{"id":21748,"date":"2023-04-15T22:23:11","date_gmt":"2023-04-15T15:23:11","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=21748"},"modified":"2023-04-17T16:52:56","modified_gmt":"2023-04-17T09:52:56","slug":"thay-khop-vai-dao-nguoc-ky-thuat-va-bien-chung","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/thay-khop-vai-dao-nguoc-ky-thuat-va-bien-chung\/","title":{"rendered":"Thay kh\u1edbp vai \u0111\u1ea3o ng\u01b0\u1ee3c: k\u1ef9 thu\u1eadt v\u00e0 bi\u1ebfn ch\u1ee9ng"},"content":{"rendered":"

Thay kh\u1edbp vai \u0111\u1ea3o ng\u01b0\u1ee3c hay thay kh\u1edbp vai to\u00e0n ph\u1ea7n \u0111\u1ea3o ng\u01b0\u1ee3c xu\u1ea5t hi\u1ec7n t\u1eeb n\u0103m 1970 v\u00e0 b\u1eaft \u0111\u1ea7u tr\u1edf n\u00ean ph\u1ed5 bi\u1ebfn v\u00e0o nh\u1eefng n\u0103m 1990. Kh\u00e1c v\u1edbi lo\u1ea1i kh\u1edbp vai to\u00e0n ph\u1ea7n truy\u1ec1n th\u1ed1ng, kh\u1edbp vai \u0111\u1ea3o ng\u01b0\u1ee3c thay \u0111\u1ed5i vai tr\u00f2 c\u1ee7a hai th\u00e0nh ph\u1ea7n kh\u1edbp nh\u00e2n t\u1ea1o: ph\u1ea7n \u1ed5 ch\u1ea3o c\u00f3 d\u1ea1ng ch\u1ecfm c\u1ea7u trong khi ph\u1ea7n x\u01b0\u01a1ng c\u00e1nh tay c\u00f3 d\u1ea1ng m\u1eb7t \u0111\u0129a l\u00f5m \u00f4m l\u1ea5y ph\u1ea7n ch\u1ecfm c\u1ea7u c\u1ee7a \u1ed5 ch\u1ea3o. <\/strong>Th\u00f4ng qua b\u00e0i vi\u1ebft, ch\u00fang t\u00f4i s\u1ebd tr\u00ecnh b\u00e0y v\u1ec1 k\u1ef9 thu\u1eadt v\u00e0 bi\u1ebfn ch\u1ee9ng c\u1ee7a thay kh\u1edbp vai \u0111\u1ea3o ng\u01b0\u1ee3c.<\/strong><\/b><\/p>\n

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

Ng\u00e0y ph\u00e1t h\u00e0nh<\/strong>: 30\/03\/2022<\/p>\n

1. K\u1ef9 thu\u1eadt thay kh\u1edbp vai \u0111\u1ea3o ng\u01b0\u1ee3c<\/h2>\n

1.1 Chu\u1ea9n b\u1ecb b\u1ec7nh nh\u00e2n<\/b><\/p>\n

    \n
  • T\u01b0 th\u1ebf b\u1ec7nh nh\u00e2n<\/i><\/b><\/li>\n<\/ul>\n

    T\u01b0 th\u1ebf th\u00edch h\u1ee3p nh\u1ea5t cho thay kh\u1edbp vai \u0111\u1ea3o ng\u01b0\u1ee3c l\u00e0 t\u01b0 th\u1ec3 \u201cbeach chair\u201d, v\u1edbi ph\u1ea7n tr\u00ean c\u1ee7a c\u01a1 th\u1ec3 g\u1eadp l\u00ean m\u1ed9t g\u00f3c kho\u00e1ng 60\u00b0 so v\u1edbi m\u1eb7t phang ngang. C\u00e1nh tay robot c\u00f3 th\u1ebf \u0111\u01b0\u1ee3c s\u1eed \u0111\u1ee5ng \u0111\u1ebf h\u1ed7 tr\u1ee3 c\u1ed1 \u0111\u1ecbnh t\u01b0 th\u1ebf tay b\u1ec7nh nh\u00e2n. M\u00e0n hu\u1ef3nh quang t\u0103ng s\u00e1ng C-arm c\u0169ng n\u00ean \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong m\u00f4 \u0111\u00ea ki\u00eam tra v\u1ecb tr\u00ed kh\u1edbp nh\u00e2n t\u1ea1o. C-arm \u0111\u01b0\u1ee3c \u0111\u1eb7t \u1edf c\u00f9ng ph\u00eda b\u00ean vai ph\u1eabu thu\u1eadt.<\/span><\/p>\n

