n x\u01b0\u01a1ng. \u0110\u00e2y l\u00e0 c\u00e1c t\u1ebf b\u00e0o kh\u00f4ng bi\u1ec7t h\u00f3a, \u0111\u01b0\u1ee3c nu\u00f4i d\u01b0\u1ee1ng b\u1edfi \u0111\u1ed9ng m\u1ea1ch \u0111\u1ea7u x\u01b0\u01a1ng.<\/li>\n<\/ul>\n<ul>\n<li>Khu v\u1ef1c th\u1ee9 hai: n\u1eb1m s\u00e1t c\u00e1c t\u1ebf b\u00e0o m\u1ea7m c\u1ee7a khu v\u1ef1c m\u1ed9t. Khu v\u1ef1c n\u00e0y g\u1ed3m c\u00e1c t\u1ebf b\u00e0o s\u1ee5n ph\u00e1t tri\u1ec3n nhanh \u0111\u01b0\u1ee3c nu\u00f4i d\u01b0\u1ee1ng b\u1edfi \u0111\u1ed9ng m\u1ea1ch \u0111\u1ea7u x\u01b0\u01a1ng. Khu v\u1ef1c n\u00e0y \u0111\u00e1p \u1ee9ng cho x\u01b0\u01a1ng ph\u00e1t tri\u1ec3n chi\u1ec1u d\u00e0i.<\/li>\n<\/ul>\n<ul>\n<li>Khu v\u1ef1c ba: bao g\u1ed3m c\u00e1c t\u1ebf b\u00e0o n\u1edf to \u0111\u00f3 l\u00e0 c\u00e1c t\u1ebf b\u00e0o s\u1ee5n trong qu\u00e1 tr\u00ecnh ch\u00edn tr\u01b0\u1edbc khi b\u1ecb calci h\u00f3a. Khu v\u1ef1c n\u00e0y \u0111\u01b0\u1ee3c nu\u00f4i b\u1eb1ng \u0111\u1ed9ng m\u1ea1ch t\u1eeb h\u00e0nh x\u01b0\u01a1ng, \u1edf \u0111\u00e2y kh\u00f4ng c\u00f3 ho\u1ea1t \u0111\u1ed9ng ph\u00e1t tri\u1ec3n. Haas v\u00e0 Harris nh\u1eadn th\u1ea5y r\u1eb1ng \u0111\u00e2y l\u00e0 v\u00f9ng y\u1ebfu nh\u1ea5t c\u1ee7a s\u1ee5n ti\u1ebfp h\u1ee3p, C\u00e1c th\u01b0\u01a1ng t\u1ed5n c\u1ee7a s\u1ee5n th\u01b0\u1eddng n\u1eb1m \u1edf khu v\u1ef1c n\u00e0y.<\/li>\n<li>Khu v\u1ef1c b\u1ed1n: bao g\u1ed3m c\u00e1c t\u1ebf b\u00e0o c\u1ed1t h\u00f3a t\u1ea1m th\u1eddi, ch\u00fang \u0111\u01b0\u1ee3c c\u1ea5p m\u00e1u t\u1eeb \u0111\u1ed9ng m\u1ea1ch nu\u00f4i c\u1ee7a h\u00e0nh x\u01b0\u01a1ng.<\/li>\n<\/ul>\n<p>Nh\u00ecn c\u00e1c h\u00ecnh tr\u00ean ta th\u1ea5y g\u00e3y LCN x\u01b0\u01a1ng c\u00e1nh tay bao g\u1ed3m m\u1ecfm tr\u00ean l\u1ed3i c\u1ea7u, l\u1ed3i c\u1ea7u v\u00e0 ph\u1ea7n ngo\u00e0i c\u1ee7a r\u00f2ng r\u1ecdc l\u00e0 v\u1ea5n \u0111\u1ec1 t\u00e1ch r\u1eddi c\u1ee7a \u0111i\u1ec3m c\u1ed1t ho\u00e1 \u0111\u1ea7u ti\u00ean \u1edf \u0111\u1ea7u d\u01b0\u1edbi XCT, v\u00e0 h\u00ecnh \u1ea3nh XQ c\u1ee7a m\u1ea3nh v\u1ee1 bao gi\u1edd c\u0169ng nh\u1ecf h\u01a1n m\u1ea3nh v\u1ee1 th\u1ef1c r\u1ea5t nhi\u1ec1u v\u00ec ph\u1ea7n s\u1ee5n kh\u00f4ng c\u1ea3n quang<\/p>\n<p>V\u1edbi tr\u1ebb em c\u00f2n m\u1ed9t \u0111\u1eb7c \u0111i\u1ec3m quan tr\u1ecdng li\u00ean quan \u0111\u1ebfn s\u1ee5n ph\u00e1t tri\u1ec3n. \u1ede tr\u1ebb em, c\u00e1c \u0111\u1ea7u x\u01b0\u01a1ng \u0111\u01b0\u1ee3c t\u1ea1o b\u1edfi c\u00e1c s\u1ee5n ph\u00e1t tri\u1ec3n, quy\u1ebft \u0111\u1ecbnh chi\u1ec1u