{"id":18161,"date":"2023-04-11T22:15:43","date_gmt":"2023-04-11T15:15:43","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=18161"},"modified":"2023-04-12T10:19:44","modified_gmt":"2023-04-12T03:19:44","slug":"phuong-phap-dieu-tri-rach-chop-xoay","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/11\/phuong-phap-dieu-tri-rach-chop-xoay\/","title":{"rendered":"Ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb r\u00e1ch ch\u00f3p xoay"},"content":{"rendered":"<p><strong>V\u1ec1 vi\u1ec7c l\u1ef1a ch\u1ecdn ph\u01b0\u01a1ng th\u1ee9c \u0111i\u1ec1u tr\u1ecb n\u00e0o th\u00ec ph\u1ea3i x\u00e9t tr\u00ean nhi\u1ec1u y\u1ebfu t\u1ed1 nh\u01b0: mong mu\u1ed1n v\u1ec1 ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n, nhu c\u1ea7u v\u1eadn \u0111\u1ed9ng; y\u1ebfu t\u1ed1 to\u00e0n tr\u1ea1ng, tu\u1ed5i c\u0169ng nh\u01b0 c\u01a1 \u0111\u1ecba c\u00e1 nh\u00e2n, c\u00f3 \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n kh\u00f4ng; th\u1eadm ch\u00ed c\u00f2n ph\u1ea3i x\u00e9t \u0111\u1ebfn v\u1ea5n \u0111\u1ec1 kinh t\u1ebf \u0111i\u1ec1u tr\u1ecb.<\/strong><\/p>\n<p><strong>T\u00f3m l\u1ea1i, tr\u01b0\u1edbc khi ch\u1ec9 \u0111\u1ecbnh h\u00ecnh th\u1ee9c \u0111i\u1ec1u tr\u1ecb n\u00e0o cho b\u1ec7nh nh\u00e2n th\u00ec ng\u01b0\u1eddi th\u1ea7y thu\u1ed1c ph\u1ea3i x\u00e9t tr\u00ean nhi\u1ec1u b\u00ecnh di\u1ec7n, linh ho\u1ea1t d\u1ef1a v\u00e0o s\u1ef1 ph\u00f9 h\u1ee3p nh\u1ea5t \u0111\u1ed1i v\u1edbi t\u1eebng b\u1ec7nh nh\u00e2n c\u1ee5 th\u1ec3. Ngo\u00e0i ra c\u1ea7n ph\u1ea3i \u0111i\u1ec1u tr\u1ecb to\u00e0n di\u1ec7n, ch\u00fa tr\u1ecdng v\u00e0o gi\u1ea3i quy\u1ebft tri\u1ec7t \u0111\u1ec3<a href=\"https:\/\/www.vinmec.com\/vi\/co-xuong-khop\/suc-khoe-thuong-thuc\/chan-doan-va-dieu-tri-rach-chop-xoay-vung-vai\/#:~:text=R%C3%A1ch%20ch%C3%B3p%20xoay%20v%C3%B9ng%20vai%20l%C3%A0%20t%C3%ACnh%20tr%E1%BA%A1ng%20%C4%91%E1%BB%A9t%20m%E1%BB%99t,v%C3%A0%20vi%C3%AAm%20kh%E1%BB%9Bp%20tho%C3%A1i%20h%C3%B3a.\"> nguy\u00ean nh\u00e2n<\/a> b\u1ec7nh bao g\u1ed3m c\u1ea3 thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng, th\u00f3i quen sinh ho\u1ea1t.<br \/>\n<\/strong><\/p>\n<h1><span style=\"font-weight: 400;\">1. \u0110i\u1ec1u tr\u1ecb T\u1ed5n th\u01b0\u01a1ng r\u00e1ch ch\u00f3p xoay b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p b\u1ea3o t\u1ed3n<\/span><\/h1>\n<h2><span style=\"font-weight: 400;\">\u00a0\u00a0\u00a01.1. Ch\u1ec9 \u0111\u1ecbnh<\/span><\/h2>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Khi kh\u00f4ng c\u00f3 ti\u1ec1n s\u1eed ch\u1ea5n th\u01b0\u01a1ng r\u00f5 r\u00e0ng m\u00e0 tri\u1ec7u ch\u1ee9ng kh\u00f4ng r\u1ea7m r\u1ed9, tr\u00ean MRI c\u00f3 t\u1ed5n th\u01b0\u01a1ng r\u00e1ch nh\u1ecf,<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">V\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n th\u1ec3 gi\u1ea3 li\u1ec7t ho\u1eb7c h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng qu\u00e1 nhi\u1ec1u c\u00f9ng n\u00ean ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa v\u1edbi c\u00e1c b\u00e0i t\u1eadp VLTL \u0111\u1ec3 c\u1ea3i thi\u1ec7n s\u1ee9c c\u01a1 xung quanh c\u00f9ng nh\u01b0 s\u1ef1 linh ho\u1ea1t c\u1ee7a kh\u1edbp tr\u01b0\u1edbc khi ti\u1ebfn h\u00e0nh ph\u1eabu thu\u1eadt.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">R\u00e1ch l\u1edbn v\u00e0 r\u1ea5t l\u1edbn m\u00e0 b\u1ec7nh nh\u00e2n ch\u1ec9 c\u00f3 nhu c\u1ea7u v\u1eadn \u0111\u1ed9ng \u00edt (nh\u1eefng sinh ho\u1ea1t c\u01a1 b\u1ea3n) ho\u1eb7c b\u1ec7nh l\u00fd to\u00e0n th\u00e2n c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u1edbi ph\u1eabu thu\u1eadt. Khi n\u00e0y m\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n nh\u1eb1m gi\u1ea3m \u0111au v\u00e0 c\u1ea3i thi\u1ec7n \u0111\u01b0\u1ee3c ch\u1ee9c n\u0103ng kh\u1edbp c\u00e0ng nhi\u1ec1u c\u00e0ng t\u1ed1t.<\/span><\/li>\n<\/ul>\n<h2><i><span style=\"font-weight: 400;\">1.2\u00a0 C\u00e1ch th\u1ee9c<\/span><\/i><\/h2>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ch\u01b0\u1eddm l\u1ea1nh; thu\u1ed1c NSAIDs, thay \u0111\u1ed5i th\u00f3i quen ho\u1ea1t \u0111\u1ed9ng ( \u0111\u1eb7c bi\u1ec7t l\u00e0 c\u00e1c \u0111\u1ed9ng t\u00e1c \u0111\u01b0a tay qu\u00e1 \u0111\u1ea7u)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">L\u00fd li\u1ec7u ph\u00e1p t\u1eadp trung v\u00e0o ph\u1ee5c h\u1ed3i l\u1ea1i t\u1ea7m v\u1eadn \u0111\u1ed9ng c\u1ee7a kh\u1edbp vai<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ti\u00eam cortisone v\u00e0o khoang d\u01b0\u1edbi m\u1ecfm c\u00f9ng vai: nh\u00e0m gi\u1ea3m \u0111au v\u00e0 h\u1ed7 tr\u1ee3 vi\u1ec7c c\u00f3 th\u1ec3 tham gia m\u1ed9t ch\u01b0\u01a1ng tr\u00ecnh v\u1eadt l\u00fd tr\u1ecb li\u1ec7u \u0111\u1ea7y \u0111\u1ee7 nh\u1ea5t.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Li\u1ec7u tr\u00ecnh I s\u1ed1 t\u00e1c gi\u1ea3 \u0111\u1ec1 xu\u1ea5t l\u00e0 n\u1ebfu b\u1ec7nh nh\u00e2n \u0111\u1ebfn v\u1edbi b\u00e1c s\u0129 trong t\u00ecnh tr\u1ea1ng \u0111au ti\u1ebfn tri\u1ec3n th\u00ec ti\u00eam 3 corticoid trong 3 th\u00e1ng \u0111\u1ea7u, sau \u0111\u00f3 duy tr\u00ec 1 m\u0169i 1 n\u0103m.<\/span><\/p>\n<p><i><span style=\"font-weight: 400;\">M\u1ed9t s\u1ed1 ch\u00fa \u00fd\u00a0 khi ch\u1ecdn \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n<\/span><\/i><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">N\u00ean ph\u1ed1i h\u1ee3p nhi\u1ec1u ph\u01b0\u01a1ng th\u1ee9c trong \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n \u0111\u1ebf t\u0103ng t\u00ednh hi\u1ec7u qu\u1ea3.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">R\u1ea5t th\u1eadn tr\u1ecdng trong m\u1ed7i m\u0169i ti\u00eam kh\u1edbp, r\u1ea5t nhi\u1ec1u b\u00e1o c\u00e1o li\u00ean quan \u0111\u1ebfn bi\u1ebfn ch\u1ee9ng c\u1ee7a ti\u00eam kh\u1edbp sai k\u1ef9 thu\u1eadt d\u1eabn t\u1edbi nhi\u1ec5m khu\u1ea9n v\u00e0 \u0111\u1ee9t g\u00e2n &#8211; s\u1ebd l\u00e0 m\u1ed9t th\u1ea3m h\u1ecda khi m\u1ee5c \u0111\u00edch ban \u0111\u1ea7u ch\u1ec9 l\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n kh\u00f4ng ph\u1eabu thu\u1eadt.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Theo d\u00f5i hi\u1ec7u qu\u1ea3 c\u1ee7a \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n 3 tu\u1ea7n I l\u1ea9n, n\u00ean ch\u1ee5p MRI ki\u1ec3m tra l\u1ea1i \u1edf th\u00e1ng th\u1ee9 4-6.<\/span><\/li>\n<\/ul>\n<h1><span style=\"font-weight: 400;\">2. \u0110i\u1ec1u tr\u1ecb T\u1ed5n th\u01b0\u01a1ng r\u00e1ch ch\u00f3p xoay b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt<\/span><\/h1>\n<h2><span style=\"font-weight: 400;\">2.1 Ch\u1ec9 \u0111\u1ecbnh<\/span><\/h2>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">R\u00e1ch ch\u00f3p xoay do ch\u1ea5n th\u01b0\u01a1ng m\u00e0 tr\u01b0\u1edbc \u0111\u00f3 ch\u1ee9c n\u0103ng kh\u1edbp vai b\u00ecnh th\u01b0\u1eddng.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u0110i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n b\u00e0i b\u1ea3n trong 3-6 th\u00e1ng m\u00e0 kh\u00f4ng \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb, ho\u1eb7c \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb r\u1ea5t ch\u1eadm k\u00e8m theo s\u1ef1 kh\u00f4ng h\u00e0i l\u00f2ng v\u1ec1 ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed5ng c\u1ee7a b\u1ec7nh nh\u00e2n.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">R\u00e1ch &gt; 3cm tr\u1edf lcn.<\/span><\/li>\n<\/ul>\n<p><b>Ph\u1eabu thu\u1eadt m\u1ed5 m\u1edf:<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt m\u1ed5 m\u1edf s\u1eeda ch\u1eefa nh\u1eefng t\u1ed5n th\u01b0\u01a1ng ch\u00f3p xoay l\u00e0 ph\u01b0\u01a1ng ph\u00e1p kinh \u0111i\u1ec3n trong l\u1ecbch s\u1eed<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u0111i\u1ec1u tr\u1ecb b\u1ec7nh, khi m\u00e0 ch\u01b0a c\u00f3 s\u1ef1 ph\u00e1t tri\u1ec3n v\u1ec1 k\u1ef9 thu\u1eadt n\u1ed9i soi. Ph\u1eabu thu\u1eadt vi\u00ean \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c bi\u1ebft \u0111\u1ebfn khi ti\u1ebfn h\u00e0nh m\u1ed5 m\u1edf kh\u00e2u l\u1ea1i ch\u00f3p xoay !\u00e0 Codman v\u00e0o n\u0103m 1911. Ti\u1ebfp sau \u0111\u00f3 r\u1ea5t nhi\u1ec1u t\u00e1c gi\u1ea3 th\u1ef1c hi\u1ec7n k\u1ef9 thu\u1eadt n\u00e0y nh\u01b0 Neer, Hawkins&#8230; v\u00e0 \u0111\u1ea1t \u0111\u01b0\u1ee3c k\u1ebft qu\u1ea3 r\u1ea5t kh\u1ea3 quan. Tuy nhi\u00ean m\u1ed9t \u0111i\u1ec1u m\u00e0 c\u00e1c t\u00e1c gi\u1ea3 \u0111\u1ec1u c\u00f4ng nh\u1eadn l\u00e0 m\u1ed5 m\u1edf th\u00ec can thi\u1ec7p kh\u00e1 l\u1edbn v\u00e0o c\u01a1 Delta (t\u00f9y m\u1ee9c \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng ch\u00f3p xoay m\u00e0 <\/span><span style=\"font-weight: 400;\">m\u1edf <\/span><span style=\"font-weight: 400;\">\u00a0r\u1ed9ng hay nh\u1ecf) \u0111i\u1ec1u n\u00e0y d\u1eabn \u0111\u1ebfn vi\u1ec7c ph\u1ee5c h\u1ed3i c\u01a1 Delta m\u1ea5t nhi\u1ec1u th\u1eddi gian \u0111o \u0111\u00f3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn qu\u00e1 tr\u00ecnh ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng kh\u1edbp vai sau ph\u1eabu thu\u1eadt.