    \"T\u01b0
    T\u01b0 th\u1ebf \u201cbeach chair\u201d trong thay kh\u1edbp vai \u0111\u1ea3o ng\u01b0\u1ee3c<\/figcaption><\/figure>\n
      \n
    • V\u00f4 c\u1ea3m<\/i><\/b><\/li>\n<\/ul>\n

      G\u00e0y m\u00ea to\u00e0n th\u00e2n l\u00e0 t\u1ed1t nh\u00e1t, c\u00f3 th\u1ec3 g\u1eaby t\u00ea v\u00f9ng.<\/span><\/p>\n

      1.2 C\u00e1c th\u00ec c\u1ee7a ph\u1eabu thu\u1eadt<\/strong><\/p>\n

      1.2.1 \u0110\u01b0\u1eddng m\u1ed5<\/b><\/p>\n

      \u0110\u01b0\u1eddng Delta-ng\u1ef1c<\/strong> (d\u01b0\u1edbi \u0111\u00e2y nh\u00f3m t\u00e1c gi\u1ea3 s\u1ebd tr\u00ecnh b\u00e0y k\u1ef9\u00a0 <\/span>thu\u1eadt mo theo \u0111\u01b0\u1eddng Delta-ng\u1ef1c)<\/span><\/p>\n

      \u0110\u01b0\u1eddng Delta ng\u1ef1c hay \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u1ea5t, cho c\u1ea3 thay kh\u1edbp vai gi\u1ea3i ph\u1eabu v\u00e0 kh\u1edbp vai \u0111\u1ea3o ng\u01b0\u1ee3c. \u0110\u01b0\u1eddng m\u1ed5 xu\u1ea5t ph\u00e1t t\u1eeb m\u1ecfm qu\u1ea1, \u0111i xu\u1ed1ng theo r\u00e3nh delta ng\u1ef1c. \u0110\u01b0\u1eddng r\u1ea1ch da th\u01b0\u1eddng k\u00e9o d\u00e0i kho\u1ea3ng 10-15 cm, thay \u0111\u00f4i tu\u1ef3 thu\u1ed9c t\u1eebng tr\u01b0\u1eddng h\u1ee3p c\u1ee5 th\u1ec3<\/span><\/p>\n

      \"\u0110\u01b0\u1eddng
      \u0110\u01b0\u1eddng m\u1ed5 Delta-ng\u1ef1c v\u00e0o kh\u1edbp vai<\/figcaption><\/figure>\n

      \u0110\u01b0\u1eddng tr\u00ean – ngo\u00e0i hay \u0111\u01b0\u1eddng xuy\u00ean C\u01a1 Delta <\/strong><\/p>\n

      Uu \u0111i\u1ec3m c\u1ee7a \u0111\u01b0\u1eddng m\u1ed5 n\u00e0y l\u00e0 kh\u00f4ng ph\u1ea3i c\u00e1t c\u01a1 d\u01b0\u1edbi vai, do \u0111\u00f3 gi\u1ea3m nguy c\u01a1 tr\u1eadt vai. \u0110\u01b0\u1eddng m\u1ed5 xu\u1ea5t ph\u00e1t t\u1eeb kh\u1edbp c\u00f9ng \u0111\u00f2n, \u0111i ra ngo\u00e0i v\u00e0 xu\u1ed1ng d\u01b0\u1edbi d\u1ecdc theo tr\u1ee5c c\u1ee7a c\u00e1nh tay. \u0110i\u00eam cu\u1ed1i c\u1ee7a \u0111\u01b0\u1eddng r\u1ea1ch da kh\u00f4ng n\u00ean c\u00e1ch b\u1edd ngo\u00e0i m\u1ecfm c\u00f9ng vai qu\u00e1 5 cm \u0111\u1ec3 tr\u00e1nh l\u00e0m t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh n\u00e1ch<\/span><\/p>\n

