{"id":18483,"date":"2023-04-12T07:35:02","date_gmt":"2023-04-12T00:35:02","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=18483"},"modified":"2023-04-14T18:23:26","modified_gmt":"2023-04-14T11:23:26","slug":"chan-doan-lam-sang-va-cac-nghiep-phap-chan-doa-trat-khop-vai-tai-dien","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/12\/chan-doan-lam-sang-va-cac-nghiep-phap-chan-doa-trat-khop-vai-tai-dien\/","title":{"rendered":"L\u00e2m s\u00e0ng v\u00e0 nghi\u1ec7m ph\u00e1p ch\u1ea9n \u0111o\u00e1n tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n"},"content":{"rendered":"<p><strong>Tr\u1eadt kh\u1edbp vai l\u00e0 s\u1ef1 m\u1ea5t ti\u1ebfp x\u00fac c\u1ee7a di\u1ec7n kh\u1edbp \u1ed5 ch\u1ea3o v\u00e0 ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay. Tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n l\u00e0 t\u00ecnh tr\u1ea1ng tr\u1eadt kh\u1edbp vai t\u1eeb l\u1ea7n 2 tr\u1edf l\u00ean (th\u01b0\u1eddng tr\u00ean 10 l\u1ea7n), sau b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 t\u1ef1 n\u1eafn \u0111\u01b0\u1ee3c. Nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n th\u00ec kh\u00f4ng c\u00f2n nh\u1eefng tri\u1ec7u ch\u1ee9ng c\u1ee7a tr\u1eadt kh\u1edbp vai c\u1ea5p t\u00ednh n\u1eefa. Th\u00f4ng qua b\u00e0i vi\u1ebft, ch\u00fang t\u00f4i s\u1ebd tr\u00ecnh b\u00e0y v\u1ec1 ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng v\u00e0 c\u00e1c nghi\u1ec7p ph\u00e1p ch\u1ea9n \u0111o\u00e1n tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n.<\/strong><\/p>\n<p><strong>Nh\u00f3m t\u00e1c gi\u1ea3:<\/strong> PGS. TS \u0110inh Ng\u1ecdc S\u01a1n, BS CKII V\u0169 Tr\u01b0\u1eddng Th\u1ecbnh<\/p>\n<p><strong>Ng\u00e0y ph\u00e1t h\u00e0nh<\/strong>: 30\/03\/2022<\/p>\n<h2><\/h2>\n<h2><b>1.Ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng<\/b> tr\u1eadt <strong>kh\u1edbp va<\/strong><b><span style=\"font-weight: 400;\"><strong>i t\u00e1i di\u1ec5n<\/strong><\/span><\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n th\u00ec kh\u00f4ng c\u00f2n nh\u1eefng tri\u1ec7u ch\u1ee9ng c\u1ee7a tr\u1eadt kh\u1edbp vai c\u1ea5p t\u00ednh n\u1eefa nh\u01b0: \u0111au, s\u01b0ng kh\u1edbp vai, b\u1ea5t l\u1ef1c v\u1eadn \u0111\u1ed9ng kh\u1edbp vai, b\u1ea7m t\u00edm da v\u00f9ng vai n\u00e1ch, h\u00f5m n\u00e1ch r\u1ed7ng&#8230;<\/span><\/p>\n<p><strong>Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n:<\/strong><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">D\u1ef1a v\u00e0o b\u1ec7nh s\u1eed c\u00f3 tr\u1eadt kh\u1edbp vai t\u1eeb 2 l\u1ea7n tr\u1edf l\u00ean.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">L\u00e2m s\u00e0ng: nguy\u00ean nh\u00e2n ch\u1ea5n th\u01b0\u01a1ng v\u00e0 c\u00e1c test kh\u00e1m kh\u1edbp vai.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">D\u1ef1a v\u00e0o <strong>XQ, CT Scan, MR<\/strong> \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh \u0111\u1eb7c \u0111i\u1ebfm v\u00e0 m\u1ee9c \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng.<\/span><\/li>\n<\/ul>\n<p><strong>1.1 B\u1ec7nh s\u1eed tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n<\/strong><\/p>\n<p><span style=\"font-weight: 400;\">B\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 \u0111\u1ebfn kh\u00e1m sau khi b\u1ecb m\u1ed9t ch\u1ea5n th\u01b0\u01a1ng tr\u1eadt kh\u1edbp vai c\u1ea5p t\u00ednh, ho\u1eb7c c\u00f3 th\u1ec3 l\u00e0 tr\u1eadt kh\u1edbp t\u00e1i di\u1ec5n, ho\u1eb7c b\u1ec7nh nh\u00e2n c\u00f3 d\u1ea5u hi\u1ec7u s\u1ee3 h\u00e3i tr\u1eadt kh\u1edbp. M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n th\u00ec \u0111\u1ebfn kh\u00e1m v\u1edbi ti\u1ec1n s\u1eed \u0111au kh\u1edbp vai m\u01a1 <\/span><span style=\"font-weight: 400;\">h\u1ed3 v\u1edbi ki\u1ec3u tr\u1eadt kh\u1edbp ho\u1eb7c h\u01b0\u1edbng tr\u1eadt kh\u1edbp kh\u00f4ng r\u00f5 r\u00e0ng ho\u1eb7c m\u1ea5t v\u1eefng kh\u1edbp. <\/span><span style=\"font-weight: 400;\">\u0110\u1ed1i v\u1edbi t\u1ea5t c\u1ea3 b\u1ec7nh nh\u00e2n th\u00ec ti\u1ec1n s\u1eed quan tr\u1ecdng c\u1ea7n xem x\u00e9t l\u00e0: tu\u1ed5i b\u1ec7nh nh\u00e2n, tay thu\u1eadn, ho\u1ea1t \u0111\u1ed9ng th\u1ec3 thao, ti\u1ec1n s\u1eed gia \u0111\u00ecnh v\u1ec1 tr\u1eadt kh\u1edbp, nguy\u00ean nh\u00e2n g\u00e2y tr\u1eadt kh\u1edbp (ch\u1ea5n th\u01b0\u01a1ng\/kh\u00f4ng do ch\u1ea5n th\u01b0\u01a1ng), s\u1ed5 l\u1ea7n tr\u1eadt kh\u1edbp t\u00e1i ph\u00e1t, m\u1ee9c \u0111\u1ed9 ch\u1ea5n th\u01b0\u01a1ng d\u1eabn \u0111\u1ebfn t\u00e1i