<\/span><\/p>\n<p>v\u1ec1 k\u1ef9 <span style=\"font-weight: 400;\">thu\u1eadt th\u00ec \u0111a s\u1ed1 t\u00e1c gi\u1ea3 ch\u1ecdn \u0111\u01b0\u1eddng v\u00e0o ph\u00eda tr\u01b0\u1edbc kh\u1edbp vai x\u1ebb theo chi\u1ec1u d\u1ecdc c\u01a1 delta \u0111\u1ec3 v\u00e0o g\u00e2n tr\u00ean gai v\u00e0 d\u01b0\u1edbi gai. Khi r\u00e1ch r\u1ed9ng ch\u00f3p xoay th\u00ec m\u1edf r\u1ed9ng \u0111\u01b0\u1eddng n\u00e0y v\u00f2ng \u00f4m b\u1edd d\u01b0\u1edbi ngo\u00e0i c\u1ee7a m\u1ecfm c\u00f9ng vai \u0111\u1ec3 c\u1eaft ph\u1ea7n b\u00e1m c\u01a1 Delta \u1edf v\u00f9ng n\u00e0y, v\u00e0o g\u00e2n d\u01b0\u1edbi gai v\u00e0 tr\u00f2n b\u00e9. \u0110\u01b0\u01a1ng nhi\u00ean, t\u1ed5n th\u01b0\u01a1ng ch\u00f3p c\u00e0ng l\u1edbn th\u00ec m\u1ee9c \u0111\u1ed9 t\u00e0n ph\u00e1 c\u01a1 Delta c\u00e0ng nhi\u1ec1u, ch\u01b0a k\u1ec3 nhi\u1ec1u t\u00e1c gi\u1ea3 \u0111\u00e0 b\u00e1o c\u00e1o v\u1ec1 vi\u1ec7c t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh v\u1eadn \u0111\u1ed9ng c\u01a1 Delta (nh\u00e1nh c\u1ee7a th\u1ea7n kinh n\u00e1ch) khi b\u00f3c t\u00e1ch c\u01a1 n\u00e0y.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Ph\u1eabu thu\u1eadt n\u1ed9i soi:<\/span><\/p>\n<p><span style=\"font-weight: 400;\">N\u1ed9i soi kh\u1edbp vai \u0111\u00e3 tr\u1edf th\u00e0nh ti\u00eau chu\u1ea9n v\u00e0ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb \u0111\u1ea1i \u0111a s\u1ed1 nh\u1eefng t\u1ed5n th\u01b0\u01a1ng c\u1ee7a ch\u00f3p xoay, v\u1edbi nhi\u1ec1u \u01b0u \u0111i\u1ec3m v\u01b0\u1ee3t tr\u1ed9i c\u1ee7a k\u1ef9 thu\u1eadt n\u1ed9i soi n\u00f3i chung c\u0169ng nh\u01b0 kh\u1eafc ph\u1ee5c \u0111\u01b0\u1ee3c t\u00ecnh tr\u1ea1ng teo c\u01a1 delta c\u1ee7a m\u1ed5 m\u1edf v\u1edbi<\/span><\/p>\n<p><span style=\"font-weight: 400;\">ph\u1eabu thu\u1eadt kh\u1edbp vai n\u00f3i ri\u00eang.<\/span><\/p>\n<h2><b><i>2.2 Chu\u1ea9n b\u1ecb v\u1ec1 g\u00e2y m\u00ea<\/i><\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Kh\u00e1m ti\u1ec1n m\u00ea \u0111\u1ec3 lo\u1ea1i b\u1ecf c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1. Tr\u01b0\u1edbc khi g\u00e2y m\u00ea n\u00ean t\u00ea \u0111\u00e1m r\u1ed1i tr\u01b0\u1edbc. Trong l\u00fac g\u00e2y m\u00ea th\u00ec kh\u1ed1ng ch\u1ebf HA t\u00e2m thu quanh l00mmHg s\u1ebd gi\u1ea3m thi\u1ec3u ch\u1ea3y m\u00e1u v\u00e0 \u0111\u01b0\u01a1ng nhi\u00ean, s\u1ebd d\u1ec5 nh\u00ecn h\u01a1n.<\/span><\/p>\n<h2><b><i>2.3 Chu\u1ea9n b\u1ecb b\u1ec7nh nh\u00e2n<\/i><\/b><\/h2>\n<p><span style=\"font-weight: 400;\">C\u00f3 th\u1ebb ch\u1ecdn t\u01b0 th\u1ebf n\u1eb1m nghi\u00eang treo tay ho\u1eb7c t\u01b0 th\u1ebf beach-chair t\u00f9y thu\u1ed9c v\u00e0o th\u00f3i quen c\u1ee7a ph\u1eabu thu\u1eadt vi\u00ean.<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">T\u01b0 th\u1ebf n\u1eb1m nghi\u00eang treo tay: \u0111\u1eb7c \u0111i\u1ec3m l\u00e0 nh\u00ecn b\u1eb1ng ng\u00f5 sau l\u00e0 ch\u1ee7 y\u1ebfu, kh\u00f4ng test \u0111\u01b0\u1ee3c ch\u00ednh x\u00e1c c\u00e1c \u0111\u1ed9ng t\u00e1c c\u1ee7a kh\u1edbp vai.<\/span><\/li>\n<\/ul>\n<figure id=\"attachment_18757\" aria-describedby=\"caption-attachment-18757\" style=\"width: 291px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Tu-the-treo-co-tay.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-18757\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Tu-the-treo-co-tay.png\" alt=\"\u1ea3nh minh h\u1ecda: T\u01b0 th\u1ebf treo c\u1ed5 tay\" width=\"291\" height=\"233\" \/><\/a><figcaption id=\"caption-attachment-18757\" class=\"wp-caption-text\">T\u01b0 th\u1ebf treo tay<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">T\u01b0 th\u1ebf beach-chair: ng\u00f5 nh\u00ecn l\u00e0 ng\u00f5 b\u00ean, thu\u1eadn ti\u1ec7n khi test khoang d\u01b0\u1edbi m\u1ecfm c\u00f9ng vai, \u0111\u1eb7c bi\u1ec7t v\u1eefng ch\u1eafc khi c\u00f3 c\u00e1nh tay robot h\u1ed7 tr\u1ee3 c\u1ed1 \u0111\u1ecbnh c\u1eb3ng tay b\u00ean m\u1ed5<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/li>\n<\/ul>\n<figure id=\"attachment_18756\" aria-describedby=\"caption-attachment-18756\" style=\"width: 232px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Tu-the-ngoi.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-18756\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Tu-the-ngoi-232x300.png\" alt=\"\u1ea3nh minh h\u1ecda: \" width=\"232\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Tu-the-ngoi-232x300.png 232w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Tu-the-ngoi.png 251w\" sizes=\"(max-width: 232px) 100vw, 232px\" \/><\/a><figcaption id=\"caption-attachment-18756\" class=\"wp-caption-text\">T\u01b0 th\u1ec3 ng\u1ed3i Ngu\u1ed3n: AANA Advanced Arthroscopy (2010), The Shoulder<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">S\u1eed d\u1ee5ng c\u00e1c ng\u00f5: ng\u00f5 sau, ng\u00f5 b\u00ean, ng\u00f5 tr\u01b0\u1edbc ho\u1eb7c ng\u00f5 tr\u01b0\u1edbc b\u00ean. X\u00e1c \u0111\u1ecbnh v\u00e0 \u0111\u00e1nh d\u1ea5u c\u00e1c ng\u00f5 n\u00e0y l\u00ean da.<\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_18755\" aria-describedby=\"caption-attachment-18755\" style=\"width: 219px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/ve-cua-vao.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-18755\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/ve-cua-vao-219x300.png\" alt=\"\u1ea3nh minh h\u1ecda: V\u1ebd v\u00e0 \u0111\u00e1nh d\u1ea5u c\u00e1c ng\u00f5 v\u00e0o Ngu\u1ed3n: T\u00e1c gi\u1ea3\" width=\"219\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/ve-cua-vao-219x300.png 219w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/ve-cua-vao.png 242w\" sizes=\"(max-width: 219px) 100vw, 219px\" \/><\/a><figcaption id=\"caption-attachment-18755\" class=\"wp-caption-text\">V\u1ebd v\u00e0 \u0111\u00e1nh d\u1ea5u c\u00e1c ng\u00f5 v\u00e0o Ngu\u1ed3n: T\u00e1c gi\u1ea3<\/figcaption><\/figure>\n<p><b>\u00a0<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Kh\u00e1m l\u1ea1i c\u00e1c test d\u01b0\u1edbi g\u00e2y m\u00ea ph\u1ed1i h\u1ee3p v\u1edbi nh\u1eadn \u0111\u1ecbnh l\u1ea1i t\u1ed5n th\u01b0\u01a1ng tr\u00ean phim MRI m\u1ed9t l\u1ea7n n\u1eefa \u0111\u1ec3 kh\u1eb3ng \u0111\u1ecbnh t\u1ed5n th\u01b0\u01a1ng. V\u00ed d\u1ee5 nh\u01b0 kh\u00e1m th\u1ea5y s\u1ef1 xoay ngo\u00e0i qu\u00e1 m\u1ee9c c\u1ee7a vai th\u00ec g\u1ea7n nh\u01b0 ch\u1eafc ch\u1eafn l\u00e0 t\u1ed5n th\u01b0\u01a1ng g\u00e2n d\u01b0\u1edbi vai.<\/span><\/p>\n<h2><b><i>2.4\u00a0 N\u1ed9i soi ch\u1ea9n \u0111o\u00e1n T\u1ed5n th\u01b0\u01a1ng r\u00e1ch.\u00a0<\/i><\/b><\/h2>\n<p><b><i>C\u00e1c b\u01b0\u1edbc th\u1ef1c hi\u1ec7n:<\/i><\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u0110\u1ea7u ti\u00ean m\u1edf ng\u1ed7 sau \u0111\u1ec3 \u0111i v\u00e0o kh\u1edbp vai, sau \u0111\u00f3 m\u1edf ti\u1ebfp c\u00e1c ng\u00f5 b\u00ean, tr\u01b0\u1edbc b\u00ean \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 v\u00e0 th\u00e1m s\u00e1t to\u00e0n di\u1ec7n c\u00e1c th\u00e0nh ph\u1ea7n c\u1ee7a kh\u1edbp vai. \u0110\u1ed7i ng\u1ed3 \u0111\u00ea c\u00f3 tr\u01b0\u1eddng nh\u00ecn \u0111\u1ea7y \u0111\u1ee7 nh\u1ea5t v\u1ec1 t\u1ed5n th\u01b0\u01a1ng.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">T\u1eadp trung \u0111\u00e1nh gi\u00e1 g\u00e2n d\u01b0\u1edbi vai, tr\u00ean gai, d\u01b0\u1edbi gai, tr\u00f2n b\u00e9 k\u00e8m theo c\u00e1c t\u1ed5n th\u01b0\u01a1ng kh\u00e1c nh\u01b0 t\u00ecnh tr\u1ea1ng \u0111\u1ea7u d\u00e0i g\u00e2n nh\u1ecb \u0111\u1ea7u ph\u1ea7n n\u1eb1m trong kh\u1edbp v\u00e0 trong r\u00e3nh nh\u1ecb \u0111\u1ea7u (\u0111\u1ee9t, r\u00e1ch, t\u01b0\u1edbc hay tr\u1eadt kh\u1ecfi r\u00e3nh nh\u1ecb \u0111\u1ea7u kh\u00f4ng). Kh\u00f4ng qu\u00ean ki\u1ec3m tra s\u1ee5n vi\u1ec1n \u1ed5 ch\u1ea3o &#8211; c\u00e1nh tay tr\u00ean, tr\u01b0\u1edbc, d\u01b0\u1edbi, ph\u00eda sau; d\u00e2y ch\u1eb1ng \u1ed5 ch\u1ea3o &#8211; c\u00e1nh tay tr\u00ean, gi\u1eefa, tr\u01b0\u1edbc d\u01b0\u1edbi v\u00e0 sau d\u01b0\u1edbi; xem c\u00f3 t\u1ed5n th\u01b0\u01a1ng s\u1ee5n kh\u1edbp ph\u00eda sau ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay kh\u00f4ng (h\u1eadu qu\u1ea3 c\u1ee7a tr\u1eadt kh\u1edbp vai tr\u01b0\u1edbc \u0111\u00f3), c\u00f3 t\u00ecnh tr\u1ea1ng tho\u00e1i h\u00f3a kh\u1edbp vai c\u0169ng nh\u01b0 vi\u00eam m\u00e0ng ho\u1ea1t d\u1ecbch kh\u00f4ng.