      \"\u0110\u01b0\u1eddng
      \u0110\u01b0\u1eddng m\u1ed5 tr\u00ean – ngo\u00e0i v\u00e0o kh\u1edbp vai<\/figcaption><\/figure>\n

      Kh\u1edbp vai<\/strong><\/p>\n

      T\u00e1ch da theo r\u00e3nh Delta ng\u1ef1c, t\u00ecm v\u00e0 b\u1ed9c l\u1ed9 t\u0129nh m\u1ea1ch \u0111\u1ea7u. T\u0129nh m\u1ea1ch \u0111\u1ea7u nam gi\u1eefa ranh gi\u1edbi c\u1ee7a c\u01a1 Delta v\u00e0 c\u01a1 ng\u1ef1c l\u1edbn. D\u1ef1a v\u00e0o t\u0129nh m\u1ea1ch n\u00e0y \u0111\u1ec3 b\u00f3c t\u00e1ch c\u01a1 ng\u1ef1c l\u1edbn v\u00e0o trong, c\u01a1 delta ra ngo\u00e0i. T\u0129nh m\u1ea1ch \u0111\u1ea7u n\u00ean \u0111\u01b0\u1ee3c v\u00e9n ra ngo\u00e0i, v\u00ec ph\u1ea7n l\u1edbn c\u00e1c nh\u00e1nh c\u1ee7a n\u00f3 n\u1eb1m v\u1ec1 ph\u00eda c\u01a1 Delta<\/span><\/p>\n

      \"X\u00e1c
      X\u00e1c \u0111\u1ecbnh r\u00e3nh Delta ng\u1ef1c v\u00e0 t\u0129nh m\u1ea1ch \u0111\u1ea7u<\/figcaption><\/figure>\n

      Sau khi b\u1ed9c l\u1ed9 \u0111\u01b0\u1ee3c khoang gian c\u01a1 Delta-ng\u1ef1c, x\u00e1c \u0111\u1ecbnh \u0111i\u1ec3m b\u00e1m c\u1ee7a c\u01a1 ng\u1ef1c l\u1edbn. H\u1ea1 1-2 cm ph\u1ea7n tr\u00ean c\u1ee7a \u0111i\u1ec3m b\u00e1m c\u01a1 ng\u1ef1c l\u1edbn, b\u1ed9c l\u1ed9 b\u1edd d\u01b0\u1edbi c\u1ee7a g\u00e2n c\u01a1 d\u01b0\u1edbi vai<\/span><\/p>\n

      \"X\u00e1c
      X\u00e1c \u0111\u1ecbnh v\u00e0 h\u1ea1 ph\u1ea7n tr\u00ean c\u1ee7a di\u1ec7n b\u00e1m c\u01a1 ng\u1ef1c l\u1edfn<\/figcaption><\/figure>\n

      B\u1ed9c l\u1ed9 m\u1ecfm qu\u1ea1 b\u1eb1ng c\u00e1ch l\u1ea7n theo g\u00e2n k\u1ebft h\u1ee3p (\u0111\u1ea7u ng\u1eafn g\u00e2n nh\u1ecb \u0111\u1ea7u v\u00e0 g\u00e2n c\u01a1 qu\u1ea1 c\u00e1nh tay). Gi\u1ea1ng v\u00e0 xoay ngo\u00e0i vai, x\u00e1c \u0111\u1ecbnh g\u00f3c gi\u1eefa d\u00e2y ch\u1eb3ng qu\u1ea1-c\u00f9ng vai v\u00e0 g\u00e2n k\u1ebft h\u1ee3p, c\u1eaft d\u00e2y ch\u1eb1ng qu\u1ea1-c\u00f9ng vai.<\/span><\/p>\n

      \"B\u1ed9c
      B\u1ed9c l\u1ed9 v\u00e0 c\u1ea5t d\u00e2y ch\u1eb1ng qu\u1ea1 c\u00f9ng vai<\/figcaption><\/figure>\n