ph\u00e1t, tr\u1eadt kh\u1edbp m\u1ed9t b\u00ean hay hai b\u00ean, c\u00f3 x\u1ea3y ra tr\u1eadt kh\u1edbp trong khi ng\u1ee7, ti\u1ec1n s\u1eed ph\u1eabu thu\u1eadt, s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a \u0111au v\u00e0 v\u1ecb tr\u00ed&#8230;<\/span><\/p>\n<p><b>1.1.2 \u0110\u1eb7c \u0111i\u1ec3m b\u1ec7nh s\u1eed c\u1ee7a tr\u1eadt <\/b><b>kh\u1edbp vai ra tr\u01b0\u1edbc<\/b><\/p>\n<ul>\n<li aria-level=\"1\"><span style=\"font-weight: 400;\">B\u1ec7nh nh\u00e2n lu\u00f4n c\u1ecf m\u1ed9t ch\u1ea5n th\u01b0\u01a1ng ban \u0111\u1ea7u g\u00e2y tr\u1eadt kh\u1edbp, v\u1edbi t\u01b0 th\u1ebf c\u00e1nh tay d\u1ea1ng, xoay ngo\u1eaft v\u00e0 \u0111\u1ed3ng th\u1eddi ch\u1ecbu m\u1ed9t l\u1ef1c \u1edf m\u1ee9c \u0111\u1ed9 l\u1edbn.<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-level=\"1\"><span style=\"font-weight: 400;\">Th\u01b0\u1eddng x\u1ea3y ra ph\u1ed1 bi\u1ebfn \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n nam, tr\u1ebb tu\u1ed5i, tham gia ho\u1ea1t \u0111\u1ed9ng th\u1ec3 thao<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-level=\"1\"><span style=\"font-weight: 400;\">Ngo\u00e0i ra, c\u1ea7n l\u01b0u \u00fd r\u1eb1ng c\u00e1c t\u1ed5n th\u01b0\u01a1ng r\u00e1ch bong bao kh\u1edbp v\u00e0 s\u1ee5n vi\u1ec1n tr\u1edf n\u00ean m\u00e0n t\u00ednh d\u1eabn \u0111\u1ebfn l\u1ef1c c\u1ea7n thi\u1ebft cho tr\u1eadt kh\u1edbp v\u00e0 n\u1eafn l\u1ea1i kh\u1edbp gi\u1ea3m \u0111i.<\/span><\/li>\n<\/ul>\n<p><b>1.1.3 \u0110\u1eb7c \u0111i\u1ec3m b\u1ec7nh s\u1eed c\u1ee7a tr\u1eadt <\/b><b>kh\u1edbp vai ra sau<\/b><\/p>\n<ul>\n<li aria-level=\"1\"><span style=\"font-weight: 400;\">B\u1ec7nh nh\u00e2n kh\u00f3 ch\u1ecbu th\u01b0\u1eddng g\u1eb7p nh\u1ea5t l\u00e0 \u0111au vai th\u01b0\u1eddng \u0111i k\u00e8m v\u1edbi gi\u1ea3m kh\u1ea3 n\u0103ng ch\u01a1i th\u1ec3 thao nh\u01b0ng kh\u00f4ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn sinh ho\u1ea1t h\u1eb1ng ng\u00e0y. \u0110au th\u01b0\u1eddng \u0111\u01b0\u1ee3c m\u00f4<\/span><span style=\"font-weight: 400;\"> t\u1ea3 l\u00e0 c\u00f3 t\u00ednh ch\u1ea5t \u0111au chung chung quanh kh\u1edbp vai ho\u1eb7c t\u00ecnh tr\u1ea1ng \u0111au \u1edd ph\u1ea7n s\u00e2u m\u1eb7t sau vai. S\u1ef1 s\u1ee3 h\u00e3i ch\u1ee7 quan trong tr\u1eadt kh\u1edbp vai ra sau hi\u1ebfm g\u1eb7p.<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-level=\"1\"><span style=\"font-weight: 400;\">Tr\u1eadt kh\u1edbp vai ra sau th\u01b0\u1eddng g\u00e2y ra kh\u00f4ng do ch\u1ea5n th\u01b0\u01a1ng (atraumatic m\u1ed9t ph\u00e1t hi\u1ec7n duy nh\u1ea5t trong m\u1ea5t v\u1eefng kh\u1edbp vai ra sau l\u00e0 b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 \u201cc\u1ed1 \u00fd\u201d l\u00e0m b\u00e1n tr\u1eadt kh\u1edbp ra sau. C\u00f3 hai lo\u1ea1i m\u1ea5t v\u1eefng kh\u1edbp v\u1edbi \u201cc\u1ed1 \u00fd\u201d:<\/span><\/li>\n<\/ul>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\"><strong>\u201cC\u1ed1 \u00fd\u201d thu\u1ed9c v\u1ec1 v\u1ecb tr\u00ed<\/strong>: t\u00ecnh tr\u1ea1ng th\u01b0\u1eddng g\u1eb7p nhi\u1ec1u <\/span>h\u01a1n, v\u1ecb tr\u00ed c\u00e1nh tay g\u1ea5p, kh\u00e9p v\u00e0 <span style=\"font-weight: 400;\">xoay trong.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\"><strong>\u201cC\u1ed1 \u00fd\u201d thu\u1ed9c v\u1ec1 c\u01a1<\/strong>: x\u1ea3y ra v\u1edbi c\u00e1nh tay \u1edf v\u1ecb tr\u00ed kh\u00e9p.<\/span><\/li>\n<\/ul>\n<p><b>1.1.4 \u0110\u1eb7c \u0111i\u1ec3m b\u1ec7nh s\u1eed c\u1ee7a tr\u1eadt <\/b><b>kh\u1edbp vai \u0111a h\u01b0\u1edbng<\/b><\/p>\n<ul>\n<li aria-level=\"1\"><span style=\"font-weight: 400;\">B\u1ec7nh s\u1eed c\u1ef1c k\u1ef3 quan tr\u1ecdng trong vi\u1ec7c \u0111\u00e1nh gi\u00e1 t\u1ea5t c\u1ea3 b\u1ec7nh nh\u00e2n m\u1ea5t v\u1eefng kh\u1edbp vai, nh\u01b0ng \u0111\u1eb7c bi\u1ec7t \u0111\u00fang \u0111\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n c\u00f3 tr\u1eadt kh\u1edbp vai \u0111a h\u01b0\u1edbng. B\u1ec7nh nh\u00e2n th\u01b0\u1eddng g\u1eb7p \u1edf \u0111\u1ed9 tu\u1ed5i thanh thi\u1ebfu ni\u00ean (13 \u0111\u1ebfn 20 tu\u1ed5i), ph\u00e0n n\u00e0n ph\u1ed5 bi\u1ebfn nh\u1ea5t l\u00e0 n\u1ed7i \u0111au v\u1edbi c\u00e1 ho\u1ea1t \u0111\u1ed9ng sinh ho\u1ea1t h\u1eb1ng ng\u00e0y v\u00e0 gi\u1ea3m kh\u1ea3 n\u0103ng th\u1ec3 thao m\u00e0 kh\u00f4ng c\u00f3 m\u1ed9t k\u00edch th\u00edch c\u1ee5 th\u1ec3 n\u00e0o. \u0110i\u1ec1u n\u00e0y th\u01b0\u1eddng th\u1ea5y trong c\u00e1c m\u00f4n th\u1ec3 thao v\u1edbi kh\u1ea3 n\u0103ng l\u1eb7p \u0111i l\u1eb7p l\u1ea1i t\u1ed5n th\u01b0\u01a1ng nh\u01b0 b\u01a1i l\u1ed9i v\u00e0 th\u1ec3 d\u1ee5c d\u1ee5ng c\u1ee5.