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u0110\u1eb7c bi\u1ec7t khi \u0111\u00e1nh gi\u00e1 ch\u00e2n b\u00e1m c\u1ee7a g\u00e2n d\u01b0\u1edbi vai n\u1ebfu c\u00f3 \u0111i\u1ec1u ki\u1ec7n th\u00ec s\u1eed d\u1ee5ng \u1ed1ng k\u00ednh 70 \u0111\u1ed9 \u0111\u1ec3 t\u0103ng th\u00eam g\u00f3c nh\u00ecn, k\u1ebft h\u1ee3p v\u1edbi vi\u1ec7c ng\u01b0\u1eddi ph\u1ee5 xoay trong v\u00e0 \u0111\u1ea9y c\u00e1nh tay ra sau.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">C\u0169ng s\u1eed d\u1ee5ng ng\u00f5 sau nh\u01b0ng l\u00f9i l\u1ea1i, \u0111\u01b0a \u1ed1ng k\u00ednh kh\u00e9o l\u00e9o l\u00ean tr\u00ean g\u00e2n ch\u00f3p xoay, v\u00e0o khoang d\u01b0\u1edbi m\u1ecfm c\u00f9ng vai. Ti\u1ebfp t\u1ee5c \u0111\u00e1nh gi\u00e1 g\u00e2n ch\u00f3p xoay, h\u00ecnh d\u1ea1ng m\u1ecfm c\u00f9ng vai (ph\u00e2n tu\u00fdp), t\u00ecnh tr\u1ea1ng d\u00e2y ch\u1eb1ng qu\u1ea1 &#8211; \u0111\u00f2n.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ti\u1ebfp theo m\u1edf ng\u00f5 b\u00ean, \u0111\u1ed5i ng\u00f5 quan s\u00e1t \u0111\u1ec3 ho\u00e0n th\u00e0nh c\u00e1i nh\u00ecn t\u1ed5ng th\u1ec3 v\u1ec1 t\u1ea5t c\u1ea3 c\u00e1c t\u1ed5n th\u01b0\u01a1ng tr\u01b0\u1edbc khi ti\u1ebfn h\u00e0nh s\u1eeda ch\u1eefa.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ch\u00fa \u00fd trong khi th\u00e1m s\u00e1t c\u1ea9n ph\u1ed1i h\u1ee3p th\u00eam c\u00e1c \u0111\u1ed9ng t\u00e1c xoay trong, xoay ngo\u00e0i v\u00e0 \u0111\u1eb7c bi\u1ec7t l\u00e0 d\u1ea1ng vai \u0111\u1ec3 t\u00ecm \u0111i\u1ec3m ch\u00e8n \u00e9p ch\u00f3p.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">v\u1ec1 th\u01b0\u01a1ng t\u1ed3n ch\u00f3p xoay th\u00ec c\u1ea7n<\/span><\/p>\n<p><span style=\"font-weight: 400;\">l\u1ea7n l\u01b0\u1ee3t nh\u1eadn \u0111\u1ecbnh:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">V\u1ecb tr\u00ed r\u00e1ch: t\u1ea1i g\u00e2n n\u00e0o<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ki\u1ec3u r\u00e1ch: ho\u00e0n to\u00e0n hay b\u00e1n ph\u1ea7n, b\u00e1n ph\u1ea7n th\u00ec r\u00e1ch \u1edb m\u1eb7t n\u00e0o: m\u1eb7t kh\u1edbp hay m\u1eb7t ho\u1ea1t d\u1ecbch, hay r\u00e1ch n\u1ed9i g\u00e2n<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">V\u1edbi r\u00e1ch b\u00e1n ph\u1ea7n th\u00ec c\u1ea7n \u0111\u01b0a i th\u01b0\u1edbc \u0111o c\u00f3 v\u1ea1ch s\u1eb5n \u0111\u1ec1 \u0111o m\u1ee9c \u0111\u1ed9 s\u00e2u c\u1ee7a v\u1ebft r\u00e1ch d\u1ef1a tr\u00ean k\u00edch th\u01b0\u1edbc ch\u1ed7 l\u1ed9 ra c\u1ee7a ch\u00e2n b\u00e1m. B\u1ea5t k\u1ec1 c\u00f3 d\u1ef1a v\u00e0o ph\u00e2n lo\u1ea1i n\u00e0o c\u1ee7a r\u00e1ch b\u00e1n ph\u1ea7n \u0111i n\u1eefa th\u00ec v\u1eabn n\u00ean ghi l\u1ea1i \u0111\u1ed9 r\u1ed9ng v\u00e0 k\u00edch th\u01b0\u1edbc tr\u01b0\u1edbc sau c\u1ee7a ch\u1ed7\u00a0 r\u00e1ch.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">V\u1edbi r\u00e1ch to\u00e0n b\u1ec1 d\u00e0y th\u00ec ti\u1ebfp t\u1ee5c \u0111\u00e1nh gi\u00e1:<\/span><\/li>\n<\/ul>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">H\u00ecnh d\u1ea1ng r\u00e1ch: c, <\/span><span style=\"font-weight: 400;\">u, <\/span><span style=\"font-weight: 400;\">L<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">K\u00edch th\u01b0\u1edbc l\u1ed7 r\u00e1ch<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">S\u1ef1 co r\u00fat g\u00e2n<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">M\u1ee9c \u0111\u1ed9 di \u0111\u1ed9ng c\u1ee7a \u0111au g\u00e2n t\u1ee5t, m\u1ee9c \u0111\u1ed9 tho\u00e1i h\u00f3a m\u1ee1 c\u0169ng nh\u01b0 ch\u1ea5t l\u01b0\u1ee3ng g\u00e2n<\/span><\/li>\n<\/ul>\n<h2><b><i>2.5 X\u1eed tr\u00ed t\u1ed5n th\u01b0\u01a1ng r\u00e1ch ch\u00f3p xoay.\u00a0<\/i><\/b><\/h2>\n<h3><i><span style=\"font-weight: 400;\">2.5.1 V\u1edbi t\u1ed5n th\u01b0\u01a1ng r\u00e1ch ch\u00f3p xoay b\u00e1n ph\u1ea7n<\/span><\/i><\/h3>\n<ul>\n<li aria-level=\"1\"><b>T\u1ed5n th\u01b0\u01a1ng r\u00e1ch <\/b><b>n\u1ed9i g\u00e2n:<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Lo\u1ea1i r\u00e1ch n\u00e0y th\u00ec kh\u00e1 l\u00e0 kh\u00f3 ph\u00e1t hi\u1ec7n b\u1eb1ng m\u1eaft th\u01b0\u1eddng, th\u01b0\u1eddng ph\u1ea3i d\u00f9ng d\u1ee5ng c\u1ee5 th\u0103m \u0111\u1ec3 t\u00ecm ch\u1ed7 r\u00e1ch tr\u00ean kh\u1eafp b\u1ec1 m\u1eb7t g\u00e2n. Khi x\u00e1c \u0111\u1ecbnh c\u00f3 r\u00e1ch n\u1ed9i g\u00e2n th\u00ec d\u00f9ng Shaver c\u1eaft l\u1ecdc ph\u1ea9n g\u00e2n ph\u1ee7 tr\u00ean l\u1ed3 r\u00e1ch (gi\u1ed1ng nh\u01b0 vi\u1ec7c r\u1ee1 b\u1ecf m\u00e1i nh\u00e0 c\u00f9a l\u1ed3 r\u00e1ch v\u1eady), sau \u0111\u00f3 \u0111\u00e1nh gi\u00e1 k\u00edch th\u01b0\u1edbc r\u00e1ch.<\/span><\/p>\n<ul>\n<li aria-level=\"1\"><b>T\u1ed5n th\u01b0\u01a1ng r\u00e1ch m\u1eb7t kh\u1edbp:<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Sau khi x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c \u0111i\u1ec3m r\u00e1ch qua n\u1ed9i soi c\u00f3 th\u1ebf d\u00f9ng kim t\u1ee7y s\u1ed1ng ho\u1eb7c kim l\u1ea5y thu\u1ed1c ch\u1ecdc t\u1eeb ngo\u00e0i da v\u00e0o v\u1ecb tr\u00ed t\u01b0\u01a1ng \u1ee9ng l\u1ed5 r\u00e1ch d\u01b0\u1edbi h\u1ed7 tr\u1ee3 n\u1ed9i soi t\u1eeb ng\u00f5 sau nh\u00ecn t\u1eeb trong kh\u1edbp. Lu\u1ed3n ] s\u1ee3i ch\u1ec9 nilon qua l\u00f2ng kim v\u00e0o kh\u1edbp roi r\u00fat b\u1ecf kim, nh\u1eb1m m\u1ee5c \u0111\u00edch \u0111\u00e1nh d\u1ea5u v\u1ecb tr\u00ed t\u01b0\u01a1ng \u1ee9ng \u0111i\u1ec3m r\u00e1ch.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<figure id=\"attachment_18754\" aria-describedby=\"caption-attachment-18754\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Danh-dau-cho-rach-bang-chi-nilon.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-18754\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Danh-dau-cho-rach-bang-chi-nilon-300x233.png\" alt=\"\u1ea3nh minh h\u1ecda: \u0110\u00e1nh d\u1ea5u v\u1ecb tr\u00ed r\u00e1ch bang chi l\u00ec \u1ecb lon Ngu\u00f4n: AANA Advanced Arthroscopy (2010), The Shoulder\" width=\"300\" height=\"233\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Danh-dau-cho-rach-bang-chi-nilon-300x233.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Danh-dau-cho-rach-bang-chi-nilon.png 379w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-18754\" class=\"wp-caption-text\">\u0110\u00e1nh d\u1ea5u v\u1ecb tr\u00ed r\u00e1ch bang chi l\u00ec \u1ecb lon Ngu\u00f4n: AANA Advanced Arthroscopy (2010), The Shoulder<\/figcaption><\/figure>\n<p><i><span style=\"font-weight: 400;\">\u00a0<\/span><\/i><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">M\u1edf th\u00eam ng\u00f5 tr\u01b0\u1edbc qua \u0111\u00f3 \u0111\u01b0a shaver ho\u1eb7c \u0111\u1ed1t \u0111i\u1ec7n l\u1ea5y b\u1ecf c\u00e1c s\u1ee3i g\u00e2n b\u1ecb t\u01b0a\u00a0 (\u0111\u1ebfn ph\u1ea7n g\u00e2n ch\u1ea3y m\u00e1u l\u00e0 t\u1ed1t nh\u1ea5t). T\u1ea1i v\u1ecb tr\u00ed \u0111\u00e3 \u0111\u00e1nh<\/span><\/p>\n<p><span style=\"font-weight: 400;\">d\u1ea5u s\u1eb5n b\u1eb1ng chi, trong khi \u1ed1ng k\u00ednh v\u1eabn soi t\u1eeb ng\u00f5 sau \u0111\u1ec3 quan s\u00e1t trong kh\u1edbp.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<p><span style=\"font-weight: 400;\"><br \/>\n<\/span><br \/>\n<b><br \/>\n<\/b><\/p>\n<figure id=\"attachment_18753\" aria-describedby=\"caption-attachment-18753\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/phan-chop-xoay-bi-rach-tua.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-18753\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/phan-chop-xoay-bi-rach-tua-300x254.png\" alt=\"\u1ea3nh minh h\u1ecda: Ph\u00e2n ch\u00f3p xoay b\u1ecb r\u00e1ch t\u01b0a Ngu\u1ed3n: AANA Advanced Arthroscopy (2010), The Shoulder\" width=\"300\" height=\"254\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/phan-chop-xoay-bi-rach-tua-300x254.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/phan-chop-xoay-bi-rach-tua.png 360w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-18753\" class=\"wp-caption-text\">Ph\u00e2n ch\u00f3p xoay b\u1ecb r\u00e1ch t\u01b0a Ngu\u1ed3n: AANA Advanced Arthroscopy (20\u1ec80), The Shoulder<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">N\u1ebfu k\u00edch th\u01b0\u1edbc v\u1ebft r\u00e1ch nh\u1ecf h\u01a1n ho\u1eb7c b\u1eb1ng 3mm th\u00ec kh\u00f4ng c\u1ea7n x\u1eed tr\u00ed g\u00ec th\u00eam.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">R\u00e1ch t\u1eeb 30 &#8211; 50% b\u1ec1 d\u00e0y v\u1edbi b\u1ec7nh nh\u00e2n \u00edt v\u1eadn \u0111\u1ed9ng vai th\u00ec c\u0169ng x\u1eed tr\u00ed nh\u01b0 tr\u00ean.