d\u00e0i v\u00e0 h\u00ecnh th\u00e1i x\u01b0\u01a1ng \u1edf tu\u1ed5i tr\u01b0\u1edfng th\u00e0nh. Khi m\u1edbi sinh, kh\u1edbp khu\u1ef7u \u0111\u01b0\u1ee3c c\u1ea5u t\u1ea1o ho\u00e0n to\u00e0n b\u1edfi c\u1ea5u tr\u00fac s\u1ee5n. Do \u0111\u00f3, c\u00e1c c\u1ea5u tr\u00fac x\u01b0\u01a1ng kh\u00f4ng th\u1ec3 ph\u00e1t hi\u1ec7n tr\u00ean XQ. C\u00e1c \u0111i\u1ec3m c\u1ed1t ho\u00e1 xu\u1ea5t hi\u1ec7n t\u1eebng b\u01b0\u1edbc theo s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a tr\u1ebb.<\/p>\n<figure id=\"attachment_18117\" aria-describedby=\"caption-attachment-18117\" style=\"width: 298px\" class=\"wp-caption alignnone\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-18117 size-full\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/z4254338679157_5f9aa0ccb685018e28fa23def16b68e7.jpg\" alt=\"minh-hoa-giai-phau-loi-cau-ngoai-xuong-canh-tay\" width=\"298\" height=\"187\" \/><figcaption id=\"caption-attachment-18117\" class=\"wp-caption-text\">H\u00ecnh 1: C\u00e1c \u0111i\u1ec3m c\u1ed1t ho\u00e1 x\u01b0\u01a1ng v\u00f9ng khu\u1ef7u<\/figcaption><\/figure>\n<ul>\n<li>L\u1ed3i c\u1ea7u ngo\u00e0i: l\u00e0 \u0111i\u1ec3m c\u1ed1t ho\u00e1 \u0111\u1ea7u ti\u00ean, b\u1eaft \u0111\u1ea7u xu\u1ea5t hi\u1ec7n t\u1eeb th\u00e1ng tu\u1ed5i th\u1ee9 3, ch\u1eadm nh\u1ea5t l\u00e0 sau 2 tu\u1ed5i, l\u00fac \u0111\u1ea7u \u1edf d\u1ea1ng h\u00ecnh c\u1ea7u, gi\u1ed1ng nh\u01b0 r\u00f2ng r\u1ecdc v\u00e0 l\u1ed3i c\u1ea7u trong. Nh\u00ecn t\u1eeb ph\u00eda b\u00ean, tr\u00f4ng c\u00f3 v\u1ebb l\u1ed3i c\u1ea7u ngo\u00e0i b\u00e1n tr\u1eadt ra tr\u01b0\u1edbc so v\u1edbi \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng c\u00e1nh tay. L\u1ed3i c\u1ea7u ngo\u00e0i s\u1ebd c\u1ed1t ho\u00e1 ho\u00e0n to\u00e0n \u1edf tu\u1ed5i 13-14.<\/li>\n<li>M\u1ecfm r\u00f2ng r\u1ecdc c\u00f3 th\u1ec3 nh\u00ecn th\u1ea5\u1ef5 \u0111i\u1ec3m c\u1ed1t ho\u00e1 tr\u00ean phim X-quang \u1edf kho\u1ea3ng 4-5 tu\u1ed5i, \u0111i\u1ec3m c\u1ed1t ho\u00e1 kh\u00f4ng nh\u1ea5t thi\u1ebft ph\u1ea3i b\u1eaft \u0111\u1ea7u t\u1eeb trung t\u00e2m v\u00f2ng s\u1ee5n. M\u1ecfm r\u00f2ng r\u1ecdc l\u00e0 \u0111i\u1ec3m c\u1ed1t ho\u00e1 ho\u00e0n to\u00e0n mu\u1ed9n nh\u1ea5t c\u1ee7a \u0111\u1ea5u d\u01b0\u1edbi x\u01b0\u01a1ng c\u00e1nh ta\u1ef5, kho\u1ea3ng 14-16 tu\u1ed5i.<\/li>\n<li>R\u00f2ng r\u1ecdc: c\u1ed1t ho\u00e1 \u1edf kho\u1ea3ng 8-15 tu\u1ed5i, c\u00f3 kho\u1ea3ng 3 \u0111i\u1ec3m c\u1ed1t ho\u00e1 \u1edf r\u00f2ng r\u1ecdc n\u1eb1m trong c\u00e1c v\u00f2ng s\u1ee5n.