      Tr\u00e1i v\u1edbi <\/span>trong thay kh\u1edbp vai ki\u1ec3u gi\u1ea3i ph\u1eabu th\u00ec d\u00e2y ch\u00e0ng qu\u1ea1-c\u00f9ng vai \u0111\u01b0\u1ee3c b\u1ea3o t\u1ed3n, n\u00f3 l\u00e0 m\u1ed9t trong c\u00e1c y\u1ebfu t\u1ed5 l\u00e0m v\u1eefng kh\u1edbp vai. Trong thay kh\u1edbp vai \u0111\u1ea3o ng\u01b0\u1ee3c, th\u00e0nh ph\u1ea7n n\u00e0y kh\u00f4ng c\u1ea7n thi\u1ebft.<\/p>\n

      Ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay th\u01b0\u1eddng c\u00f3 th\u1ec1 \u0111\u01b0\u1ee3c b\u1ed9 l\u1ed9 d\u1ec5 d\u00e0ng qua ph\u1ea7n ch\u00f3p xoay b\u1ecb t\u1ed5n th\u01b0\u01a1ng<\/span><\/p>\n

      \"Ch\u1ecfm
      Ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay \u0111\u01b0\u1ee3c b\u1ed9c l\u1ed9 qua ph\u1ea7n ch\u00f3p xoay b\u1ecb t\u1ed5n th\u01b0\u01a1ng<\/figcaption><\/figure>\n

      Trong tr\u01b0\u1eddng h\u1ee3p c\u01a1 d\u01b0\u1edbi vai c\u00f2n nguy\u00ean v\u1eb9n, kh\u00f4ng g\u00e2n k\u1ebft h\u1ee3p v\u00e0o trong b\u1ed9c l\u1ed9 c\u01a1 d\u01b0\u1edbi vai, th\u1ef1c hi\u1ec7n kh\u00e2u v\u00e0 c\u1eaft g\u00e2n c\u01a1 d\u01b0\u1edbi vai nh\u01b0 trong k\u1ef3 thu\u1eadt thay kh\u1edbp vai to\u00e0n <\/span>ph\u1ea7n:<\/span><\/p>\n

      + D\u00f9ng 2 s\u1ee3i ch\u1ec9 ni lon 2-0 kh\u00e2u ngang g\u00e2n d\u01b0\u1edbi vai, ph\u00eda ngo\u00e0i \u0111o\u1ea1n chuy\u1ec3n ti\u1ebfp g\u00e2n c\u01a1 15mm.<\/span><\/p>\n

      + D\u00f9ng dao c\u1eaft ngang g\u00e2n d\u01b0\u1edbi vai v\u00e0 bao kh\u1edbp d\u1ecdc theo co gi\u1ea3i ph\u1eabu x\u01b0\u01a1ng c\u00e1nh tay<\/span><\/p>\n

      \"Kh\u00e2u
      Kh\u00e2u v\u00e0 c\u1eaft g\u00e2n d\u01b0\u1edbi vai<\/figcaption><\/figure>\n

      N\u1ebfu \u0111\u1ea7u d\u00e0i g\u00e2n nh\u1ecb \u0111\u1ea7u c\u00f2n 4.3. Chu\u1ea9n b\u1ecb ph\u1ea7n x\u01b0\u01a1ng c\u00e1nh tay nguy\u00ean v\u1eb9n, c\u00f3 2 l\u1ef1a ch\u1ecdn \u0111\u00f3 l\u00e0 lo\u1ea1i c\u00f3 xi-m\u0103ng c\u1eaft \u0111\u00e2u d\u00e0i g\u00e2n nh\u1ecb \u0111\u1ea7u ho\u1eb7c c\u1ea5t. \u0110\u00e1nh tr\u1eadt kh\u1edbp vai nh\u1eb9 nh\u00e0ng v\u00e0 kh\u00e2u \u0111\u00ednh v\u00e0o c\u01a1 d\u01b0\u1edbi vai.<\/span> b\u00e0ng c\u00e1ch xoay ngo\u00e0i c\u1ea3nh tay<\/span><\/p>\n

      \"\u0110\u00e1nh
      \u0110\u00e1nh tr\u1eadt v\u00e0 b\u1ed9c \u1ec9 \u1ed9 ch\u00f2m x\u01b0\u01a1ng c\u00e1nh tay<\/figcaption><\/figure>\n