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Tuy nhi\u00ean v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 nhu c\u1ea7u v\u1eadn \u0111\u1ed9ng cao h\u01a1n nh\u01b0 ng\u01b0\u1eddi lao \u0111\u1ed9ng ch\u00e2n tay th\u01b0\u1eddng mang v\u00e1c hay v\u1eadn \u0111\u1ed9ng vi\u00ean th\u00ec r\u00e1ch tr\u00ean 30 % b\u1ec1 d\u00e0y (t\u01b0\u01a1ng \u1ee9ng v\u1edbi &gt; 4mm) th\u00ec n\u00ean s\u1eeda ch\u1eefa nh\u1eb1m t\u0103ng kh\u1ea3 n\u0103ng li\u1ec1n g\u00e2n c\u0169ng nh\u01b0 h\u1ea1n ch\u1ebf vi\u1ec7c ch\u1ed7 r\u00e1ch lan r\u1ed9ng th\u00eam. R\u00e1ch t\u1eeb 4-8 mm th\u00ec c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng m\u1ed9t trong 2 k\u1ef9 thu\u1eadt sau:<\/span><\/p>\n<p><span style=\"font-weight: 400;\">+ Khi \u0111\u00e1nh gi\u00e1 ch\u1ea5t l\u01b0\u1ee3ng g\u00e2n c\u00f2n<\/span><\/p>\n<p><span style=\"font-weight: 400;\">l\u1ea1i qu\u00e1 x\u1ea5u (c\u00f3 hi\u1ec7n t\u01b0\u1ee3ng t\u01b0\u1edbc v\u00e0 tho\u00e1i h\u00f3a) ho\u1eb7c di\u1ec7n ch\u00e2n b\u00e1m c\u00f2n qu\u00e1 m\u1ecfng th\u00ec n\u00ean l\u00e0m r\u00e1ch ho\u00e0n to\u00e0n sau \u0111\u00f3 ti\u1ebfn h\u00e0nh kh\u00e2u 1 h\u00e0ng ho\u1eb7c b\u1eafc c\u1ea7u.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">+ N\u1ebfu ph\u1ea7n g\u00e2n c\u00f2n l\u1ea1i t\u1ed1t th\u00ec d\u00f9ng k\u1ef9 thu\u1eadt kh\u00e2u xuy\u00ean g\u00e2n: t\u00f9y v\u00e0o k\u00edch th\u01b0\u1edbc m\u00e0 ch\u1ecdn s\u1eed d\u1ee5ng 1 ho\u1eb7c 2 neo, \u0111\u00f3ng xuy\u00ean qua ph\u1ea7n g\u00e2n ch\u00f3p xoay v\u00e0o ch\u1ed7 ti\u1ebfp gi\u00e1p x\u01b0\u01a1ng &#8211; s\u1ee5n ch\u1ecfm c\u00e1nh tay. Bu\u1ed9c ch\u1ec9 c\u1ee7a neo v\u1edbi nhau ho\u1eb7c bu\u1ed9c chi c\u1ee7a 2 neo v\u1edbi nhau \u0111\u1ec3 \u00e9p ph\u1ea7n g\u00e2n xu\u1ed1ng m\u1eb7t x\u01b0\u01a1ng. Cu\u1ed1i c\u00f9ng n\u01a1 bu\u1ed9c s\u1ebd <\/span><span style=\"font-weight: 400;\">n\u1eb1m tr\u00ean m\u1eb7t ho\u1ea1t d\u1ecbch c\u1ee7a ch\u00f3p.<\/span><\/p>\n<figure id=\"attachment_18752\" aria-describedby=\"caption-attachment-18752\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/ky-thuat-khau-xien-gan.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-18752\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/ky-thuat-khau-xien-gan-300x145.png\" alt=\"\u1ea3nh minh h\u1ecda : H\u00ecnh d\u1ea1ng m\u1ecfm c\u00f9ng vai, A: h\u00ecnh ph\u1eb3ng, B; h\u00ecnh cong, C: h\u00ecnh m\u00f3c Ngu\u1ed3n: Burkhart s.s, et al (2006), L\u00ecppincotte Williams &amp; Wilkins Philadelphia\" width=\"300\" height=\"145\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/ky-thuat-khau-xien-gan-300x145.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/ky-thuat-khau-xien-gan.png 521w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-18752\" class=\"wp-caption-text\">H\u00ecnh d\u1ea1ng m\u1ecfm c\u00f9ng vai, A: h\u00ecnh ph\u1eb3ng, B; h\u00ecnh cong, C: h\u00ecnh m\u00f3c Ngu\u1ed3n: Burkhart s.s, et al (2006), L\u00ecppincotte Williams &amp; Wilkins Philadelphia<\/figcaption><\/figure>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Vi\u1ec7c b\u1ea3o t\u1ed3n ch\u00e2n b\u00e1m c\u00f2n l\u1ea1i r\u1ea5t c\u00f3 \u00fd ngh\u0129a v\u00ec n\u00f3 duy tr\u00ec \u0111\u01b0\u1ee3c chi\u1ec1u d\u00e0i nguy\u00ean th\u1ee7y c\u1ee7a g\u00e2n v\u00e0 cung c\u1ea5p 1 h\u00e0ng t\u01b0\u01a1ng \u0111\u01b0\u01a1ng nh\u01b0 l\u00e0 ph\u01b0\u01a1ng ph\u00e1p kh\u00e2u 2 h\u00e0ng.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Ch\u00fa \u00fd: vi\u1ec7c quy\u1ebft \u0111\u1ecbnh s\u1eed d\u1ee5ng k\u1ef9 thu\u1eadt kh\u00e2u xuy\u00ean g\u00e2n hay kh\u00f4ng ph\u1ee5 thu\u1ed9c v\u00e0o 2 v\u1ea5n \u0111\u1ec1 ch\u00ednh: th\u1ee9 nh\u1ea5t l\u00e0 ch\u1ea5t l\u01b0\u1ee3ng g\u1ea7n (nh\u01b0 \u0111\u00e3 n\u00f3i \u1edf tr\u00ean), I<\/span><span style=\"font-weight: 400;\">1<\/span><span style=\"font-weight: 400;\">\u00d3 c\u00f3 kh\u1ea3 n\u0103ng ch\u1ecbu \u0111\u01b0\u1ee3c l\u1ef1c t\u1ea3i tr\u1ecdng v\u00e0 th\u1ec3 li\u1ec1n \u0111\u01b0\u1ee3c hay kh\u00f4ng. Th\u1ee9 hai l\u00e0 ph\u1eabu thu\u1eadt vi\u00ean c\u00f3 v\u1eebng v\u00e0ng v\u1edbi k\u1ef9 thu\u1eadt n\u00e0y kh\u00f4ng. N\u1ebfu kh\u00f4ng th\u00ec quy\u1ebft \u0111\u1ecbnh l\u00e0m r\u00e1ch g\u00e2n ho\u00e0n to\u00e0n r\u1ed3i kh\u00e2u n\u00ean l\u00e0 l\u1ef1a ch\u1ecdn \u01b0u ti\u00ean.<\/span><\/p>\n<ul>\n<li><b>T\u1ed5n th\u01b0\u01a1ng r\u00e1ch m\u1eb7t ho\u1ea1t d\u1ecbch<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">V\u1edbi m\u1ee9c \u0111\u1ed9 r\u00e1ch nh\u1ecf &lt; 3mm thi th\u00e1i \u0111\u1ed9 x\u1eed l\u00fd l\u00e0 t\u01b0\u01a1ng t\u1ef1 nh\u01b0 r\u00e1ch m\u1eb7t kh\u1edbp c\u00f9ng k\u00edch th\u01b0\u1edbc (t\u1ee9c l\u00e0 ch\u1ec9 c\u1ea7n c\u1eaft l\u1ecdc \u0111\u1ebfn ph\u1ea7n g\u00e2n ch\u1ea3y m\u00e1u v\u00e0 kh\u00f4ng ph\u1ea3i s\u1eeda ch\u1eefa g\u00e2n) tuy nhi\u00ean ph\u1ea3i \u0111\u1ed5i ng\u00f5 l\u00e0m vi\u1ec7c \u0111\u1ebf \u0111\u01b0a d\u1ee5ng c\u1ee5 nam ph\u00eda tr\u00ean ch\u00f3p &#8211; d\u01b0\u1edbi m\u1ecfm c\u00f9ng vai, thay b\u1eb1ng m\u1edf ng\u00f5 tr\u01b0\u1edbc th\u00ec n\u00ean m\u1edf ng\u00f5 tr\u01b0\u1edbc b\u00ean.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Sau \u0111\u00f3 ph\u1ea3i t\u1ea1o h\u00ecnh m\u1ecfm c\u00f9ng vai b\u1ed1 sung \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb nguy\u00ean nh\u00e2n ch\u00e8n \u00e9p g\u00e2y r\u00e1ch m\u1eb7t ho\u1ea1t d\u1ecbch.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">T\u01b0\u01a1ng t\u1ef1 v\u1edbi v\u1ebft r\u00e1ch &gt; 4mm, nhu c\u1ea7u ho\u1ea1t \u0111\u1ed9ng cao th\u00ec c\u00f3 2 s\u1ef1 l\u1ef1a ch\u1ecdn sau khi \u0111\u00e3 ti\u1ebfn h\u00e0nh c\u1eaft l\u1ecdc g\u00e2n t\u1ed1t:<\/span><\/p>\n<p><span style=\"font-weight: 400;\">+ Ch\u1ea5t l\u01b0\u1ee3ng g\u00e2n x\u1ea5u: l\u00e0m r\u00e1ch ho\u00e0n to\u00e0n -&gt; k\u00e9o g\u00e2n kh\u00e2u \u0111\u00ednh v\u00e0o l\u1ed3i c\u1ee7 b\u1eb1ng k\u1ef9 thu\u1eadt ] h\u00e0ng ho\u1eb7c b\u1eafc c\u1ea7u.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">+ Ch\u1ea5t l\u01b0\u1ee3ng g\u00e2n t\u1ed1t: \u0111\u00f3ng neo s\u00e1t b\u1edd ngo\u00e0i c\u1ee7 l\u1edbn x\u01b0\u01a1ng c\u00e1nh tay v\u00e0 ch\u1ec9 kh\u00e2u l\u1ea5y ph\u00e0n r\u00e1ch b\u00e1n ph\u1ea7n m\u1eb7t ho\u1ea1t d\u1ecbch b\u1eb1ng k\u1ef9 thu\u1eadt 1 h\u00e0ng.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">V\u1edbi r\u00e1ch b\u00e1n ph\u1ea7n g\u00e2n d\u01b0\u1edbi vai th\u00ec ch\u1ee7 y\u1ebfu l\u00e0 r\u00e1ch \u0111\u1ea7u tr\u00ean, lan xu\u1ed1ng d\u01b0\u1edbi. Ph\u1ee5c h\u1ed3i b\u1eb1ng c\u00e1ch \u0111\u1eb7t neo t\u1ea1i s\u00e1t b\u1edd ngo\u00e0i c\u1ee7 b\u00e9 x\u01b0\u01a1ng c\u00e1nh tay t\u01b0\u01a1ng \u1ee9ng v\u1ecb tr\u00ed r\u00e1ch, sau \u0111\u00f3 kh\u00e2u theo k\u1ef9 thu\u1eadt 1 h\u00e0ng v\u1edbi neo \u0111\u00f4i.<\/span><\/p>\n<ul>\n<li><b>C\u00e1ch th\u1ee9c t\u1ea1o h\u00ecnh khoang d\u01b0\u1edbi m\u1ecfm c\u00f9ng vai:<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Tr\u01b0\u1edbc h\u1ebft ph\u1ea3i hi\u1ec3u r\u1eb1ng v\u1edbi t\u1ed5n th\u01b0\u01a1ng r\u00e1ch m\u1eb7t ho\u1ea1t d\u1ecbch th\u00ec y\u1ebfu t\u1ed1 ch\u00e8n \u00e9p c\u01a1 h\u1ecdc (ch\u00e8n \u00e9p d\u01b0\u1edbi m\u1ecfm c\u00f9ng vai) \u0111\u00f3ng vai tr\u00f2 c\u01a1 b\u1ea3n v\u1ec1 b\u1ec7nh l\u00fd. C\u00f3 th\u1ec3 n\u00f3i \u0111\u00e2y l\u00e0 th\u1ec3 r\u00e1ch do m\u00f2n l\u00e0 ch\u1ee7 y\u1ebfu. V\u00ec v\u1eady vi\u1ec7c t\u1ea1o h\u00ecnh m\u1ecfm c\u00f9ng vai n\u00ean \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u1edf h\u1ea7u h\u1ebft c\u00e1c tr\u01b0\u1eddng h\u1ee3p ph\u00e1t hi\u1ec7n r\u00e1ch \u1edd m\u1eb7t ho\u1ea1t d\u1ecbch.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">V\u1eady th\u00ec d\u1ef1a v\u00e0o h\u00ecnh d\u1ea1ng m\u1ecfm c\u00f9ng vai ta th\u1ea5y s\u1ef1 ch\u00e8n \u00e9p th\u01b0\u1eddng \u1edf tu\u00fdp 2,3 \u1edf v\u1ecb tr\u00ed 1\/3 tr\u01b0\u1edbc ngo\u00e0i do \u0111\u00f3 vi\u1ec7c gi\u1ea3i ph\u00f3ng khoang d\u01b0\u1edbi m\u1ecfm c\u00f9ng vai ph\u1ea3i t\u1eadp trung v\u00e0o t\u1ea1o h\u00ecnh v\u1ecb tr\u00ed n\u00e0y ch\u1ee9 kh\u00f4ng ph\u1ea3i to\u00e0n b\u1ed9 m\u1eb7t d\u01b0\u1edbi c\u1ee7a m\u1ecfm c\u00f9ng vai.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<figure id=\"attachment_18751\" aria-describedby=\"caption-attachment-18751\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/hinh-dang-mom-cung-vai.