<\/li>\n<li>Ch\u1ecfm quay: b\u1eaft \u0111\u1ea9u c\u1ed1t ho\u00e1 t\u1eeb 3-6 tu\u1ed5i.<\/li>\n<li>M\u1ecfm tr\u00ean l\u1ed3i c\u1ea7u: b\u1eaft \u0111\u1ea7u \u1edf kho\u1ea3ng 10-12 tu\u1ed5i, c\u00f3 c\u1ea5u tr\u00fac d\u1ea1ng h\u00ecnh \u00ca ke, \u0111\u1eb7c \u0111i\u1ec3m n\u00e0y l\u00e0m cho d\u1ec5 b\u1ecf s\u00f3t m\u1ed9t g\u00e3y x\u01b0\u01a1ng \u1edf v\u00f9ng n\u00e0y. Th\u00f4ng th\u01b0\u1eddng, m\u1ecfm tr\u00ean l\u1ed3i c\u1ea7u s\u1ebd h\u1ee3p nh\u1ea5t v\u1edbi l\u1ed3i c\u1ea7u ngo\u00e0i tr\u01b0\u1edbc khi s\u00e1t nh\u1eadp v\u1edbi h\u00e0nh x\u01b0\u01a1ng c\u1ee7a \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng c\u00e1nh tay.<\/li>\n<\/ul>\n<p>Nh\u01b0 v\u1eady b\u1ed1n \u0111i\u1ec3m c\u1ed1t ho\u00e1 (l\u1ed3i c\u1ea7u ngo\u00e0i, m\u1ecfm tr\u00ean l\u1ed3i c\u1ea7u, r\u00f2ng r\u1ecdc x\u01b0\u01a1ng c\u00e1nh tay, v\u00e0 m\u1ecfm r\u00f2ng r\u1ecdc) s\u1ebd k\u1ebft h\u1ee3p v\u1edbi nhau tr\u01b0\u1edbc khi s\u00e1t nh\u1eadp ho\u00e0n to\u00e0n v\u1edbi h\u00e0nh x\u01b0\u01a1ng c\u1ee7a \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng c\u00e1nh tay, kho\u1ea3ng 13-16 tu\u1ed5i.<\/p>\n<p>S\u1ee5n ph\u00e1t tri\u1ec3n l\u00e0 m\u1ed9t c\u1ea5u tr\u00fac d\u1ec5 b\u1ecb t\u1ed5n th\u01b0\u01a1ng.<\/p>\n<p>Ch\u1ee9c n\u0103ng c\u1ee7a n\u00f3, thi\u1ebft y\u1ebfu trong s\u1ef1 ph\u00e1t tri\u1ec3n, \u0111\u00f2i h\u1ecfi s\u1ef1 ch\u00fa \u00fd \u0111\u1eb7c bi\u1ec7t trong vi\u1ec7c \u0111i\u1ec1u\u00a0 tr\u1ecb ch\u1ec9nh h\u00ecnh v\u00e0 ph\u1eabu thu\u1eadt x\u01b0\u01a1ng \u1edf tr\u1ebb em.<\/p>\n<p>S\u1ee5n ph\u00e1t tri\u1ec3n \u0111\u1ea1i di\u1ec7n cho khu v\u1ef1c &#8220;qu\u00e1 \u0111\u1ed9&#8221; s\u1ee5n n\u1eb1m gi\u1eefa hai \u0111o\u1ea1n x\u01b0\u01a1ng c\u1ee9ng nh\u1eafc, l\u00e0 nh\u1eefng v\u00f9ng t\u1eadp trung \u00e1p su\u1ea5t c\u01a1 h\u1ecdc, v\u00f9ng d\u1ec5 t\u1ed5n th\u01b0\u01a1ng trong c\u00e1c b\u1ec7nh l\u00fd ch\u1ea5n th\u01b0\u01a1ng.<\/p>\n<figure id=\"attachment_18118\" aria-describedby=\"caption-attachment-18118\" style=\"width: 561px\" class=\"wp-caption alignnone\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-18118\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/z4254338943212_af0f8ebf7fe36b1d3eb601aa383afae0-300x62.png\" alt=\"\" width=\"561\" height=\"116\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/z4254338943212_af0f8ebf7fe36b1d3eb601aa383afae0-300x62.