<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-level=\"1\"><span style=\"font-weight: 400;\">Nhi\u1ec1u b\u1ec7nh nh\u00e2n tr\u1eadt kh\u1edbp \u0111a h\u01b0\u1edbng, nh\u01b0ng kh\u00f4ng ph\u1ea3i t\u1ea5t c\u1ea3 c\u00f3 c\u00e1c kh\u1edbp si\u00eau di \u0111\u1ed9ng v\u00e0 thu\u1ed9c nh\u00f3m c\u00f3 th\u1ec3 c\u00f3 h\u1ed9i ch\u1ee9ng Fillers Danlos (H\u1ed9i ch\u1ee9ng Ehlers-Dank l\u00e0 b\u1ec7nh di truy\u1ec1n. Bi\u1ec3u hi\u1ec7n \u0111i\u1ec3n h\u00ecnh c\u1ee7a b\u1ec7nh l\u00e0 \u0111a, m\u00f4, kh\u1edbp l\u1ecfng l\u1ebbo do vi\u1ec7c s\u1ea3n xu\u1ea5t c\u00e1c collagen b\u1ea5t th\u01b0\u1eddng) ho\u1eb7c h\u1ed9i ch\u1ee9ng kh\u00e1c d\u1eabn \u0111\u1ebfn l\u1ecfng l\u1ebbo d\u00e2y ch\u1eb1ng.<\/span><\/li>\n<\/ul>\n<p><strong>1.2 L\u00e2m s\u00e0ng c\u1ee7a tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n<\/strong><\/p>\n<p><span style=\"font-weight: 400;\">Kh\u00e1m l\u00e2m s\u00e0ng b\u1ec7nh nh\u00e2n v\u1edbi tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n b\u1ea5t \u0111\u1ea7u b\u1eb1ng h\u1ecfi:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Nguy\u00ean nh\u00e2n v\u00e0 v\u1ecb tr\u00ed c\u00e1nh tay nh\u01b0 th\u1ebf n\u00e0o s\u1ebd g\u00e2y ra t\u00ecnh tr\u1ea1ng tr\u1eadt kh\u1edbp?<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">H\u01b0\u1edbng n\u00e0o th\u00ec x\u1ea3y ra tr\u1eadt kh\u1edbp?<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">M\u1ee5c \u0111\u00edch l\u00e0 kh\u00f4ng l\u00e0m tr\u1eadt trong khi ki\u1ec3m tra, nh\u01b0ng trong tr\u01b0\u1eddng h\u1ee3p n\u1ebfu b\u1ea3o \u0111\u1ea3m an to\u00e0n th\u00ec b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 ch\u1ee9ng m\u00ecnh tr\u1eadt kh\u1edbp vai?<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Kh\u00e1m <\/span><span style=\"font-weight: 400;\">k\u1ef9 <\/span><span style=\"font-weight: 400;\">l\u01b0\u1eddng c\u1ea3 hai kh\u1edbp vai, <\/span><span style=\"font-weight: 400;\">kh\u1edbp vai <b><\/b><\/span><span style=\"font-weight: 400;\">b\u00ecnh th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 so s\u00e1nh, \u0111\u1ed1i chi\u1ebfu l\u00e2m s\u00e0ng.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Kh\u00e1m ki\u1ec3m tra bao g\u1ed3m \u0111\u00e1nh gi\u00e1:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Kh\u1edbp vai c\u00f3 b\u1ecb teo, c\u00f3 b\u1ea5t \u0111\u1ed1i x\u1ee9ng kh\u00f4ng?<\/span><\/li>\n<\/ul>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u0110\u00e1nh gi\u00e1 v\u1eadn \u0111\u1ed9ng x\u01b0\u01a1ng vai v\u00e0 r\u1ed1i lo\u1ea1n v\u1eadn \u0111\u1ed9ng x\u01b0\u01a1ng b\u1ea3 vai th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn m\u1ea5t v\u1eefng: ch\u00fa \u00fd c\u1ea9n th\u1eadn \u0111\u1ebfn chuy\u1ec3n \u0111\u1ed9ng c\u1ee7a x\u01b0\u01a1ng vai, s\u1eb9o ph\u1eabu thu\u1eadt tr\u01b0\u1edbc <\/span><span style=\"font-weight: 400;\">\u0111\u00e2y\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">S\u1edd n\u1eafn x\u00e1c \u0111\u1ecbnh \u0111i\u1ec3m \u0111au bao kh\u1edbp ph\u00eda tr\u01b0\u1edbc, ph\u00eda sau<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u0110\u00e1nh gi\u00e1 t\u1ed5n th\u01b0\u01a1ng ch\u00f3p xoay, \u0111\u1eb7c bi\u1ec7t \u1edf b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">\u0110\u1ec3 x\u00e1c \u0111\u1ecbnh t\u1ea7m v\u1eadn \u0111\u1ed9ng ch\u1ee7 y\u1ebfu c\u1ee7a kh\u1edbp vai: \u0111o x\u00e1c \u0111\u1ecbnh t\u1ea7m v\u1eadn \u0111\u1ed9ng c\u1ea3 hai b\u00ean, so s\u00e1nh v\u00e0 ghi l\u1ea1i s\u1ef1 kh\u00e1c bi\u1ec7t c\u1ee7a t\u1ea7m v\u1eadn \u0111\u1ed9ng ch\u1ee7 \u0111\u1ed9ng v\u00e0 th\u1ee5 \u0111\u1ed9ng. M\u1ed9t s\u1ed1 \u0111i\u1ec3m l\u01b0u \u00fd:<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">\u0110\u1ed9 cao v\u1ec1 ph\u00eda tr\u01b0\u1edbc trong m\u1eb7t ph\u1eb3ng x\u01b0\u01a1ng vai<\/span><\/li>\n<\/ul>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Xoay ngo\u00e0i, xoay trong v\u1edbi c\u00e1nh tay kh\u00e9p<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Xoay ngo\u00e0i, xoay trong v\u1edbi c\u00e1nh tay d\u1ea1ng: c\u1ea7n l\u01b0u \u00fd n\u1ebfu t\u0103ng &gt; 90 \u0111\u1ed9 th\u01b0\u1eddng g\u1eb7p trong m\u1ea5t v\u1eefng \u0111a h\u01b0\u1edbng.