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-18751\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/hinh-dang-mom-cung-vai-300x137.png\" alt=\"\u1ea3nh minh h\u1ecda: M\u00e0i m\u1ecfm c\u00f9ng vai Ngu\u1ed3n: AANA Advanced Arthroscopy (2010), The Shoulder\" width=\"300\" height=\"137\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/hinh-dang-mom-cung-vai-300x137.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/hinh-dang-mom-cung-vai.png 563w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-18751\" class=\"wp-caption-text\">M\u00e0i m\u1ecfm c\u00f9ng vai Ngu\u1ed3n: AANA Advanced Arthroscopy (2010), The Shoulder<\/figcaption><\/figure>\n<p><i><span style=\"font-weight: 400;\">\u00a0<\/span><\/i><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">C\u00f3 r\u1ea5t nhi\u1ec1u ph\u01b0\u01a1ng ph\u00e1p \u0111\u00e3 \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 \u0111\u1ec3 t\u1ea1o h\u00ecnh khu v\u1ef1c n\u00e0y nh\u01b0ng m\u1ee5c \u0111\u00edch cu\u1ed1i c\u00f9ng l\u00e0 chuy\u1ec3n t\u1eeb m\u1ecfm c\u00f9ng vai tu\u00fdp 2,3 v\u1ec1 tu\u00fdp 1 hay l\u00e0 l\u00e0m ph\u1eb3ng m\u1eb7t d\u01b0\u1edbi m\u1ecfm c\u00f9ng vai. Th\u00f4ng th\u01b0\u1eddng hay s\u1eed d\u1ee5ng m\u0169i m\u00e0i x\u01b0\u01a1ng.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">N\u1ebfu m\u1ecfm c\u00f9ng vai \u0111\u00e3 l\u00e0 tu\u00fdp 1 r\u1ed3i th\u00ec ch\u1ec9 c\u1ea7n m\u00e0i cho m\u1ecbn m\u1eb7t d\u01b0\u1edbi m\u1ecfm c\u00f9ng vai ch\u1ee9 kh\u00f4ng c\u1ea7n thay \u0111\u1ed5i h\u00ecnh d\u1ea1ng ban \u0111\u1ea7u.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_18750\" aria-describedby=\"caption-attachment-18750\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/dot-dien-va-mai.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-18750\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/dot-dien-va-mai-300x267.png\" alt=\"\u1ea3nh minh h\u1ecda: \u0110\u1ed1t \u0111i\u1ec7n v\u00e0 m\u00e0i m\u1ecbn m\u1eb7t d\u01b0\u1edbi m\u1ecfm c\u00f9ng vai Ngu\u1ed3n: AANA Advanced Arthroscopy (2010), The Shoulder\" width=\"300\" height=\"267\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/dot-dien-va-mai-300x267.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/dot-dien-va-mai.png 317w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-18750\" class=\"wp-caption-text\">\u0110\u1ed1t \u0111i\u1ec7n v\u00e0 m\u00e0i m\u1ecbn m\u1eb7t d\u01b0\u1edbi m\u1ecfm c\u00f9ng vai Ngu\u1ed3n: AANA Advanced Arthroscopy (2010), The Shoulder<\/figcaption><\/figure>\n<p><span style=\"font-weight: 400;\">V\u1edbi r\u00e1ch b\u00e1n ph\u1ea7n th\u00ec ch\u1ec9 c\u1ea7n lo\u1ea1i b\u1ecf nh\u1eefng ch\u1ed3i x\u01b0\u01a1ng ph\u00eda tr\u01b0\u1edbc ngo\u00e0i nh\u00f4 l\u00ean nhi\u1ec1u nh\u1ea5t ph\u00eda tr\u01b0\u1edbc ngo\u00e0i ch\u1ee9 kh\u00f4ng nh\u1ea5t thi\u1ebft ph\u1ea3i m\u00e0i nhi\u1ec1u x\u01b0\u01a1ng.<\/span><\/p>\n<figure id=\"attachment_18773\" aria-describedby=\"caption-attachment-18773\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/mai-mom-ung-vai.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-18773\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/mai-mom-ung-vai-300x259.png\" alt=\"\u1ea3nh minh h\u1ecda: m\u00e0i m\u1ecfm c\u00f9ng vai\" width=\"300\" height=\"259\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/mai-mom-ung-vai-300x259.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/mai-mom-ung-vai.png 305w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-18773\" class=\"wp-caption-text\">M\u00e0i m\u1ecfm c\u00f9ng vai<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Cu\u1ed1i c\u00f9ng, d\u00f9 l\u00e0 m\u00e0i \u0111\u1ebfn m\u1ee9c \u0111\u1ed9 n\u00e0o th\u00ec c\u0169ng n\u00ean d\u1ea1ng vai v\u00e0 xoay trong \u0111\u1ec3 xem c\u00f2n \u0111i\u1ec3m ch\u00e8n \u00e9p n\u00e0o t\u1eeb m\u1ecfm c\u00f9ng vai xu\u1ed1ng ch\u00f3p hay kh\u00f4ng.<\/span><\/p>\n<h3><b><i>2.5.2 V\u1edbi t\u1ed5n th\u01b0\u01a1ng r\u00e1ch ch\u00f3p xoay ho\u00e0n to\u00e0n<\/i><\/b><i><span style=\"font-weight: 400;\">: <\/span><\/i><i><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/i><span style=\"font-weight: 400;\">T\u1ea1o h\u00ecnh m\u1ecfm c\u00f9ng vai v\u00e0 ho\u1eb7c m\u1ecfm qu\u1ea1 (n\u1ebfu c\u00f3 t\u1ed5n th\u01b0\u01a1ng g\u00e2n d\u01b0\u1edbi vai)<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">C\u1eaft l\u1ecdc g\u00e2n r\u00e1ch \u0111\u1ebfn ph\u00e0n g\u00e2n ch\u1ea3y m\u00e1u. M\u00e0i ch\u00e2n b\u00e1m c\u1ee7a g\u00e2n \u0111\u1ebfn khi ch\u1ea3y m\u00e1u, ch\u00fa \u00fd kh\u00f4ng l\u00e0m t\u1ed5n th\u01b0\u01a1ng \u0111\u1ebfn ph\u1ea7n x\u01b0\u01a1ng c\u1ee9ng. C\u1eaft l\u1ecdc t\u1ed5 ch\u1ee9c xung quanh g\u00e2n \u0111\u1ec3 l\u00e0m g\u00e2n di \u0111\u1ed9ng. Ti\u1ebfn h\u00e0nh kh\u00e2u g\u00e2n: c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng neo kim lo\u1ea1i ho\u1eb7c neo nh\u1ef1a, v\u00e0 th\u01b0\u1eddng l\u00e0 neo \u0111\u00f4i.\u00a0<\/span><\/p>\n<p><i><span style=\"font-weight: 400;\">a)\u00a0 T\u1ed5n th\u01b0\u01a1ng r\u00e1ch nh\u1ecf &lt; lem v\u00e0 g\u00e1n di \u0111\u1ed9ng: <\/span><\/i><span style=\"font-weight: 400;\">kh\u00e2u g\u00e2n b\u1eb1ng k\u1ef9 thu\u1eadt kh\u00e2u 1 h\u00e0ng, v\u1ecb tr\u00ed \u0111\u1eb7t neo t\u1ea1i c\u1ee7 l\u1edbn ho\u1eb7c s\u00e1t m\u00e9p ngo\u00e0i c\u1ee7 l\u1edbn x\u01b0\u01a1ng c\u00e1nh tay.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<figure id=\"attachment_18735\" aria-describedby=\"caption-attachment-18735\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/llllll.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-18735\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/llllll-300x250.png\" alt=\"\u1ea3nh minh h\u1ecda: K\u1ef9 thu\u1eadt kh\u00e2u 1 h\u00e0ng v\u00e0 2 h\u00e0ng\" width=\"300\" height=\"250\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/llllll-300x250.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/llllll.png 480w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-18735\" class=\"wp-caption-text\">K\u1ef9 thu\u1eadt kh\u00e2u 1 h\u00e0ng v\u00e0 2 h\u00e0ng<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<p><i><span style=\"font-weight: 400;\">b) T\u1ed5n th\u01b0\u01a1ng r\u00e1ch\u00a0 t\u1eeb 1 &#8211; 5 cm:<\/span><\/i><span style=\"font-weight: 400;\"> l\u00e0 lo\u1ea1i r\u00e1ch th\u01b0\u1eddng g\u1eb7p nh\u1ea5t<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ki\u00eau t\u1ed5n th\u01b0\u01a1ng r\u00e1ch h\u00ecnh ch\u1eef <\/span><b>c <\/b><span style=\"font-weight: 400;\">(h\u00ecnh li\u1ec1m) s\u1ebd \u0111\u01b0\u1ee3c k\u00e9o \u0111\u1ea7u g\u00e2n ra, kh\u00e2u tr\u1ef1c ti\u1ebfp v\u00e0o c\u1ee7 l\u1edbn x\u01b0\u01a1ng c\u00e1nh tay b\u1eb1ng neo \u0111\u00f4i k\u1ef9 thu\u1eadt 1 h\u00e0ng ho\u1eb7c b\u1eafc c\u1ea7u.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_18736\" aria-describedby=\"caption-attachment-18736\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/jj.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-18736\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/jj-300x210.png\" alt=\"\u1ea3nh minh h\u1ecda: R\u00e1ch h\u00ecnh ch\u1eef c v\u00e0 kh\u00e2u l\u1ea1i v\u00e0 k\u1ef9 thu\u1eadt kh\u00e2u b\u1eafc c\u1ea7u Ngu\u1ed3n: AANA Advanced Arthroscopy (2010), The Shoulder\" width=\"300\" height=\"210\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/jj-300x210.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/jj.png 567w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-18736\" class=\"wp-caption-text\">R\u00e1ch h\u00ecnh ch\u1eef c v\u00e0 kh\u00e2u l\u1ea1i v\u00e0 k\u1ef9 thu\u1eadt kh\u00e2u b\u1eafc c\u1ea7u Ngu\u1ed3n: AANA Advanced Arthroscopy (2010), The Shoulder<\/figcaption><\/figure>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ki\u1ec3u t\u1ed5n th\u01b0\u01a1ng r\u00e1ch h\u00ecnh ch\u1eef u hay L th\u00ec tr\u01b0\u1edbc h\u1ebft s\u1eed d\u1ee5ng k\u1ef9 thu\u1eadt h\u1ed9i t\u1ee5 m\u00e9p b\u00ean \u2014 b\u00ean (hay l\u00e0 k\u1ef9 thu\u1eadt kh\u00e2u \u0111\u00f3ng b\u1edbt t\u1ed5n th\u01b0\u01a1ng) sau \u0111\u00f3 m\u1edbi kh\u00e2u ch\u00f3p v\u00e0o x\u01b0\u01a1ng. Th\u01b0\u1eddng ph\u1ea3i kh\u00e2u 3-4 m\u0169i kh\u00e2u b\u1eb1ng ch\u1ec9 kh\u00f4ng ti\u00eau m\u1edbi \u0111\u00f3ng \u0111\u01b0\u1ee3c h\u1ebft t\u1ed5n th\u01b0\u01a1ng \u1edf 2 l\u00e1 tr\u01b0\u1edbc v\u00e0 sau.<\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_18737\" aria-describedby=\"caption-attachment-18737\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/222.