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/z4254338943212_af0f8ebf7fe36b1d3eb601aa383afae0.png 646w\" sizes=\"(max-width: 561px) 100vw, 561px\" \/><figcaption id=\"caption-attachment-18118\" class=\"wp-caption-text\">Lo\u1ea1i I\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0Lo\u1ea1i II\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 Lo\u1ea1i III\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 Lo\u1ea1i IV\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 Lo\u1ea1i V<\/figcaption><\/figure>\n<p>H\u00ecnh: Ph\u00e2n lo\u1ea1i g\u00e3y x\u01b0\u01a1ng tr\u1ebb em theo Salter v\u00e0 Haris<\/p>\n<p>H\u01a1n n\u1eefa, c\u00e1c ho\u1ea1t \u0111\u1ed9ng trao \u0111\u1ed5i ch\u1ea5t m\u1ea1nh m\u1ebd trong s\u1ee5n ph\u00e1t tri\u1ec3n gi\u1ea3i th\u00edch s\u1ef1 nh\u1ea1y c\u1ea3m v\u1edbi c\u00e1c r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a v\u00e0 c\u00e1c b\u1ec7nh l\u00fd m\u1eafc ph\u1ea3i. \u0110i\u1ec1u n\u00e0y gi\u1ea3i th\u00edch t\u1ea1i sao c\u00e1c g\u00e3y x\u01b0\u01a1ng v\u00f9ng kh\u1edbp \u1edf tr\u1ebb em d\u1ec5 d\u1eabn \u0111\u1ebfn c\u00e1c bi\u1ebfn d\u1ea1ng th\u1ee9 ph\u00e1t.<\/p>\n<p>*T\u1edbi s\u1edbm:<\/p>\n<ul>\n<li>\u0110au ch\u00f3i \u1edf ph\u00eda ngo\u00e0i c\u1ee7a khu\u1ef7u, t\u01b0\u01a1ng \u1ee9ng m\u1ecfm tr\u00ean l\u1ed3i c\u1ea7u.<\/li>\n<li>Khu\u1ef7u tay s\u01b0ng n\u1ec1 \u1edf ph\u00eda ngo\u00e0i, bi\u1ebfn d\u1ea1ng n\u00e0y l\u00e0m ngh\u0129 \u0111\u1ebfn g\u00e3\u1ef5 LCN.<\/li>\n<\/ul>\n<p>G\u00e3y \u0111\u1ed9 I \u0111\u01a1n thu\u1ea7n c\u00f3 \u0111au LCN t\u1ef1 nhi\u00ean, \u0111au t\u0103ng khi g\u1ea5p c\u1ed5 tay v\u00e0 xoay ng\u1eeda b\u00e0n ta\u1ef5. G\u00e3y \u0111\u1ed9 II, III c\u00f3 th\u1ec3 th\u1ea5y l\u1ea1o x\u1ea1o x\u01b0\u01a1ng.<\/p>\n<ul>\n<li>N\u1ebfu mu\u1ed9n h\u01a1n v\u00e0i ng\u00e0\u1ef5, khu\u1ef7u s\u01b0ng tr\u00f2n c\u0103ng c\u00f3 th\u1ec3 c\u00f3 ph\u1ecfng n\u01b0\u1edbc.<\/li>\n<\/ul>\n<p>V\u1edbi c\u00e1c d\u1ea5u hi\u1ec7u nh\u01b0 tr\u00ean khu tr\u00fa \u1edf ph\u00eda ngo\u00e0i c\u00f9a khu\u1ef7u sau ch\u1ea5n th\u01b0\u01a1ng th\u00ec ta c\u1ea7n ngh\u0129 \u0111\u1ebfn<\/p>\n<p>v\u1ee1 LCN v\u00e0 cho ch\u1ee5p X-quang khu\u1ef7u th\u1eb3ng v\u00e0 nghi\u00eang \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n.<\/p>\n<p>*T\u1edbi mu\u1ed9n: n\u1ec3u g\u00e3y LCN kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb s\u1edbm, t\u1edbi mu\u1ed9n sau 3 tu\u1ea7n th\u00ec kh\u00f4ng c\u00f2n \u0111\u1ee7 c\u00e1c d\u1ea5u hi\u1ec7u nh\u01b0 m\u00f4 t\u1ea3.