<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-level=\"1\"><span style=\"font-weight: 400;\">Kh\u00e1m \u0111\u00e1nh gi\u00e1 l\u1ecfng d\u00e2y ch\u1eb1ng to\u00e0n th\u00e2n: s\u1eed d\u1ee5ng thang \u0111i\u1ec3m Beighton, \u0111i\u1ec3m Beighton &gt; 4 \u0111i\u1ec3m th\u00ec ch\u1ea9n \u0111o\u00e1n l\u1ecfng d\u00e2y ch\u1eb1ng to\u00e0n th\u00e2n<\/span><\/li>\n<\/ul>\n<h2><b>2. C\u00e1c nghi\u1ec7m ph\u00e1p ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n<\/b><\/h2>\n<p><b>2.1 Nghi\u1ec7m ph\u00e1p ng\u0103n k\u00e9o (Drawer test)<\/b><\/p>\n<figure id=\"attachment_19068\" aria-describedby=\"caption-attachment-19068\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-19068\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-06.59.41-300x103.png\" alt=\"Nghi\u1ec7m ph\u00e1p ng\u0103n k\u00e9o (Drawer test)\" width=\"300\" height=\"103\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-06.59.41-300x103.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-06.59.41-1024x352.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-06.59.41-768x264.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-06.59.41.png 1340w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-19068\" class=\"wp-caption-text\">Nghi\u1ec7m ph\u00e1p ng\u0103n k\u00e9o (Drawer test)<\/figcaption><\/figure>\n<ul>\n<li aria-level=\"1\"><span style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">X\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 l\u1ecfng c\u1ee7a kh\u1edbp. B\u1ec7nh nh\u00e2n ng\u1ed3i, c\u00e1nh tay \u1edb b\u00ean c\u1ea1nh th\u00e2n ng\u01b0\u1eddi, th\u01b0 gi\u00e3n c\u01a1 v\u00f9ng vai (th\u00e0 l\u1ecfng vai), c\u1eb3ng tay \u0111\u1eb7t tr\u00ean \u0111\u00f9i c\u00f9ng b\u00ean. Ng\u01b0\u1eddi kh\u00e1m ng\u1ed3i ph\u00eda sau b\u1ec7nh nh\u00e2n, gi\u1eef \u1ed5n \u0111\u1ecbnh m\u1ecfm c\u00f9ng vai b\u1eb1ng m\u1ed9t tay trong<\/span><b> <\/b><span style=\"font-weight: 400;\">khi tay c\u00f2n l\u1ea1i di chuy\u1ec3n ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay theo chi\u1ec1u tr\u01b0\u1edbc sau, \u0111\u1ed3ng th\u1eddi t\u1ea1o m\u1ed9t \u00e1p l\u1ef1c nh\u1eb9 nh\u00e0ng l\u00ean trung t\u00e2m \u1ed5 ch\u1ea3o. \u0110\u1ed1i v\u1edbi kh\u1edbp vai b\u00ecnh th\u01b0\u1eddng, s\u1ef1 di chuy\u1ec3n n\u00e0y l\u00e0 nh\u1ecbp nh\u00e0ng v\u1edbi \u0111i\u1ec3m d\u1eebng cu\u1ed1i c\u00f9ng v\u1eefng ch\u1eafc. N\u1ebfu di chuy\u1ec3n n\u00e0y l\u00e0m xu\u1ea5t hi\u1ec7n tri\u1ec7u ch\u1eedng l\u00e2m s\u00e0ng: e s\u1ee3 ho\u1eb7c \u0111au th\u00ec c\u00f3 th\u00ea ch\u1ea5n \u0111o\u00e1n m\u1ea5t v\u1eefng kh\u1edbp vai (tr\u01b0\u1edbc ho\u1eb7c sau).<\/span><\/span><\/li>\n<\/ul>\n<p><b>2.2 Nghi\u1ec7m ph\u00e1p \u0111\u00e8 \u0111\u1ea9y (Load and Shift Test)<\/b><\/p>\n<p><span style=\"font-weight: 400;\">X\u00e1c \u0111\u1ecbnh ch\u00ednh x\u00e1c m\u1ee9c \u0111\u1ed9 t\u1ea3i v\u00e0 thay \u0111\u1ed5i c\u1ee7a kh\u1edbp vai, th\u01b0\u1eddng th\u1ef1c hi\u1ec7n d\u01b0\u1edbi g\u00e2y m\u00ea. B\u1ec7nh nh\u00e2n n\u0103m ng\u1eeda, c\u00e1nh tay d\u1ea1ng kho\u1ea3ng 60 \u0111\u1ed9, c\u1eb3ng tay \u1edf t\u01b0 th\u1ebf trung gian, t\u1ea1o m\u1ed9t l\u1ef1c \u00e9p \u0111\u1ea9y tr\u00ean x\u01b0\u01a1ng c\u00e1nh tay v\u00e0o \u1ed5 ch\u1ea3o. Sau \u0111\u00f3 di chuy\u1ec3n \u0111\u1ea7u tr\u00ean x\u01b0\u01a1ng c\u00e1nh tay ra tr\u01b0\u1edbc ho\u1eb7c ra sau \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u00ednh l\u00f2ng v\u00e0 \u0111au.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">X\u1ebfp <\/span><span style=\"font-weight: 400;\">th\u00e0nh 3 ph\u00e2n lo\u1ea1i:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\"><strong>Ph\u00e2n lo\u1ea1i 1 +<\/strong>; Di chuy\u1ec3n \u0111\u00e2u tr\u00ean x\u01b0\u01a1ng c\u00e1nh tay \u0111\u1ebfn vi\u1ec1n \u1ed5<\/span><span style=\"font-weight: 400;\">\u00a0ch\u1ea3o<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\"><strong>Ph\u00e2n lo\u1ea1i 2+<\/strong>: Di chuy\u1ec3n \u0111\u1ea7u tr\u00ean x\u01b0\u01a1ng c\u00e1nh tay v\u01b0\u1ee3t qua vi\u1ec1n \u1ed5<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><span style=\"font-weight: 400;\">ch\u1ea3o (tr\u1eadt kh\u1edbp) nh\u01b0ng c\u00f3 th\u1ec3 t\u1ef1 n\u1eafn l\u1ea1i.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"><strong>Ph\u00e2n lo\u1ea1i 3+<\/strong>: Di chuy\u1ec3n \u0111\u1ea7u tr\u00ean x\u01b0\u01a1ng c\u00e1nh tay v\u01b0\u1ee3t qua vi\u00ean \u1ed5 ch\u1ea3o (tr\u1eadt kh\u1edbp) nh\u01b0ng kh\u00f4ng th\u1ec3 t\u1ef1 n\u1eafn l\u1ea1i.