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-18737\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/222-300x113.png\" alt=\"\u1ea3nh minh h\u1ecda: R\u00e1ch h\u00ecnh ch\u1eef u v\u00e0 k\u1ef9 thu\u1eadt kh\u00e2u l\u1ea1i Ngu\u1ed3n: AANA Advanced Arthroscopy (2010), The Shoulder\" width=\"300\" height=\"113\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/222-300x113.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/222.png 616w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-18737\" class=\"wp-caption-text\">R\u00e1ch h\u00ecnh ch\u1eef u v\u00e0 k\u1ef9 thu\u1eadt kh\u00e2u l\u1ea1i Ngu\u1ed3n: AANA Advanced Arthroscopy (2010), The Shoulder<\/figcaption><\/figure>\n<figure id=\"attachment_18738\" aria-describedby=\"caption-attachment-18738\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/i-1.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-18738\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/i-1-300x123.png\" alt=\"\u1ea3nh minh h\u1ecda: r\u00e1ch h\u00ecnh ch\u1eef L v\u00e0 kh\u00e2u l\u1ea1i\" width=\"300\" height=\"123\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/i-1-300x123.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/i-1.png 624w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-18738\" class=\"wp-caption-text\">r\u00e1ch h\u00ecnh ch\u1eef L v\u00e0 kh\u00e2u l\u1ea1i<\/figcaption><\/figure>\n<p>Vi\u1ec7c kh\u00e2u b\u00ean-b\u00ean \u0111\u00f3ng t\u1ed5n th\u01b0\u01a1ng l\u00e0 r\u1ea5t h\u1eefu \u00edch n\u1ebfu nh\u01b0 kh\u00f4ng mu\u1ed1n n\u00f3i l\u00e0 b\u1eaft bu\u1ed9c v\u00ec n\u00f3 \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 gi\u1ea3m s\u1ee9c c\u0103ng t\u1ea1i m\u00e9p kh\u00e2u d\u00ednh v\u00e0o x\u01b0\u01a1ng, t\u1ea1o \u0111i\u1ec1u ki\u1ec7n l\u00e0nh g\u00e2n t\u1ed1t h\u01a1n, c\u0169ng nh\u01b0 l\u00e0m gi\u1ea3m th\u1ee5 c\u1ea3m \u0111au m\u00e0 ph\u01b0\u01a1ng ph\u00e1p th\u1ef1c hi\u1ec7n l\u1ea1i \u0111\u01a1n gi\u1ea3n.<\/p>\n<p>Ch\u00fang t\u00f4i \u0111\u1ec1 xu\u1ea5t k\u1ef9 thu\u1eadt 1 h\u00e0ng s\u1eed d\u1ee5ng m\u0169i Masson Allen c\u1ea3i bi\u00ean nh\u1eb1m tr\u00e1nh vi\u1ec7c x\u00e9 ch\u1ec9 ph\u1ed1i h\u1ee3p v\u1edbi micro fracture \u0111\u1ec3 t\u0103ng kh\u1ea3 n\u0103ng li\u00ean g\u00e2n<\/p>\n<figure id=\"attachment_18739\" aria-describedby=\"caption-attachment-18739\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/777.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-18739\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/777-300x87.png\" alt=\"\u1ea3nh minh h\u1ecda: m\u0169i Masson Allen cai bi\u00ean va k\u1ef9 thu\u1eadt Micro Fracture\" width=\"300\" height=\"87\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/777-300x87.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/777.png 618w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-18739\" class=\"wp-caption-text\">m\u0169i Masson Allen cai bi\u00ean va k\u1ef9 thu\u1eadt Micro Fracture<\/figcaption><\/figure>\n<p><span style=\"font-weight: 400;\"><br \/>\n<\/span><i><\/i><\/p>\n<p><i><span style=\"font-weight: 400;\">c) T\u1ed5n th\u01b0\u01a1ng r\u00e1ch &gt; 5cm<\/span><\/i><\/p>\n<p><span style=\"font-weight: 400;\">Trong qu\u00e1 kh\u1ee9 khi m\u00e0 th\u1ef1c hi\u1ec7n c\u00e1c ph\u01b0\u01a1ng ph\u00e1p gi\u1ea3i ph\u00f3ng, l\u00e0m di \u0111\u1ed9ng g\u00e2n c\u0169ng kh\u00f4ng th\u1ec3 k\u00e9o m\u00e9p g\u00e2n t\u1edbi \u0111\u01b0\u1ee3c \u0111i\u1ec3m b\u00e1m nguy\u00ean th\u1ee7y th\u00ec ng\u01b0\u1eddi ta c\u0169ng c\u00f3 th\u1ec3 ch\u1ea5p nh\u1eadn vi\u1ec7c kh\u00e2u b\u00ean &#8211; b\u00ean kh\u00e9p b\u1edbt t\u1ed5n th\u01b0\u01a1ng sau \u0111\u00f3 \u0111\u00ednh m\u1ed9t ph\u1ea7n g\u00e2n v\u00e0o ch\u00e2n b\u00e1m (m\u1ee5c \u0111\u00edch ch\u00ednh l\u00e0 \u0111\u1ec3 ph\u1ee5c h\u1ed3i c\u1eb7p \u0111\u00f4i l\u1ef1c). M\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p ph\u1ea3i chuy\u1ec3n \u0111i\u1ec3m b\u00e1m kh\u00e2u g\u00e2n v\u00ec g\u00e2n qu\u00e1 c\u0103ng d\u1ec5 d\u1eabn \u0111\u1ebfn kh\u00f4ng li\u1ec1n g\u00e2n (trong tr\u01b0\u1eddng h\u1ee3p g\u00e2n di \u0111\u1ed9ng qu\u00e1 \u00edt, r\u00e1ch r\u1ed9ng v\u00e0 \u0111\u1ec3 l\u00e2u).<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">N\u1ebfu v\u1eabn kh\u00f4ng th\u1ec3 kh\u00e2u \u0111\u01b0\u1ee3c th\u00ec ti\u1ebfn h\u00e0nh \u201ck\u1ef9 thu\u1eadt tr\u01b0\u1ee3t \u0111\u01a1n\u201d. K\u1ef9 thu\u1eadt n\u00e0y l\u00e0 c\u1eaft t\u00e1ch c\u1ea1nh tr\u01b0\u1edbc c\u1ee7a g\u00e2n tr\u00ean gai ra kh\u1ecfi v\u00f9ng gian ch\u00f3p xoay. \u0110\u01b0\u1eddng c\u1ea5t \u0111i t\u1eeb ch\u1ed7 ngay tr\u00ean g\u1ed1c c\u1ee7a g\u00e2n nh\u1ecb \u0111\u1ea7u h\u01b0\u1edbng th\u1eb3ng \u0111\u1ebfn n\u1ec1n c\u1ee7a m\u1ecfm qu\u1ea1. Khi \u0111\u00f3 g\u00e2n tr\u00ean gai ho\u1eb7c d\u01b0\u1edbi vai \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n t\u00ednh di \u0111\u1ed9ng th\u00ec m\u1edbi c\u00f3 th\u1ec3 kh\u00e2u k\u00e9o m\u00e9p g\u00e2n t\u1ef1 do v\u00e0o c\u00f9 l\u1edbn b\u1eb1ng nero \u0111\u01b0\u1ee3c.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/li>\n<\/ul>\n<figure id=\"attachment_18740\" aria-describedby=\"caption-attachment-18740\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/ky-thuat-truot-don.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-18740\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/ky-thuat-truot-don-300x104.png\" alt=\"\u1ea3nh minh h\u1ecda: K\u1ef9 thu\u1eadt tr\u01b0\u1ee3t \u0111\u01a1n Ngu\u1ed3n: AANA Advanced Arthroscopy (20 JO), The Shoulder\" width=\"300\" height=\"104\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/ky-thuat-truot-don-300x104.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/ky-thuat-truot-don.png 629w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-18740\" class=\"wp-caption-text\">K\u1ef9 thu\u1eadt tr\u01b0\u1ee3t \u0111\u01a1n Ngu\u1ed3n: AANA Advanced Arthroscopy (20 JO), The Shoulder<\/figcaption><\/figure>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">N\u00f3i chung v\u1edbi k\u1ef3 thu\u1eadt n\u00e0y th\u00ec th\u01b0\u1eddng ch\u1ec9 gi\u1ea3i ph\u00f3ng th\u00eam \u0111\u01b0\u1ee3c s\u1ef1 di \u0111\u1ed9ng 1- 2cm c\u1ee7a c\u1ea1nh b\u00ean ph\u00eda tr\u01b0\u1edbc g\u00e2n tr\u00ean gai. Khi m\u00e0 s\u1ef1 di \u0111\u1ed9ng nh\u01b0 v\u1eady l\u00e0 kh\u00f4ng \u0111\u1ee7 cho vi\u1ec7c k\u00e9o g\u00e2n ra kh\u00e2u \u1edf ch\u00e2n b\u00e1m th\u00ec c\u1ea7n th\u1ef1c hi\u1ec7n th\u00eam m\u1ed9t \u0111\u01b0\u1eddng b\u00f3c t\u00e1ch n\u1eefa nh\u1eb1m t\u00e1ch g\u00e2n tr\u00ean gai ra kh\u1ecfi g\u00e2n d\u01b0\u1edbi gai. Vi\u1ec7c th\u1ef1c hi\u1ec7n \u0111\u1ed3ng th\u1eddi 2 k\u1ef3 thu\u1eadt n\u00e0y c\u00f3 t\u00ean l\u00e0 \u201ck\u1ef3 thu\u1eadt tr\u01b0\u1ee3t \u0111\u00f4i\u201d.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<figure id=\"attachment_18741\" aria-describedby=\"caption-attachment-18741\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/ky-thuat-truot-doi.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-18741\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/ky-thuat-truot-doi-300x83.png\" alt=\"\u1ea3nh minh h\u1ecda: K\u1ef9 thu\u1eadt tr\u01b0\u1ee3t \u0111\u00f4i Ngu\u1ed3n: AANA Advanced Arthroscopy (2010), The Shoulder\" width=\"300\" height=\"83\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/ky-thuat-truot-doi-300x83.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/ky-thuat-truot-doi.png 640w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-18741\" class=\"wp-caption-text\">K\u1ef9 thu\u1eadt tr\u01b0\u1ee3t \u0111\u00f4i Ngu\u1ed3n: AANA Advanced Arthroscopy (2010), The Shoulder<\/figcaption><\/figure>\n<p><span style=\"font-weight: 400;\">K\u1ef9 thu\u1eadt n\u00e0y \u0111\u00f2i h\u1ecfi b\u1eaft bu\u1ed9c ph\u00e1i n\u1ed9i soi b\u1ed9c l\u1ed9 gai vai, \u0111\u00e2y l\u00e0 m\u1ed1c ph\u00e2n chia gi\u1eefa g\u00e2n tr\u00ean gai v\u00e0 d\u01b0\u1edbi gai. Sau \u0111\u00f3 d\u00f9ng k\u00e9o n\u1ed9i soi c\u1eaft \u0111\u1ec3 t\u00e1ch g\u00e2n tr\u00ean gai v\u00e0 d\u01b0\u1edbi gai, m\u0169i k\u00e9o h\u01b0\u1edbng th\u1eb3ng v\u00e0o gai vai.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">M\u1ed9t \u0111i\u1ec3m ch\u00fa \u00fd \u1edf k\u1ef9 thu\u1eadt c\u1eaft n\u00e0y l\u00e0 c\u1ea7n tr\u00e1nh l\u00e0m t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh tr\u00ean vai n\u1eb1m v\u00f2ng quanh n\u1ec1n gai vai. Th\u1ee7 thu\u1eadt l\u00e0 n\u00ean k\u00e9o g\u00e2n tr\u00ean gai v\u00e0 d\u01b0\u1edbi gai v\u1ec1 ph\u00eda sau, \u0111\u1ed3ng th\u1eddi khi c\u1eaft ph\u1ea3i n\u00e2ng k\u00e9o l\u00ean cao h\u01a1n v\u1ecb tr\u00ed sau tr\u00ean c\u1ee7a c\u1ed5 \u1ed5 ch\u1ea3o nh\u1eb1m tr\u00e1nh v\u01b0\u1edbng v\u00e0o th\u1ea7n kinh tr\u00ean vai.