<\/p>\n<p>Khi \u0111\u00e3 h\u1ebft ph\u00f9 n\u1ec1 th\u00ec s\u1ebd th\u1ea5y g\u1ed3 b\u1ea5t th\u01b0\u1eddng c\u1ee7a LCN \u1edf m\u1eb7t ngo\u00e0i c\u1ee7a khu\u1ef7u.<\/p>\n<p>C\u00f3 th\u1ec3 do d\u00ednh kh\u1edbp khi b\u1ec7nh nh\u00e2n (BN) kh\u00f4ng th\u1ec3 du\u1ed7i khu\u1ef7u ho\u1eb7c g\u1ea5p khu\u1ef7u m\u00e0 ch\u1ec9 v\u1eadn \u0111\u1ed9ng khu\u1ef7u trong kho\u1ea3ng 20 \u0111\u1ed9.<\/p>\n<h3>M\u1ed9t s\u1ed1 \u0111i\u1ec3u c\u1ea7n l\u01b0u \u00fd:<\/h3>\n<ul>\n<li>T\u1ed5n th\u01b0\u01a1ng ph\u1ea7n m\u1ec3m:<\/li>\n<\/ul>\n<p>+ \u0110\u01b0\u1eddng g\u00e3y th\u01b0\u1eddng xu\u1ea5t ph\u00e1t t\u1eeb ph\u00eda sau b\u00ean c\u1ee7a h\u00e0nh x\u01b0\u01a1ng n\u00ean c\u00f3 th\u1ec3 t\u1ed5n th\u01b0\u01a1ng m\u00f4 m\u1ec1m gi\u1eefa nguy\u00ean \u1ee7y c\u01a1 du\u1ed7i c\u1ed5 tay quay d\u00e0i v\u00e0 c\u01a1 ng\u1eeda c\u1eb3ng tay .<\/p>\n<p>+ C\u00e0ng nhi\u1ec1u t\u1ed5n th\u01b0\u01a1ng m\u00f4 m\u1ec1m, c\u00e0ng s\u01b0ng n\u1ec1 nhi\u1ec1u, c\u00e0ng t\u0103ng kh\u1ea3 n\u0103ng di l\u1ec7ch mu\u1ed9n sau n\u00e0y.<\/p>\n<ul>\n<li>S\u1ef1 di l\u1ec7ch v\u00e0 m\u1ea5t v\u1eefng kh\u1edbp khu\u1ef7u:<\/li>\n<\/ul>\n<p>+ T\u00e1c \u0111\u1ed9ng c\u01a1 g\u00e2y ra di l\u1ec7ch.<\/p>\n<p>+ N\u1ebfu 2 m\u1eb7t g\u00e3y c\u00f2n ti\u1ebfp x\u00fac nhau, s\u1ef1 di l\u1ec7ch m\u1ea3nh g\u00e3y \u0111\u01a1n gi\u1ea3n ch\u1ec9 l\u00e0 nghi\u00eang sang b\u00ean. N\u1ebfu g\u00e3y ho\u00e0n to\u00e0n s\u1ebd c\u00f3 di l\u1ec7ch xa h\u01a1n v\u00e0 c\u00f3 di l\u1ec7ch xoay nhi\u1ec1u m\u1ee9c \u0111\u1ed9 (c\u00f3 th\u1ec3 xoay \u0111\u1ebfn 180 \u0111\u1ed9). Di l\u1ec7ch xoay c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf m\u1eb7t ph\u1eb3ng tr\u00e1n hay m\u1eb7t ph\u1eb3ng ngang.<\/p>\n<p>+ Trong g\u00e3y Milch I c\u00f3 th\u1ec3 c\u00f3 v\u1eb9o ngo\u00e0i nh\u1eb9 m\u00e0 kh\u00f4ng c\u00f3 tr\u1eadt kh\u1edbp. Khu\u1ef7u c\u00f2n v\u1eefng v\u00ec r\u00f2ng r\u1ecdc c\u00f2n nguy\u00ean v\u1eb9n.<\/p>\n<p>+ Trong g\u00e3y Milch II, kh\u1edbp khu\u1ef7u tr\u1edf n\u00ean m\u1ea5t v\u1eefng v\u00ec \u0111\u01b0\u1eddng g\u00e3y ph\u00e1 h\u1ee7y m\u00e1 r\u00f2ng r\u1ecdc l\u00e0m cho \u0111\u1ea7u g\u1ea7n x\u01b0\u01a1ng tr\u1ee5 v\u00e0 x\u01b0\u01a1ng quay di l\u1ec7ch ra sau b\u00ean. c\u1eb3ng tay xoay theo m\u1eb7t ph\u1eb3ng tr\u00e1n v\u00e0 c\u00f3 th\u1ec3 c\u00f3 tr\u1eadt kh\u1edbp quay LCN v\u00e0 ch\u1ecfm quay-x\u01b0\u01a1ng tr\u1ee5.<\/p>\n<h2>3. Ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh<\/h2>\n<h3>1.1 X-quang<\/h3>\n<ul>\n<li>Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh.<\/li>\n<li>Ph\u00e2n lo\u1ea1i v\u00e0 ph\u00e2n \u0111\u1ed9 \u0111\u01b0\u1eddng g\u00e3y.<\/li>\n<\/ul>\n<p>C\u00f3 th\u1ec3 g\u1eb7p kh\u00f3 kh\u0103n trong ph\u00e2n bi\u1ec7t hai l\u1ed3i c\u1ea7u XCT, c\u00f3 di l\u1ec7ch ra gi\u1eefa sau, x\u01b0\u01a1ng quay. Trong g\u00e3y ho\u00e0n to\u00e0n , c\u00f3 di l\u1ec7ch ra sau \u00a0v\u1eabn c\u00f2n m\u1ed1i li\u00ean h\u1ec7 gi\u1eefa trung t\u00e2m c\u1ed1t h\u00f3a v\u00e0 \u0111\u1ea7u g\u1ea7n x\u01b0\u01a1ng quay.<\/p>\n<h3>1.2 Ch\u1ee5p MRI<\/h3>\n<p>Tr\u00ean phim XQ th\u01b0\u1eddng \u0111\u00f4i khi kh\u00f4ng \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c m\u1ee9c \u0111\u1ed9 g\u00e3y v\u00e0 nguy c\u01a1 di l\u1ec7ch c\u1ee7a m\u1ea3nh v\u1ee1 l\u1ed3i c\u1ea7u ngo\u00e0i, \u0111\u1eadc bi\u1ec7t \u1edf tr\u1ebb nh\u1ecf tu\u1ed5i (3-4 tu\u1ed5i), Ch\u1ee5p MRI v\u1edbi l\u00e1t c\u1eaft 1,5mm- 2mm, ngo\u00e0i \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c m\u1ee9c \u0111\u1ed9 g\u00e3y v\u00e0 nguy c\u01a1 di l\u1ec7ch, c\u00f2n cho ph\u00e9p ph\u00e1t hi\u1ec7n c\u00e1c th\u01b0\u01a1ng t\u1ed5n kh\u00e1c c\u1ee7a kh\u1edbp.<\/p>\n<figure id=\"attachment_18120\" aria-describedby=\"caption-attachment-18120\" style=\"width: 293px\" class=\"wp-caption alignnone\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-18120 \" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/z4254339545688_41a81e93664e970d4cf223c9f787d7e2.jpg\" alt=\"minh-hoa-gay-loi-cau-ngoai-xct-o-tre-em\" width=\"293\" height=\"383\" \/><figcaption id=\"caption-attachment-18120\" class=\"wp-caption-text\">H\u00ecnh \u1ea3nh MRI kh\u1edbp khu\u1ef7u trong g\u00e3y LCN x\u01b0\u01a1ng c\u00e1nh tay tr\u1ebb em<\/figcaption><\/figure>\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<a class=\"contact-button link-in-body\" href=\"https:\/\/vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/phuc-hoi-chuc-nang-gay-tren-loi-cau-xuong-canh-tay\/#\"><b class=\"link-in-body\">HOTLINE<\/b><\/a>\u00a0ho\u1eb7c \u0111\u1eb7t l\u1ecbch tr\u1ef1c ti\u1ebfp\u00a0<a class=\"appointment-button link-in-body\" href=\"https:\/\/vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/phuc-hoi-chuc-nang-gay-tren-loi-cau-xuong-canh-tay\/#\"><b class=\"link-in-body\">T\u1ea0I \u0110\u00c2Y<\/b><\/a>. T\u1ea3i v\u00e0 \u0111\u1eb7t l\u1ecbch kh\u00e1m t\u1ef1 \u0111\u1ed9ng tr\u00ean\u00a0<a class=\"link-in-body\" href=\"https:\/\/vinmec.com\/myvinmec\/\" target=\"_blank\" rel=\"noopener\">\u1ee9ng d\u1ee5ng MyVinmec<\/a>\u00a0\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<ol>\n<li>Campbell&#8217;s Operative Orthopaedics. Canale ST, Beaty JH. Eleventh edition. Mosby E\u1ec9sevier.