      D\u00f9i \u1ed1ng tu\u1ef5: V\u1ecb tr\u00ed c\u1ee7a d\u00f9i th\u1eb3ng v\u1edbi tr\u1ee5c c\u1ee7a x\u01b0\u01a1ng c\u00e1nh tay (h\u01b0\u1edbng n\u1eb1m ph\u00eda sau 1 cm so v\u1edbi r\u00e3nh nh\u1ecb \u0111\u1ea7u). Trong tr\u01b0\u1eddng h\u1ee3p ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay b\u1ecb bi\u1ebfn d\u1ea1ng nhi\u1ec1u, r\u1ea5t kh\u00f3 \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh \u0111i\u1ec3m v\u00e0o. T\u1ed1t nh\u1ea5t n\u00ean d\u00f9ng C-arm \u0111\u1ec3 ki\u1ec3m tra v\u1ecb tr\u00ed v\u00e0o ph\u00f9 h\u1ee3p<\/p>\n

      \"D\u00f9i
      D\u00f9i \u1ed1ng tuy x\u01b0\u01a1ng c\u00e1nh tay<\/figcaption><\/figure>\n
        \n
      • \u0110\u1eb7t \u0111\u1ecbnh v\u1ecb c\u1eaft ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay: th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u0111\u1eb7t v\u1edbi g\u00f3c ng\u1ea3 sau t\u1eeb 0\u00b0 \u0111\u1ebfn 20\u00b0. G\u00f3c ng\u1ea3 sau 0\u00b0 (t\u01b0 th\u1ebf trung gian) c\u00f3 \u01b0u \u0111i\u1ebfm l\u00e0 \u00edt b\u1ecb c\u1ea5n khi xoay trong, tuy nhi\u00ean nh\u01b0\u1ee3c \u0111i\u1ec3m l\u00e0 \u0111\u01b0\u1eddng c\u1eaft kh\u00f4ng gi\u1ea3i ph\u1eabu trong tr\u01b0\u1eddng h\u1ee3p g\u00f3c ng\u1ea3 sau nguy\u00ean thu\u1ef7 c\u1ee7a ch\u1ecfm <\/span>x\u01b0\u01a1ng c\u00e1nh tay l\u1edbn. G\u00f3c ng\u1ea3 sau 20\u00b0 g\u1ea7n v\u1edbi gi\u1ea3i ph\u1eabu h\u01a1n, tuy nhi\u00ean c\u00f3 nh\u01b0\u1ee3c \u0111i\u1ec3m l\u00e0 th\u00e0nh ph\u1ea7n ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay d\u1ec1 b\u1ecb c\u1ea5n khi xoay trong. Do \u0111\u00f3, n\u00ean ch\u1ecdn g\u00f3c ng\u1ea3 sau kho\u1ea3ng 10\u00b0 \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c c\u1ea3 2 y\u00eau c\u1ea7u tr\u00ean.<\/li>\n<\/ul>\n
        \"Hi\u1ec7n
        Hi\u1ec7n t\u01b0\u1ee3ng c\u1ea5n c\u1ee7a th\u00e0nh ph\u1ea7n ch\u00f2m x\u01b0\u01a1ng c\u1ea3nh tay v\u1edbi \u1ed5 ch\u1ea3o khi xoay trong \u0111\u1ed5i v\u1edbi g\u00f3c ng\u1ea3 20\u00b0 c\u1ee7a \u0111\u01b0\u1eddng c\u1eaft ch\u1ecfm<\/figcaption><\/figure>\n

        Doa ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay: Th\u00f4ng th\u01b0\u1eddng c\u00f3 2 c\u1edd l\u00e0 36 mm v\u00e0 42 mm. C\u1ee1 nh\u1ecf gi\u00fap kh\u1edbp vai linh \u0111\u1ed9ng h\u01a1n, c\u00f2n c\u1ee1 to th\u00ec ch\u1ed5ng m\u1ea5t v\u1eebng t\u1ed1t hon. H\u01b0\u1edbng doa ch\u00f2m vu\u00f4ng g\u00f3c v\u1edbi <\/span>\u0111\u01b0\u1eddng c\u1eaft.<\/span><\/p>\n