<\/span><\/li>\n<\/ul>\n<p><b>2.3 Nghi\u1ec7m ph\u00e1p k\u00e9o gi\u00e3n (Slucus Test)<\/b><\/p>\n<p><span style=\"font-weight: 400;\">B\u1ec7nh nh\u00e2n ng\u1ed3i, th\u01b0 gi\u00e3n c\u01a1 v\u00f9ng vai (th\u1ea3 l\u1ecfng vai), c\u00e1nh tay \u1edf b\u00ean c\u1ea1nh th\u00e2n ng\u01b0\u1eddi. Sau \u0111\u00f3 c\u00e1nh tay \u0111\u01b0\u1ee3c k\u00e9o t\u1eeb tr\u00ean xu\u1ed1ng d\u01b0\u1edbi. Nghi\u1ec7m ph\u00e1p n\u00e0y x\u00e1c \u0111\u1ecbnh kho\u1ea3ng c\u00e1ch gi\u1eefa m\u1ecfm c\u00f9ng vai v\u00e0 \u0111\u1ea7u tr\u00ean x\u01b0\u01a1ng c\u00e1nh tay <\/span>x\u1ebfp <span style=\"font-weight: 400;\">th\u00e0nh 3 ph\u00e2n lo\u1ea1i:<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\"><strong>Ph\u00e2n lo\u1ea1i 1+<\/strong>: Kho\u1ea3ng c\u00e1ch nh\u1ecf h\u01a1n 1 cm<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\"><strong>Ph\u00e2n lo\u1ea1i 2+<\/strong>: Kho\u1ea3ng c\u00e1ch t\u1eeb 1-2cm\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\"><strong>Ph\u00e2n lo\u1ea1i 3+<\/strong>: Kho\u1ea3ng c\u00e1ch &gt; 2cm<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Quan tr\u1ecdng, d\u1ea5u hi\u1ec7u Sulcus th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ebf \u0111\u00e1nh gi\u00e1 l\u1ecfng bao kh\u1edbp ph\u00eda d\u01b0\u1edbi v\u00e0 \u0111\u01b0\u1ee3c coi l\u00e0 d\u01b0\u01a1ng t\u00ednh cho n\u1ebfu b\u1ec7nh nh\u00e2n c\u00f3 e s\u1ee3 ho\u1eb7c \u0111au.<\/span><\/p>\n<ul>\n<li aria-level=\"1\"><span style=\"font-weight: 400;\">D\u1ea5u hi\u1ec7u n\u00e0y c\u0169ng th\u01b0\u1eddng g\u1eb7p \u1edb b\u1ec7nh nh\u00e2n tr\u1eadt kh\u1edbp ra sau v\u00e0 \u0111a <\/span>h\u01b0\u1edbng.<\/li>\n<\/ul>\n<figure id=\"attachment_19071\" aria-describedby=\"caption-attachment-19071\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-19071\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-07.05.13-300x135.png\" alt=\"Nghi\u1ec7m ph\u00e1p k\u00e9o gi\u00e3n (Slucus Test)\" width=\"300\" height=\"135\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-07.05.13-300x135.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-07.05.13-1024x462.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-07.05.13-768x346.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-07.05.13.png 1158w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-19071\" class=\"wp-caption-text\">Nghi\u1ec7m ph\u00e1p k\u00e9o gi\u00e3n (Slucus Test)<\/figcaption><\/figure>\n<p><b>2.4 Nghi\u1ec7m ph\u00e1p qu\u00e1 gi\u1ecdng (Gagey <\/b><b>Hyperabduction Test)<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Nghi\u1ec7m ph\u00e1p n\u00e0y \u0111\u00e1nh gi\u00e1 t\u00ednh l\u1ecfng c\u1ee7a bao kh\u1edbp ph\u00eda d\u01b0\u1edbi v\u00e0 m\u1ea5t v\u1eefng kh\u1edbp vai. Ng\u01b0\u1eddi kh\u00e1m \u0111\u1ee9ng ph\u00eda sau b\u1ec7nh nh\u00e2n v\u1edbi c\u1eb3ng tay \u00e9p xu\u1ed1ng \u0111ai vai c\u1ee7a b\u1ec7nh nh\u00e2n trong khi s\u1eed d\u1ee5ng tay kia nh\u1eb9 nh\u00e0ng d\u1ea1ng th\u1ee5 \u0111\u1ed9ng c\u00e1nh tay c\u1ee7a b\u1ec7nh nh\u00e2n. Khu\u1ef7u c\u1ee7a b\u1ec7nh nh\u00e2n g\u1ea5p 90 \u0111\u1ed9.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">V\u1edbi nghi\u1ec7m ph\u00e1p n\u00e0y \u0111\u1ed9ng t\u00e1c d\u1ea1ng b\u00ecnh th\u01b0\u1eddng l\u00e0 85 &#8211; 90 \u0111\u1ed9. N\u1ebfu b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 d\u1ea1ng h\u01a1n 105 \u0111\u1ed9 l\u00e0 c\u00f3 t\u0103ng t\u00ednh l\u1ecfng bao kh\u1edbp trong khi nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng e s\u1ee3 g\u1ee3i \u00fd ch\u1ea9n \u0111o\u00e1n m\u1ea5t v\u1eefng\u00a0 <b><\/b><\/span><span style=\"font-weight: 400;\">ph\u00eda d\u01b0\u1edbi.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Nghi\u1ec7m ph\u00e1p n\u00e0y th\u01b0\u1eddng d\u01b0\u01a1ng t\u00ednh \u1edf b\u1ec7nh nh\u00e2n m\u1ea5t v\u1eefng \u0111a h\u01b0\u1edbng, b\u1ec7nh nh\u00e2n \u0111\u00e3 t\u1eebng \u0111i\u1ec1u tr\u1ecb kh\u00e2u l\u1ea1i bao kh\u1edbp ph\u00eda tr\u01b0\u1edbc &#8211; d\u01b0\u1edbi (d\u01b0\u01a1ng t\u00ednh kho\u1ea3ng 85%) v\u00e0 khuy\u00ean n\u00ean th\u1ef1c hi\u1ec7n cho t\u1ea5t c\u00e1.<\/span><\/p>\n<figure id=\"attachment_19072\" aria-describedby=\"caption-attachment-19072\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-19072\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-07.07.38-300x221.png\" alt=\"Nghi\u1ec7m ph\u00e1p qu\u00e1 gi\u1ecdng (Gagey Hyperabduction Test)\" width=\"300\" height=\"221\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-07.07.38-300x221.