<\/li>\n<li>Rockwood &amp; Green&#8217;s Fractures in Children, 7th Edition<\/li>\n<li>Handbook of Fracture, 5E (2014), Pediatric Elbow<\/li>\n<li>Practical Procedures in OrthopaedicTrauma Surgery<\/li>\n<li>MasterTechniques in Orthopaedic Surgery Relevant Surgical Exposures<\/li>\n<li>AO Principles of Fracture Management<\/li>\n<li>Operative Techniques in Pediatric Orthopaedics, Chapter 2: Open Reduction and Internal Fixation of Displaced Lateral Condyle Fractures of the Humerus<\/li>\n<li>Tachdjian&#8217;s Pediatric Orthopaedics, 5th Edition, Joh Herring, Chapter 33: Upper Extremity Injuries<\/li>\n<\/ol>\n<ol start=\"9\">\n<li>Gray&#8217;s Anatomy, 40th Edition Atlas gi\u1ea3i ph\u1eabu ng\u01b0\u1eddi, Frank H.Netter, 2013 Edition<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>G\u00e3y l\u1ed3i c\u1ea7u ngo\u00e0i x\u01b0\u01a1ng c\u00e1nh tay \u1edf tr\u1ebb em l\u00e0 g\u00e3y \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng c\u00e1nh tay, \u0111\u01b0\u1eddng g\u00e3y n\u1eb1m t\u1eeb m\u1ecfm tr\u00ean l\u1ed3i c\u1ea7u \u0111\u1ebfn r\u00f2ng r\u1ecdc x\u01b0\u01a1ng c\u00e1nh tay. G\u00e3y l\u1ed3i c\u1ea7u ngo\u00e0i x\u01b0\u01a1ng c\u00e1nh tay l\u00e0 g\u00e3y x\u01b0\u01a1ng th\u01b0\u1eddng g\u1eb7p, \u0111\u1ee9ng th\u1ee9 hai sau trong c\u00e1c g\u00e3y x\u01b0\u01a1ng v\u00f9ng khu\u1ef7u \u1edf tr\u1ebb [&hellip;]<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[40],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>L\u00e2m s\u00e0ng v\u00e0 ch\u1ea9n \u0111o\u00e1n g\u00e3y l\u1ed3i c\u1ea7u ngo\u00e0i x\u01b0\u01a1ng c\u00e1nh tay \u1edf tr\u1ebb em - Vinmec<\/title>\n<meta name=\"description\" content=\"G\u00e3\u1ef5 l\u1ed3i c\u1ea7u ngo\u00e0i x\u01b0\u01a1ng c\u00e1nh tay \u1edf tr\u1ebb em l\u00e0 g\u00e3y \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng c\u00e1nh tay, \u0111\u01b0\u1eddng g\u00e3y n\u1eb1m t\u1eeb m\u1ecfm tr\u00ean l\u1ed3i c\u1ea7u \u0111\u1ebfn r\u00f2ng r\u1ecdc x\u01b0\u01a1ng c\u00e1nh tay.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"L\u00e2m s\u00e0ng v\u00e0 ch\u1ea9n \u0111o\u00e1n g\u00e3y l\u1ed3i c\u1ea7u ngo\u00e0i x\u01b0\u01a1ng c\u00e1nh tay \u1edf tr\u1ebb em - 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