        Doa h\u00e0nh x\u01b0\u01a1ng v\u00e0 th\u00e2n x\u01b0\u01a1ng: Doa th\u00e2n x\u01b0\u01a1ng c\u00e1nh tay v\u1edbi k\u00edch th\u01b0\u1edbc m\u0169i doa t\u0103ng d\u1ea7n cho \u0111\u1ebfn khi c\u1ea3m gi\u00e1c doa h\u1ebft l\u00f2ng tu\u1ef7, ch\u1ea1m th\u00e0nh x\u01b0\u01a1ng c\u1ee9ng<\/span><\/p>\n

        L\u1eafp chu\u00f4i th\u1eed: Sau khi doa \u1ed1ng tu\u00fd, l\u1eafp chu\u00f4i th\u1eed v\u00e0 \u0111\u00e1nh d\u1ea5u v\u1ecb tr\u00ed c\u1ee7a chu\u00f4i th\u1eed<\/span><\/p>\n

        \"L\u1eafp
        L\u1eafp chu\u00f4i th\u1eed v\u00e0 \u0111\u1ea3nh d\u1ea5u<\/figcaption><\/figure>\n

        L\u1eafp chu\u00f4i th\u1eadt: th\u01b0\u1eddng \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n sau khi l\u1eafp th\u00e0nh ph\u1ea7n \u1ed5 ch\u1ea3o, \u0111\u1ec3 vi\u1ec7c b\u1ed9c l\u1ed9 \u1ed1 ch\u1ea3o d\u1ec5 d\u00e0ng h\u01a1n. S\u1eed d\u1ee5ng ch\u1ed1t ch\u1eb7n xi m\u0103ng trong l\u00f2ng \u1ed1ng tu\u1ef7, c\u00e1ch \u0111i\u1ec3m d\u01b0\u1edbi c\u00f9ng c\u1ee7a chu\u00f4i kho\u1ea3ng 1 cm. N\u1ebfu g\u00e2n c\u01a1 <\/span>d\u01b0\u1edbi vai c\u00f2n nguy\u00ean v\u1eb9n, kh\u00e2u 1 <\/span>m\u0169i xuy\u00ean x\u01b0\u01a1ng v\u00e0o m\u00e2u \u0111\u1ed9ng b\u00e9 \u0111\u1ec3 ph\u1ee5c h\u1ed3i l\u1ea1i \u0111i\u1ec3m b\u00e1m g\u00e2n d\u01b0\u1edbi vai. B\u01a1m xi m\u0103ng v\u00e0 l\u00e1p chu\u00f4i th\u1eadt theo m\u1ed1c \u0111\u00e3 \u0111\u00e1nh d\u1ea5u<\/span><\/p>\n

        1.2.2 Chu\u1ea9n b\u1ecb \u1ed5 ch\u1ea3o<\/strong><\/p>\n

          \n
        • Sau khi chu\u1ea9n b\u1ecb xong ph\u1ea7n x\u01b0\u01a1ng c\u00e1nh tay, v\u00e9n \u0111\u1ea7u tr\u00ean x\u01b0\u01a1ng c\u00e1nh tay ra sau, b\u1ed9c l\u1ed9 o ch\u00e0o.<\/span><\/li>\n
        • \u0110\u1eb7t \u0111\u1ecbnh v\u1ecb th\u00e0nh ph\u1ea7n <\/span>0<\/span> ch\u1ea3o sao cho b\u1edd d\u01b0\u1edbi thanh \u0111\u1ecbnh v\u1ecb tr\u00f9ng <\/span><\/span>v\u1edbi b\u1edd d\u01b0\u1edbi \u1ed5 ch\u1ea3o. H\u01b0\u1edbng c\u1ee7a \u0111\u1ecbnh v\u1ecb n\u00ean nghi\u00eang xu\u1ed1ng d\u01b0\u1edbi 10\u00b0 \u0111\u1ec3 tr\u00e1nh hi\u1ec7n t\u01b0\u1ee3ng c\u1ea5n th\u00e0nh ph\u1ea7n x\u01b0\u01a1ng c\u00e1nh tay v\u00e0o b\u1edd d\u01b0\u1edbi \u1ed1 ch\u1ea3o.<\/li>\n
        • Khoan \u0111inh \u0111\u1ecbnh v\u1ecb v\u00e0o l\u1ed7 trung t\u00e2m v\u00e0 ti\u1ebfn h\u00e0nh doa \u1ed5 ch\u1ea3o. Ch\u1ec9 c\u1ea7n doa h\u1ebft l\u1edbp s\u1ee5n, tr\u00e1nh doa nhi\u1ec1u v\u00e0o ph\u1ea7n x\u01b0\u01a1ng x\u1ed1p<\/span><\/li>\n
        • \u0110\u1eb7t ch\u00e2n \u0111\u1ec3 th\u00e0nh ph\u1ea7n \u1ed5 ch\u1ea3o v\u00e0o v\u1ecb tr\u00ed, khoan b\u1eafn c\u00e1c v\u00edt c\u1ed1 \u0111\u1ecbnh<\/li>\n
        • Cu\u1ed1i c\u00f9ng, l\u1eafp m\u1eb7t c\u1ea7u \u1ed5 ch\u1ea3o v\u00e0 c\u1ed1 \u0111\u1ecbnh b\u1eb1ng b\u1eafn v\u00edt trung t\u00e2m<\/li>\n<\/ul>\n