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-07.07.38.png 682w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-19072\" class=\"wp-caption-text\">Nghi\u1ec7m ph\u00e1p qu\u00e1 gi\u1ecdng (Gagey Hyperabduction Test)<\/figcaption><\/figure>\n<p><strong>2.5 Nghi\u1ec7m ph\u00e1p ki\u1ec3m tra tr\u1eadt kh\u1edbp vai ra tr\u01b0\u1edbc<\/strong><\/p>\n<p><strong>2.5.1 Nghi\u1ec7m ph\u00e1p e s\u1ee3 (Apprehension Test)<\/strong><\/p>\n<p><span style=\"font-weight: 400;\">Ban \u0111\u1ea7u \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 b\u1edfi Rowe and Zarins. B\u1ec7nh nh\u00e2n ng\u1ed3i ho\u1eb7c n\u1eb1m <\/span><span style=\"font-weight: 400;\">ng\u1eeda v\u1edbi ng\u01b0\u1eddi kh\u00e1m \u0111\u1ee9ng v\u1ec1 ph\u00eda vai c\u1ea7n th\u0103m kh\u00e1m. T\u1eeb v\u1ecb tr\u00ed c\u00e1nh tay d\u1ea1ng 90 \u0111\u1ed9 v\u00e0 xoay trung gian, kh\u1edbp vai \u0111\u01b0\u1ee3c xoay ngo\u00e0i cho \u0111\u1ebfn khi \u0111\u1ea1t gi\u1edbi h\u1ea1n t\u1ed1i \u0111a ho\u1eb7c b\u1ec7nh nh\u00e2n c\u1ea3m gi\u00e1c \u201ce s\u1ee3\u201d.<\/span><\/p>\n<figure id=\"attachment_19073\" aria-describedby=\"caption-attachment-19073\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-19073\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-07.09.56-300x232.png\" alt=\"Nghi\u1ec7m ph\u00e1p e s\u1ee3 (Apprehension Test)\" width=\"300\" height=\"232\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-07.09.56-300x232.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-07.09.56.png 626w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-19073\" class=\"wp-caption-text\">Nghi\u1ec7m ph\u00e1p e s\u1ee3 (Apprehension Test)<\/figcaption><\/figure>\n<p><strong>2.5.2 Nghi\u1ec7m ph\u00e1p n\u1eafm\u00a0tr\u1eadt (Relocation test)<\/strong><\/p>\n<p><span style=\"font-weight: 400;\">Nghi\u1ec7m ph\u00e1p n\u00e0y \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 b\u1edfi Jobe v\u00e0 c\u1ed9ng s\u1ef1. C\u00e1ch th\u1ef1c &#8211; hi\u00ean l\u01b0\u01a1ng t\u1ef1 \u201cnghi\u1ec7m ph\u00e1p e s\u1ee3\u201d nh\u01b0ng ng\u01b0\u1eddi kh\u00e1m d\u00f9ng l\u00f2ng b\u00e0n <\/span><span style=\"font-weight: 400;\">lay \u00e9p m\u1ed9t l\u1ef1c v\u1eeba ph\u1ea3i l\u00ean m\u1eb7t tr\u01b0\u1edbc kh\u1edbp vai b\u1ec7nh nh\u00e2n \u0111\u1ec3 lo\u1ea1i tr\u1eeb c\u1ea3m gi\u00e1c \u201ce s\u1ee3\u201d. <\/span><span style=\"font-weight: 400;\">\u201cN\u1eafn tr\u1eadt\u201d v\u00e0 \u201ce s\u1ee3\u201d l\u00e0 hai nghi\u1ec7m ph\u00e1p<\/span><\/p>\n<p><span style=\"font-weight: 400;\">h\u1ed7 tr\u1ee3 nhau trong ch\u1ea9n \u0111o\u00e1n.<\/span><\/p>\n<figure id=\"attachment_19074\" aria-describedby=\"caption-attachment-19074\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-19074\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-07.11.33-300x219.png\" alt=\"Nghi\u1ec7m ph\u00e1p n\u1eafm\u00a0tr\u1eadt (Relocation test)\" width=\"300\" height=\"219\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-07.11.33-300x219.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-07.11.33.png 640w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-19074\" class=\"wp-caption-text\">Nghi\u1ec7m ph\u00e1p n\u1eafm\u00a0tr\u1eadt (Relocation test)<\/figcaption><\/figure>\n<p><strong>2.5.3 Nghi\u1ec7m ph\u00e1p \u0111\u00f2n b\u1ea9y<\/strong><\/p>\n<figure id=\"attachment_19075\" aria-describedby=\"caption-attachment-19075\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-19075\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-07.15.02-300x222.png\" alt=\"Nghi\u1ec7m ph\u00e1p \u0111\u00f2n b\u1ea9y\u00a0\" width=\"300\" height=\"222\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-07.15.02-300x222.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-07.15.02.png 616w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-19075\" class=\"wp-caption-text\">Nghi\u1ec7m ph\u00e1p \u0111\u00f2n b\u1ea9y<\/figcaption><\/figure>\n<p><span style=\"font-weight: 400;\">B\u1ec7nh nh\u00e2n n\u1eb1m ng\u1eefa, kh\u1edbp vai \u1edf xa m\u00e9p c\u1ee7a b\u00e0n kh\u00e1m, c\u00e1nh tay d\u1ea1ng 90 \u0111\u1ed9. Ng\u01b0\u1eddi kh\u00e1m \u0111\u1ee9ng v\u1ec1 p<\/span><span style=\"font-weight: 400;\">h\u00eda vai c\u1ea9n th\u0103m kh\u00e1m, m\u1ed9t tay \u0111\u1eb7t m\u1eb7t sau vai b\u1ec7nh nh\u00e2n l\u00e0m \u0111i\u1ec3m <i>(Fulcrum test) <\/i><\/span><span