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<figure id=\"attachment_18742\" aria-describedby=\"caption-attachment-18742\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/bbbbbb.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-18742\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/bbbbbb-300x205.png\" alt=\"\u1ea3nh minh h\u1ecda: N\u00f4ng k\u00e9o khi c\u1eaft t\u00e1ch g\u00e2n tr\u00ean gai v\u00e0 d\u01b0\u1edbi gai Ngu\u1ed3n: AANA Advanced Arthroscopy (2010), The Shoulder\" width=\"300\" height=\"205\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/bbbbbb-300x205.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/bbbbbb.png 341w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-18742\" class=\"wp-caption-text\">N\u00e2ng k\u00e9o khi c\u1eaft t\u00e1ch g\u00e2n tr\u00ean gai v\u00e0 d\u01b0\u1edbi gai Ngu\u1ed3n: AANA Advanced Arthroscopy (2010), The Shoulder<\/figcaption><\/figure>\n<p><span style=\"font-weight: 400;\"><br \/>\n<\/span><br \/>\n<span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<p><span style=\"font-weight: 400;\">K\u1ef9 thu\u1eadt tr\u01b0\u1ee3t \u0111\u00f4i c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3i ph\u00f3ng th\u00eam 3 &#8211; 5cm c\u1ea1nh b\u00ean c\u1ee7a g\u00e2n tr\u00ean gai v\u00e0 d\u01b0\u1edbi gai. T\u1eeb \u0111\u00f3 k\u00e9o t\u1eebng g\u00e2n ri\u00eang r\u1ebd kh\u00e2u t\u1eadn &#8211; t\u1eadn v\u00e0o ch\u00e2n b\u00e1m c\u1ee7a ch\u00fang, sau \u0111\u00f3 m\u1edbi kh\u00e2u b\u00ean &#8211; b\u00ean gi\u1eefa 2 g\u00e2n \u0111\u1ec3 \u0111\u00f3ng kho\u1ea3ng tr\u1ed1ng gi\u1eefa 2 g\u00e2n v\u00e0 tr\u00e1nh c\u0103ng m\u1ed1i kh\u00e2u \u1edb \u0111i\u1ec3m b\u00e1m.<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><i><span style=\"font-weight: 400;\">T\u1ed5n th\u01b0\u01a1ng r\u00e1ch qu\u1ea3 l\u1edbn kh\u00f4ng th\u1ec3 s\u1eeda ch\u1eefa \u0111\u01b0\u1ee3c:<\/span><\/i><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Khi m\u00e0 t\u1ea5t c\u1ea3 c\u00e1c c\u00f4ng c\u1ee5 tr\u00ean kh\u00f4ng th\u1ec3 gi\u00fap kh\u00e2u ph\u1ee5c h\u1ed3i l\u1ea1i ch\u00f3p xoay \u0111\u01b0\u1ee3c th\u00ec chuy\u1ec3n sang c\u00e1c ph\u01b0\u01a1ng th\u1ee9c \u0111i\u1ec1u tr\u1ecb gi\u00e1n ti\u1ebfp, \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">N\u1ed9i soi c\u1eaft l\u1ecdc t\u1ed5 ch\u1ee9c vi\u00eam, tho\u00e1i h\u00f3a, c\u00e1c gai x\u01b0\u01a1ng v\u00e0 l\u00e0m gi\u1ea3m s\u1ef1 ch\u00e8n cp \u1edf khoang d\u01b0\u1edbi m\u1ecfm c\u00f9ng vai l\u00e0 c\u00e1c b\u01b0\u1edbc l\u00e0m c\u01a1 b\u1ea3n.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Ti\u1ebfp theo b\u1ed9 3 k\u1ef9 thu\u1eadt c\u1ea7n \u0111\u01b0\u1ee3c xem x\u00e9t th\u1ef1c hi\u1ec7n l\u00e0 \u0111\u00ednh \u0111\u1ea7u d\u00e0i g\u00e2n nh\u1ecb \u0111\u1ea7u v\u00e0o x\u01b0\u01a1ng v\u00e0 c\u1eaft \u0111\u1ea7u xa c\u1ee7a x\u01b0\u01a1ng \u0111\u00f2n v\u00e0 gi\u1ea3i \u00e1p th\u1ea7n kinh tr\u00ean vai (n\u1ebfu nh\u01b0 tr\u01b0\u1edbc ph\u1eabu thu\u1eadt \u0111\u00e3 th\u1eed phong b\u1ebf th\u1ea7n kinh tr\u00ean vai th\u1ea5y c\u00f3 c\u1ea3i thi\u1ec7n \u0111\u01b0\u1ee3c m\u1ee9c \u0111\u1ed9 \u0111au).<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Sau m\u1ed5 b\u1ed5 sung b\u1eb1ng c\u00e1c b\u00e0i t\u1eadp ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng nh\u1eb1m t\u0103ng s\u1ee9c c\u01a1 c\u1ee7a c\u00e1c c\u01a1 l\u00e2n c\u1eadn c\u00f2n l\u1ea1i \u0111\u1ec3 c\u1ea3i thi\u1ec7n t\u1ea7m v\u1eadn \u0111\u1ed9ng kh\u1edbp.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Ngo\u00e0i ra nh\u1eefng n\u0103m g\u1ea7n \u0111\u00e2y c\u00f2n ph\u00e1t tri\u1ec3n th\u00eam c\u00e1c ph\u01b0\u01a1ng ph\u00e1p nh\u00e0m gi\u1ea3i quy\u1ebft tri\u1ec7u ch\u1ee9ng cho lo\u1ea1i r\u00e1ch n\u00e0y:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">T\u1ea1o h\u00ecnh bao kh\u1edbp ph\u00eda tr\u00ean v\u1edbi m\u1ea3nh gh\u00e9p t\u1ef1 th\u00e2n, \u0111\u1ed3ng lo\u1ea1i, d\u1ecb lo\u1ea1i, ho\u1eb7c t\u1ed5ng h\u1ee3p. M\u1ee5c \u0111\u00edch c\u1ee7a ph\u1eabu thu\u1eadt n\u00e0y l\u00e0 t\u1ea1o n\u00fat ch\u1eb7n \u0111\u1ec3 ng\u0103n kh\u00f4ng cho <\/span><span style=\"font-weight: 400;\">ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay ch\u1ea1y l\u00ean tr\u00ean.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Ch\u1ec9 \u0111\u1ecbnh: <\/span><i><span style=\"font-weight: 400;\">\u1edf<\/span><\/i><span style=\"font-weight: 400;\"> nh\u1eefng b\u1ec7nh nh\u00e2n d\u01b0\u1edbi 65 tu\u1ed5i, ch\u01b0a c\u00f3 bi\u1ec3u hi\u1ec7n tho\u00e1i h\u00f3a kh\u1edbp <\/span><span style=\"font-weight: 400;\">vai.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">M\u1ea3nh gh\u00e9p t\u1ef1 th\u00e2n th\u01b0\u1eddng d\u00f9ng l\u00e0 c\u00e2n Facial Lata, lo\u1ea1i n\u00e0y an to\u00e0n nh\u01b0ng ph\u1ea3i hy sinh n\u01a1i cho.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">M\u1ea3nh gh\u00e9p d\u1ecb lo\u1ea1i ho\u1eb7c t\u1ed5ng h\u1ee3p th\u00ec c\u00f3 \u01b0u \u0111i\u1ec3m l\u00e0 kh\u00f4ng ph\u1ea3i hi sinh n\u01a1i cho nh\u01b0ng v\u1eabn c\u00f2n nh\u1eefng b\u0103n kho\u0103n v\u1ec1 ph\u1ea3n \u1ee9ng th\u1ea3i gh\u00e9p c\u0169ng nh\u01b0 kh\u1ea3 n\u0103ng <\/span><span style=\"font-weight: 400;\">kh\u00f4ng li\u1ec1n cao.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<figure id=\"attachment_18743\" aria-describedby=\"caption-attachment-18743\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/uuu.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-18743\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/uuu-300x243.png\" alt=\"\u1ea3nh minh h\u1ecda: Chuy\u1ec3n ph\u1ea7n th\u1ea5p c\u01a1 thang Ngu\u1ed3n: Joaquin Sanchez-Sotelo, Mayo Clinic\" width=\"300\" height=\"243\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/uuu-300x243.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/uuu.png 560w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-18743\" class=\"wp-caption-text\">Chuy\u1ec3n ph\u1ea7n th\u1ea5p c\u01a1 thang Ngu\u1ed3n: Joaquin Sanchez-Sotelo, Mayo Clinic<\/figcaption><\/figure>\n<p><span style=\"font-weight: 400;\">Chuy\u1ec3n g\u00e2n: c\u00f3 th\u1ec3 th\u1ef1c hi\u1ec7n qua m\u1ed5 m\u1edf ho\u1eb7c ph\u1ed1i h\u1ee3p v\u1edbi n\u1ed9i soi kh\u1edbp nh\u1eb1m chuy\u1ec3n c\u00e1c g\u00e2n \u0111\u1ebfn b\u00e1m v\u00e0o c\u1ee7 l\u1edbn x\u01b0\u01a1ng c\u00e1nh tay \u0111\u1ec3 b\u00f9 v\u00e0o l\u1ef1c m\u00e0 ch\u00f3p xoay \u0111\u00e3 m\u1ea5t.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Ch\u1ec9 \u0111\u1ecbnh cho nh\u1eefng b\u1ec7nh nh\u00e2n tr\u1ebb, nhu c\u1ea7u v\u1eadn \u0111\u1ed9ng cao v\u00e0 kh\u1ea3 n\u0103ng t\u1eadp ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng t\u1ed1t.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<figure id=\"attachment_18744\" aria-describedby=\"caption-attachment-18744\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/jjjj.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-18744\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/jjjj-300x153.png\" alt=\"\u1ea3nh minh h\u1ecda: Chuy\u1ec3n ph\u1ea7n th\u1ea5p c\u01a1 thang Ngu\u1ed3n: Joaquin Sanchez-Sotelo, Mayo Clinic\" width=\"300\" height=\"153\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/jjjj-300x153.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/jjjj.png 405w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-18744\" class=\"wp-caption-text\">Chuy\u1ec3n ph\u1ea7n th\u1ea5p c\u01a1 thang Ngu\u1ed3n: Joaquin Sanchez-Sotelo, Mayo Clinic<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_18745\" aria-describedby=\"caption-attachment-18745\" style=\"width: 291px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/0.