          1.2.3 Th\u1eed v\u00e0 \u0111\u1eb7t l\u1ea1i kh\u1edbp vai<\/strong><\/p>\n

            \n
          • Sau khi l\u1eafp xong th\u00e0nh ph\u1ea7n m\u1eb7t c\u1ea7u \u1ed5 ch\u1ea3o, ti\u1ebfn h\u00e0nh l\u1eafp insert th\u1eed\u00a0<\/span><\/li>\n
          • K\u1ef9 thu\u1eadt \u0111\u1eb7t l\u1ea1i kh\u1edbp vai: k\u00e9o c\u00e1nh tay d\u1ecdc tr\u1ee5c, t\u1eeb t\u1eeb xoay trong v\u00e0 g\u1ea5p vai, C\u00f3 th\u1ebf d\u00f9ng m\u1ed9t ng\u00f3n tay \u0111\u1eb7t v\u00e0o m\u1eb7t insert \u0111\u1ec3 h\u01b0\u1edbng d\u1eabn v\u00e0o \u0111\u0169ng v\u1ecb tr\u00ed c\u1ee7a m\u1eb7t c\u1ea7u \u1ed1 ch\u1ea3o. Sau khi \u0111\u1eadt l\u1ea1i kh\u1edbp, <\/span>ki\u1ec3m tra t\u1ea7m v\u1eadn \u0111\u1ed9ng kh\u1edbp. Ki\u1ec3m tra kh\u1edbp ch\u1eb7t hay l\u1ecfng b\u1eb1ng test piston: test piston n\u00ean v\u00e0o kho\u1ea3ng 1-2 min, n\u1ebfu l\u1edbn h\u01a1n ch\u1ee9ng t\u1ecf kh\u1edbp qu\u00e1 l\u1ecfng, c\u00f2n b\u1eb1ng 0 th\u00ec kh\u1edbp qu\u00e1 ch\u1eb7t.<\/li>\n
          • Sau khi ki\u1ec3m tra insert th\u1eed \u0111\u1ea1t y\u00eau c\u1ea7u, l\u1eafp insert th\u1eadt v\u00e0 \u0111\u1eb7t l\u1ea1i kh\u1edbp vai. Kh\u00e2u l\u1ea1i g\u00e2n d\u01b0\u1edbi vai v\u00e0o m\u1ea5u \u0111\u1ed9ng b\u00e9 bang ch\u1ec9 kh\u00e2u xuy\u00ean <\/span><\/span>x\u01b0\u01a1ng \u0111\u00e3 chu\u1ea9n b\u1ecb t\u1eeb tr\u01b0\u1edbc.<\/li>\n
          • \u0110\u1eb7t d\u1eabn l\u01b0u v\u00e0 \u0111\u00f3ng v\u1ebft<\/span> m\u1ed5.<\/span> Cho <\/span><\/span>b\u1ec7nh nh\u00e2n \u0111eo t\u00fai treo tay ho\u1eb7c \u00e1o De Sault gi\u1ea1ng vai.<\/li>\n<\/ul>\n