style=\"font-weight: 400;\">t\u1ef1a trong khi tay c\u00f2n l\u1ea1i nh\u1eb9 nh\u00e0ng <b><\/b><\/span><span style=\"font-weight: 400;\">m\u1edf r\u1ed9ng v\u00e0 xoay ngo\u00e0i tay b\u1ec7nh nh\u00e2n. Nghi\u1ec7m ph\u00e1p d\u01b0\u01a1ng t\u00ednh n\u1ebfu <\/span><span style=\"font-weight: 400;\">b\u1ec7nh nh\u00e2n \u201ce s\u1ee3\u2019 tr\u1eadt kh\u1edbp,<\/span><\/p>\n<p><span style=\"font-weight: 400;\">C\u00e1c nghi\u00ean c\u1ee9u cho th\u1ea5y t\u00ednh \u0111\u1eb7c hi\u1ec7u \u201cApprehension Tests\u201d, \u201cRelocation test\u201d tr\u00ean 90%. \u0110\u1ed9 nh\u1ea1y c\u1ee7a t\u1ea5t c\u1ea3 c\u00e1c nghi\u1ec7m ph\u00e1p n\u00e0y \u0111ao \u0111\u1ed9ng t\u1eeb kho\u1ea3ng 50% \u0111\u1ebfn 70%.<\/span><\/p>\n<p><strong>2.6 Nghi\u1ec7m ph\u00e1p ki\u1ec3m tra tr\u1eadt kh\u1edbp vai ra sau<\/strong><\/p>\n<p><span style=\"font-weight: 400;\">Kh\u00e1m, \u0111\u00e1nh gi\u00e1 t\u1ed1t nh\u1ea5t t\u01b0 th\u1ebf b\u1ec7nh nh\u00e2n l\u00e0 ng\u1ed3i ho\u1eb7c \u0111\u1ee9ng \u0111\u1ec3 d\u1ec5 d\u00e0ng h\u00ecnh dung h\u1ec7 th\u1ed1ng c\u01a1 ph\u00eda sau v\u00e0 \u0111\u01b0\u1eddng vi\u1ec1n x\u01b0\u01a1ng. <b><\/b><\/span><span style=\"font-weight: 400;\">B\u1ec7nh nh\u00e2n b\u1ecb tr\u1eadt kh\u1edbp ra sau n\u1eb7ng th\u00ec v\u1edbi \u0111\u1ed9ng t\u00e1c kh\u00e9p v\u00e0 xoay trong c\u00f3 th\u1ec3 x\u1ea3y ra tr\u1eadt kh\u1edbp v\u00e0 v\u1ecb tr\u00ed \u201ce s\u1ee3\u201d.<\/span><\/p>\n<p><strong>Jerk test<\/strong><\/p>\n<figure id=\"attachment_19076\" aria-describedby=\"caption-attachment-19076\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-19076\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-07.17.23-300x230.png\" alt=\"Jerk test\" width=\"300\" height=\"230\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-07.17.23-300x230.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-07.17.23.png 622w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-19076\" class=\"wp-caption-text\">Jerk test<\/figcaption><\/figure>\n<ul>\n<li><span style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">B\u1ec7nh nh\u00e2n t\u01b0 th\u1ebf ng\u1ed3i, c\u00e1nh tay n\u00e2ng l\u00ean 90 \u0111\u1ed9 v\u00e0 xoay trong, m\u1ed9t t\u1ea3i tr\u1ecdng tr\u1ee5c \u0111\u01b0\u1ee3c \u0111\u1eadt sao cho \u0111\u1ea7u tr\u00ean x\u01b0\u01a1ng c\u00e1nh tay \u00e9p s\u00e1t v\u00e0o \u00f4 ch\u1ea3o v\u00e0 x\u01b0\u01a1ng vai \u0111\u01b0\u1ee3c \u1ed5n \u0111\u1ecbnh <\/span><\/span>b\u1eb1ng tay kia c\u1ee7a ng\u01b0\u1eddi kh\u00e1m. Sau \u0111\u00f3 d\u1ea7n d\u1ea7n kh\u00e9p kh\u1edbp vai, \u0111\u1ea7u tr\u00ean x\u01b0\u01a1ng c\u00e1nh tay c\u00f3 th\u1ec3 b\u00e1n tr\u1eadt ho\u1eb7c th\u1eadm ch\u00ed tr\u1eadt ra sau v\u00e0 t\u1ea1o m\u1ed9t c\u00fa gi\u1eadt b\u1ea5t ng\u1edd. Khi kh\u1edbp vai tr\u1edf v\u1ec1 l\u1ea1i t\u01b0 th\u1ebf ban \u0111\u1ea7u c\u1ee7a n\u00f3, \u0111\u1ea7u tr\u00ean x\u01b0\u01a1ng c\u00e1nh tay s\u1ebd \u0111\u1ed9t ng\u1ed9t tr\u1edf l\u1ea1i \u1ed1 ch\u1ea3o v\u00e0 t\u1ea1o m\u1ed9t c\u00fa gi\u1eadt kh\u00e1c. Nghi\u1ec7m ph\u00e1p n\u00e0y kh\u00f3 th\u1ef1c hi\u1ec7n n\u1ebfu b\u1ec7nh nh\u00e2n kh\u00f4ng ho\u00e0n to\u00e0n th\u01b0 gi\u00e3n.<\/li>\n<\/ul>\n<p><b>2.7 Nghi\u1ec7m ph\u00e1p ki\u1ec3m tra tr\u1eadt \u0111a h\u01b0\u1edbng<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Kh\u00f4ng c\u00f3 m\u1ed9t nghi\u1ec7m ph\u00e1p ki\u1ec3m tra \u0111\u1eb7c bi\u1ec7t \u0111\u1edbi v\u1edbi tr\u1eadt kh\u1edbp vai \u0111a h\u01b0\u1edbng. Nh\u01b0ng c\u00f3 m\u1ed9t s\u1ed1 v\u1ea5n \u0111\u1ec1 c\u1ea7n l\u01b0u \u00fd \u0111\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n tr\u1eadt kh\u1edbp vai \u0111a h\u01b0\u1edbng:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">B\u1ec7nh nh\u00e2n h\u1ea7u nh\u01b0 lu\u00f4n bi\u1ec3u hi\u1ec7n d\u1ea5u hi\u1ec7u vai b\u1ecb k\u00e9o \u0111\u00e0i ra, ho\u1eb7c \u0111\u00f4i khi vai \u0111\u01b0\u1ee3c h\u1ed7 tr\u1ee3 b\u1edfi m\u1ed9t \u0111ai c\u1ed1 \u0111\u1ecbnh vai.<\/span><\/li>\n<\/ul>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">R\u1ed1i lo\u1ea1n v\u1eadn \u0111\u1ed9ng x\u01b0\u01a1ng vai c\u00f3 th\u1ec3 l\u00e0 nguy\u00ean nh\u00e2n ho\u1eb7c k\u1ebft qu\u1ea3 c\u1ee7a tr\u1eadt kh\u1edbp \u0111a h\u01b0\u1edbng.