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-18745\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/0-291x300.png\" alt=\"\u1ea3nh minh h\u1ecda: Chuy\u1ec3n c\u01a1 l\u01b0ng r\u1ed9ng Ngu\u1ed3n: Lennard Funk (2012), J Shoulder Elbow Surg\" width=\"291\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/0-291x300.png 291w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/0.png 388w\" sizes=\"(max-width: 291px) 100vw, 291px\" \/><\/a><figcaption id=\"caption-attachment-18745\" class=\"wp-caption-text\">Chuy\u1ec3n c\u01a1 l\u01b0ng r\u1ed9ng Ngu\u1ed3n: Lennard Funk (2012), J Shoulder Elbow Surg<\/figcaption><\/figure>\n<p><span style=\"font-weight: 400;\">Thay kh\u1edbp \u0111\u1ea3o ng\u01b0\u1ee3c: l\u00e0 lo\u1ea1i kh\u1edbp thi\u1ebft k\u1ebf v\u1edbi m\u1ee5c \u0111\u00edch thay th\u1ebf c\u01a1 ch\u1ebf v\u1eadn \u0111\u1ed9ng c\u1ee7a ph\u1ea7n ch\u00f3p xoay \u0111\u00e3 b\u1ecb t\u1ed5n th\u01b0\u01a1ng b\u00e0ng vi\u1ec7c s\u1eed d\u1ee5ng l\u1ef1c k\u00e9o c\u00f2n l\u1ea1i c\u1ee7a c\u01a1 Delta v\u00e0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">nh\u00f3m c\u01a1 l\u00e2n c\u1eadn nh\u1eb1m ph\u1ee5c h\u1ed3i \u0111\u1ed9ng t\u00e1c \u0111\u01b0a tay l\u00ean cao trong c\u00e1c sinh ho\u1ea1t h\u00e0ng ng\u00e0y.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Ch\u1ec9 \u0111\u1ecbnh: \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i, c\u00f3 k\u00e8m tho\u00e1i h\u00f3a kh\u1edbp vai<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<figure id=\"attachment_18746\" aria-describedby=\"caption-attachment-18746\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/khop-vao-dao-nguoc.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-18746\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/khop-vao-dao-nguoc-300x147.png\" alt=\"\u1ea3nh minh h\u1ecda: Kh\u1edbp vai to\u00e0n ph\u1ea7n (b\u00ean tr\u00e1i) v\u00e0 \u00ec lo\u1ea1i kh\u1edbp \u0111\u1ea3o ng\u01b0\u1ee3c (b\u00ean ph\u1ea3i)\" width=\"300\" height=\"147\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/khop-vao-dao-nguoc-300x147.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/khop-vao-dao-nguoc.png 509w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-18746\" class=\"wp-caption-text\">Kh\u1edbp vai to\u00e0n ph\u1ea7n (b\u00ean tr\u00e1i) v\u00e0 \u00ec lo\u1ea1i kh\u1edbp \u0111\u1ea3o ng\u01b0\u1ee3c (b\u00ean ph\u1ea3i)<\/figcaption><\/figure>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u0110\u1eb7t b\u00f3ng (balloon) khoang d\u01b0\u1edbi m\u1ecfm c\u00f9ng vai: ph\u00e1t tri\u1ec3n v\u00e0o kho\u1ea3ng n\u0103m 2010 \u1edf ch\u00e2u \u00c2u. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y l\u00e0 \u0111\u01b0a 1 t\u00fai b\u00f3ng kh\u00f4ng kh\u00ed ho\u1eb7c d\u1ecbch v\u00e0o khoang d\u01b0\u1edbi m\u1ecfm c\u00f9ng vai gi\u00fap t\u0103ng<\/span><\/p>\n<p><span style=\"font-weight: 400;\">kho\u1ea3ng r\u1ed9ng c\u1ee7a khoang tr\u00e1nh vi\u1ec7c ch\u1ecfm di chuy\u1ec3n l\u00ean tr\u00ean c\u1ecd x\u00e1t v\u00e0o m\u1ecfm c\u00f9ng vai.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Ch\u1ec9 \u0111\u1ecbnh: cho nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 nhu c\u1ea7u v\u1eadn \u0111\u1ed9ng nhi\u1ec1u, gi\u1ea3m \u0111au <\/span><b>l\u00e0 <\/b><span style=\"font-weight: 400;\">ch\u00ednh.<\/span><\/p>\n<figure id=\"attachment_18747\" aria-describedby=\"caption-attachment-18747\" style=\"width: 299px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/ky-thuat-dat-bong.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-18747\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/ky-thuat-dat-bong.png\" alt=\"\u1ea3nh minh h\u1ecda: c\u1ed5 \u0111\u1ecbnh \u0111\u1ea7u d\u00e0i g\u00e2n nh\u1ecb \u0111\u1ea7u v\u00e0o r\u00e3nh nh\u1ecb \u0111\u1ea7u tr\u00ean m\u00f4 ph\u1ecfng (b\u00ean ph\u1ea3i) v\u00e0 th\u1ef1c t\u1ebf tr\u00ean n\u1ed9i soi (b\u00ean tr\u00e1i)\" width=\"299\" height=\"214\" \/><\/a><figcaption id=\"caption-attachment-18747\" class=\"wp-caption-text\">c\u1ed5 \u0111\u1ecbnh \u0111\u1ea7u d\u00e0i g\u00e2n nh\u1ecb \u0111\u1ea7u v\u00e0o r\u00e3nh nh\u1ecb \u0111\u1ea7u tr\u00ean m\u00f4 ph\u1ecfng (b\u00ean ph\u1ea3i) v\u00e0 th\u1ef1c t\u1ebf tr\u00ean n\u1ed9i soi (b\u00ean tr\u00e1i)<\/figcaption><\/figure>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><i><span style=\"font-weight: 400;\">C\u00e1c t\u1ed5n th\u01b0\u01a1ng ph\u1ed1i h\u1ee3p<\/span><\/i><\/li>\n<\/ul>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u0110\u1ed1t m\u00f4 vi\u00eam d\u00e0y, ho\u1ea1t m\u1ea1c vi\u00eam b\u00e0ng \u0111\u1ea7u \u0111\u1ed1t s\u00f3ng cao t\u1ea7n, c\u1eaft l\u1ecdc t\u00fai ho\u1ea1t d\u1ecbch xung huy\u1ebft b\u1eb1ng Shaver.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">T\u1ed5n th\u01b0\u01a1ng\u00a0 SLAP \u0111\u1ed9 I th\u00ec c\u1eaft l\u1ecdc; \u0111\u1ed9 2 tr\u1edf l\u00ean th\u00ec kh\u00e2u s\u1ee5n vi\u1ec1n.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">T\u1ed5n th\u01b0\u01a1ng \u0111\u1ea7u d\u00e0i g\u00e2n nh\u1ecb \u0111\u1ea7u th\u00ec t\u1ed1t nh\u1ea5t l\u00e0 \u0111\u00ednh l\u1ea1i v\u00e0o r\u00e3nh nh\u1ecb \u0111\u1ea7u b\u1eb1ng v\u00edt ch\u1eb9n sinh h\u1ecdc. Chi ti\u1ebfn h\u00e0nh c\u00e1c \u0111\u01a1n thu\u1ea7n \u0111\u1ea7u d\u00e0i g\u00e2n nh\u1ecb \u0111\u1ea7u n\u1ebfu r\u00e1ch &gt; 50% v\u00e0 nhu c\u1ea7u v\u1eadn \u0111\u1ed9ng th\u1ea5p \u1edf nh\u1eefng ng\u01b0\u1eddi cao tu\u1ed5i.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<figure id=\"attachment_18748\" aria-describedby=\"caption-attachment-18748\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/co-dinh.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-18748\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/co-dinh-300x130.png\" alt=\"\u1ea3nh minh h\u1ecda: C\u1ed1 \u0111\u1ecbnh \u0111\u1ea7u d\u00e0i g\u00e2n nh\u1ecb \u0111\u1ea7u v\u00e0o r\u00e3nh nh\u1ecb \u0111\u1ea7u tr\u00ean m\u00f4 ph\u1ecfng (b\u00ean ph\u1ea3i) v\u00e0 th\u1ef1c t\u1ebf tr\u00ean n\u1ed9i soi (b\u00ean tr\u00e1i)\" width=\"300\" height=\"130\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/co-dinh-300x130.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/co-dinh.png 550w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-18748\" class=\"wp-caption-text\">C\u1ed1 \u0111\u1ecbnh \u0111\u1ea7u d\u00e0i g\u00e2n nh\u1ecb \u0111\u1ea7u v\u00e0o r\u00e3nh nh\u1ecb \u0111\u1ea7u tr\u00ean m\u00f4 ph\u1ecfng (b\u00ean ph\u1ea3i) v\u00e0 th\u1ef1c t\u1ebf tr\u00ean n\u1ed9i soi (b\u00ean tr\u00e1i)<\/figcaption><\/figure>\n<p><span style=\"font-weight: 400;\">T\u1ea1o h\u00ecnh m\u1eb7t sau m\u1ecfm qu\u1ea1 n\u1ebfu kho\u1ea3ng c\u00e1ch t\u1eeb \u0111\u1ec9nh m\u1ecfm qu\u1ea1 \u0111\u1ebfn di\u1ec7n tr\u01b0\u1edbc c\u1ee7a g\u00e2n d\u01b0\u1edbi vai &lt; 7mm do h\u1eb9p kho\u1ea3ng n\u00e0y c\u0169ng c\u00f3 th\u1ec3 l\u00e0 nguy\u00ean nh\u00e2n c\u01a1 h\u1ecdc g\u00e2y m\u00e0i m\u00f2n g\u00e2n d\u01b0\u1edbi vai. Tuy nhi\u00ean kh\u00f4ng \u0111\u01b0\u1ee3c l\u00e0m h\u1ecfng \u0111i\u1ec3m b\u00e1m c\u1ee7a c\u00e1c d\u00e2y ch\u1eb1ng b\u00e1m v\u00e0o m\u1ecfm qu\u1ea1. \u0110\u1ea1t y\u00eau c\u1ea7u khi m\u1eb7t sau m\u1ecfm qu\u1ea1 c\u00f3 xu h\u01b0\u1edbng song song v\u1edbi m\u1eb7t ph\u1eb3ng g\u00e2n d\u01b0\u1edbi vai.<\/span><\/p>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_18749\" aria-describedby=\"caption-attachment-18749\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/tao-hinh-mom-qua.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-18749\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/tao-hinh-mom-qua-300x265.png\" alt=\"\u1ea3nh minh h\u1ecda: T\u1ea1o h\u00ecnh m\u1ecfm qu\u1ea1 Ngu\u1ed3n: AANA Advanced Arthroscopy (2010), The Shoulder\" width=\"300\" height=\"265\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/tao-hinh-mom-qua-300x265.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/tao-hinh-mom-qua.png 312w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-18749\" class=\"wp-caption-text\">T\u1ea1o h\u00ecnh m\u1ecfm qu\u1ea1 Ngu\u1ed3n: AANA Advanced Arthroscopy (2010), The Shoulder<\/figcaption><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>V\u1ec1 vi\u1ec7c l\u1ef1a ch\u1ecdn ph\u01b0\u01a1ng th\u1ee9c \u0111i\u1ec1u tr\u1ecb n\u00e0o th\u00ec ph\u1ea3i x\u00e9t tr\u00ean nhi\u1ec1u y\u1ebfu t\u1ed1 nh\u01b0: mong mu\u1ed1n v\u1ec1 ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n, nhu c\u1ea7u v\u1eadn \u0111\u1ed9ng; y\u1ebfu t\u1ed1 to\u00e0n tr\u1ea1ng, tu\u1ed5i c\u0169ng nh\u01b0 c\u01a1 \u0111\u1ecba c\u00e1 nh\u00e2n, c\u00f3 \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n kh\u00f4ng; th\u1eadm ch\u00ed c\u00f2n ph\u1ea3i [&hellip;]<\/p>\n","protected":false},"author":59,"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>Ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb r\u00e1ch ch\u00f3p xoay - Vinmec<\/title>\n<meta name=\"description\" content=\"C\u1ea7n x\u00e9t nhi\u1ec1u y\u1ebfu t\u1ed1 mong mu\u1ed1n v\u1ec1 ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng, nhu c\u1ea7u v\u1eadn \u0111\u1ed9ng. 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