            \u00a02. Bi\u1ebfn ch\u1ee9ng\u00a0<\/strong><\/h2>\n

            L\u1ecfng kh\u1edbp nh\u00e2n t\u1ea1o: C\u00f3 th\u1ec3 l\u1ecfng \u1edf<\/span> – <\/span>ph\u00eda x\u01b0\u01a1ng c\u00e1nh tay, ho\u1eb7c \u1edb ph\u00eda \u1ed5\u00a0ch\u1ea3o, c\u00f3 khi l\u1ecfng c\u1ea3 hai v\u1ecb tr\u00ed<\/p>\n

            Tr\u1eadt kh\u1edbp nh\u00e2n t\u1ea1o<\/span><\/p>\n

            G\u00e3y x\u01b0\u01a1ng quanh kh\u1edbp nh\u00e2n t\u1ea1o:<\/span><\/p>\n

              \n
            • C\u00f3 th\u1ec3 g\u1eaby trong qu\u00e1 tr\u00ecnh ph\u1eabu thu\u1eadt ho\u1eb7c sau ph\u1eabu thu\u1eadt<\/li>\n
            • T\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh<\/li>\n
            • Nhi\u1ec5m tr\u00f9ng lo\u1ea1n d\u01b0\u1ee1ng c\u01a1 Delta c\u1ee9ng kh\u1edbp vai<\/li>\n<\/ul>\n

              Thay kh\u1edbp vai \u0111\u1ea3o ng\u01b0\u1ee3c th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong tr\u01b0\u1eddng h\u1ee3p t\u1ed5n th\u01b0\u01a1ng kh\u1edbp vai c\u00f3 k\u00e8m theo t\u1ed1n th\u01b0\u01a1ng ch\u00f3p xoay kh\u00f4ng th\u1ec3 ph\u1ee5c h\u1ed3i. Nh\u1eed s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 c\u01a1 sinh h\u1ecdc, kh\u1edbp <\/span>vai \u0111\u1ea3o ng\u01b0\u1ee3c cho k\u1ebft qu\u1ea3 ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng t\u1ed1t h\u01a1n kh\u1edbp vai ki\u1ebfu gi\u1ea3i ph\u1eabu trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p m\u1ea5t ch\u1ee9c n\u0103ng ch\u00f3p xoay, tuy nhi\u00ean, t\u1ec9 l\u1ed9 bi\u1ebfn ch\u1ee9ng c\u00f3 th\u1ec3 x\u1ea3y ra trong v\u00e0 sau m\u1ed5 l\u1ea1i cao h\u01a1n.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

              Thay kh\u1edbp vai \u0111\u1ea3o ng\u01b0\u1ee3c hay thay kh\u1edbp vai to\u00e0n ph\u1ea7n \u0111\u1ea3o ng\u01b0\u1ee3c xu\u1ea5t hi\u1ec7n t\u1eeb n\u0103m 1970 v\u00e0 b\u1eaft \u0111\u1ea7u tr\u1edf n\u00ean ph\u1ed5 bi\u1ebfn v\u00e0o nh\u1eefng n\u0103m 1990. Kh\u00e1c v\u1edbi lo\u1ea1i kh\u1edbp vai to\u00e0n ph\u1ea7n truy\u1ec1n th\u1ed1ng, kh\u1edbp vai \u0111\u1ea3o ng\u01b0\u1ee3c thay \u0111\u1ed5i vai tr\u00f2 c\u1ee7a hai th\u00e0nh ph\u1ea7n kh\u1edbp nh\u00e2n t\u1ea1o: ph\u1ea7n \u1ed5 […]<\/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":"\nThay kh\u1edbp vai \u0111\u1ea3o ng\u01b0\u1ee3c: k\u1ef9 thu\u1eadt v\u00e0 bi\u1ebfn ch\u1ee9ng - Vinmec<\/title>\n<meta name=\"description\" content=\"M\u00f4 t\u1ea3 k\u1ef9 thu\u1eadt v\u00e0 bi\u1ebfn ch\u1ee9ng c\u1ee7a thay kh\u1edbp vai \u0111\u1ea3o ng\u01b0\u1ee3c. 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