<\/span><\/li>\n<\/ul>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">D\u1ea5u hi\u1ec7u l\u1ecfng kh\u1edbp to\u00e0n th\u00e2n<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Ki\u1ec3m tra g\u1ea5p, d\u1ea1ng, xoay trong v\u00e0 <\/span><\/span><span style=\"font-weight: 400;\">xoay ngo\u00e0i c\u1ee7a kh\u1edbp vai v\u1edbi c\u00e1nh tay c\u1ea1nh th\u00e2n m\u00ecnh, v\u00e0 v\u1edbi vai d\u1ea1ng 90 \u0111\u1ed9. So s\u00e1nh v\u1edbi vai b\u00ean c\u1ea1nh. <\/span><span style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Nh\u01b0 \u0111\u00e3 n\u00eau \u1edf tr\u00ean, tr\u1eadt kh\u1edbp xu\u1ed1ng d\u01b0\u1edbi th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn tr\u1eadt kh\u1edbp \u0111a h\u01b0\u1edbng n\u00ean c\u00f3 <\/span><\/span>th\u1ec3 s\u1eed d\u1ee5ng c\u00e1c nghi\u1ec7m ph\u00e1p ki\u1ebfm tra l\u1ecfng bao kh\u1edbp ph\u00eda d\u01b0\u1edbi nh\u01b0: Sulcus Test, Gagcy Hyperabduction Test \u0111\u1ebf \u0111\u00e1nh gi\u00e1. B\u1ec7nh nh\u00e2n ng\u1ed3i, ng\u01b0\u1eddi kh\u00e1m \u0111\u1eb7t m\u1ed9t tay l\u00ean \u0111\u1ea7u g\u1ea7n x\u01b0\u01a1ng c\u00e1nh tay v\u00e0 tay c\u00f2n l\u1ea1i nam khu\u1ef7u. \u00c1p d\u1ee5ng m\u1ed9t t\u1ea3i l\u00ean ph\u00eda tr\u01b0\u1edbc &#8211; ph\u00eda sau &#8211; ph\u00eda d\u01b0\u1edbi. Th\u1ef1c hi\u1ec7n xoay quanh tr\u1ee5c c\u1ecf th\u1ec3 ch\u1ee9ng minh s\u1ef1 b\u1ea5t \u1ed5n. L\u01b0u \u00fd m\u1ee9c \u0111\u1ed9 chuy\u1ec3n \u0111\u1ed9ng c\u1ee7a vai theo t\u1eebng h\u01b0\u1edbng.<\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Kh\u00e1m \u0111\u00e1nh gi\u00e1 ch\u00f3p xoay: h\u1ea7u h\u1ebft b\u1ec7nh nh\u00e2n tr\u1eadt kh\u1edbp vai \u0111a h\u01b0\u1edbng ch\u00f3p xoay b\u1ecb\u00a0<\/span><span style=\"font-weight: 400;\">k\u00edch th\u00edch l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y \u0111au vi n\u00f3 b\u00f9 \u0111\u1eafp cho s\u1ef1 l\u1ecfng l\u1ebbo c\u1ee7a bao kh\u1edbp.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Kh\u00e1m \u0111\u00e1nh gi\u00e1 v\u1eadn \u0111\u1ed9ng c\u1ed9t s\u1ed1ng c\u1ed5 \u0111\u1ebf x\u00e1c \u0111\u1ecbnh xem c\u1ecf d\u1ea5u hi\u1ec7u c\u1ee7a ch\u00e8n \u00e9p r\u1ed7 th\u1ea7n kinh kh\u00f4ng?<\/span><\/li>\n<\/ul>\n<p>\u0110\u1ec3 \u0111\u1eb7t l\u1ecbch kh\u00e1m t\u1ea1i vi\u1ec7n, Qu\u00fd kh\u00e1ch vui l\u00f2ng b\u1ea5m s\u1ed1\u00a0<b class=\"link-in-body\">HOTLINE<\/b>\u00a0ho\u1eb7c \u0111\u1eb7t l\u1ecbch tr\u1ef1c ti\u1ebfp\u00a0<b class=\"link-in-body\">T\u1ea0I \u0110\u00c2Y<\/b>. 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<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tr\u1eadt kh\u1edbp vai l\u00e0 s\u1ef1 m\u1ea5t ti\u1ebfp x\u00fac c\u1ee7a di\u1ec7n kh\u1edbp \u1ed5 ch\u1ea3o v\u00e0 ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay. Tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n l\u00e0 t\u00ecnh tr\u1ea1ng tr\u1eadt kh\u1edbp vai t\u1eeb l\u1ea7n 2 tr\u1edf l\u00ean (th\u01b0\u1eddng tr\u00ean 10 l\u1ea7n), sau b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 t\u1ef1 n\u1eafn \u0111\u01b0\u1ee3c. Nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n [&hellip;]<\/p>\n","protected":false},"author":49,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[75,40],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>L\u00e2m s\u00e0ng v\u00e0 nghi\u1ec7m ph\u00e1p ch\u1ea9n \u0111o\u00e1n tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n<\/title>\n<meta name=\"description\" content=\"Nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n th\u00ec kh\u00f4ng c\u00f2n nh\u1eefng tri\u1ec7u ch\u1ee9ng c\u1ee7a tr\u1eadt kh\u1edbp vai c\u1ea5p t\u00ednh n\u1eefa v\u00e0 c\u00f3 nhi\u1ec1u nghi\u1ec7p ph\u00e1p \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" 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tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n th\u00ec kh\u00f4ng c\u00f2n nh\u1eefng tri\u1ec7u ch\u1ee9ng c\u1ee7a tr\u1eadt kh\u1edbp vai c\u1ea5p t\u00ednh n\u1eefa v\u00e0 c\u00f3 nhi\u1ec1u nghi\u1ec7p ph\u00e1p \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n","og_url":"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/12\/chan-doan-lam-sang-va-cac-nghiep-phap-chan-doa-trat-khop-vai-tai-dien\/","og_site_name":"Vinmec","article_published_time":"2023-04-12T00:35:02+00:00","article_modified_time":"2023-04-14T11:23:26+00:00","og_image":[{"url":"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-06.59.41-300x103.png"}],"author":"Yen Cao Thi","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Yen Cao Thi","Est. reading time":"13 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