{"id":2670,"date":"2023-04-09T19:29:23","date_gmt":"2023-04-09T12:29:23","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=2670"},"modified":"2023-04-14T14:46:50","modified_gmt":"2023-04-14T07:46:50","slug":"chan-doan-va-dieu-tri-trat-khop-cung-don","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/chan-doan-va-dieu-tri-trat-khop-cung-don\/","title":{"rendered":"Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb tr\u1eadt kh\u1edbp c\u00f9ng \u0111\u00f2n"},"content":{"rendered":"<p><strong>Tr\u1eadt kh\u1edbp c\u00f9ng \u0111\u00f2n chi\u1ebfm kho\u1ea3ng 9 &#8211; 10% ch\u1ea5n th\u01b0\u01a1ng c\u1ea5p t\u00ednh v\u00f9ng \u0111ai vai. <\/strong><strong>Th\u01b0\u1eddng x\u1ea3y ra \u1edf nh\u00f3m tr\u1ebb tu\u1ed5i (10 &#8211; \u00ad20 tu\u1ed5i) v\u00e0 li\u00ean quan \u0111\u1ebfn th\u1ec3 thao. <\/strong><strong>G\u1eb7p \u1edf nam nhi\u1ec1u h\u01a1n n\u1eef, (t\u1ec9 l\u1ec7 nam:n\u1eef kho\u1ea3ng 5:1).<\/strong><\/p>\n<p><strong>Nh\u00f3m t\u00e1c gi\u1ea3:<\/strong> PGS.TS. Tr\u1ea7n Trung D\u0169ng, TS. \u0110\u1ed7 V\u0103n Minh, ThS. L\u00ea Kh\u00e1ng Tr\u00ecnh, ThS. Nguy\u1ec5n Anh \u0110\u1ee9c, ThS. Nguy\u1ec5n Trung V\u0103n, ThS. Tr\u1ea7n \u0110\u1ee9c Tu\u1ea5n, Bs.CKII. V\u0169 Quang Ngh\u0129a<\/p>\n<h1>1. \u0110\u1ea1i c\u01b0\u01a1ng<\/h1>\n<h2>1.1 Gi\u1ea3i ph\u1eabu kh\u1edbp c\u00f9ng \u0111\u00f2n<\/h2>\n<ul>\n<li>Kh\u1edbp c\u00f9ng \u0111\u00f2n l\u00e0 m\u1ed9t kh\u1edbp \u0111\u1ed9ng gi\u1eefa \u0111\u1ea7u ngo\u00e0i x\u01b0\u01a1ng \u0111\u00f2n v\u00e0 m\u1eb7t trong m\u1ecfm c\u00f9ng vai, di\u1ec7n kh\u1edbp \u0111\u01b0\u1ee3c bao ph\u1ee7 b\u1edfi s\u1ee5n s\u1ee3i.<\/li>\n<li>M\u1eb7t phang kh\u1edbp r\u1ea5t thay \u0111\u1ed5i, c\u00f3 th\u1ec3 th\u1eb3ng \u0111\u1ee9ng ho\u1eb7c nghi\u00eang trong t\u1edbi 50\u00b0 (H\u00ecnh 6.1).<\/li>\n<\/ul>\n<p><figure id=\"attachment_2694\" aria-describedby=\"caption-attachment-2694\" style=\"width: 223px\" class=\"wp-caption alignnone\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-2694 \" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/6.1-110x300.jpg\" alt=\"minh-hoa-giai-phau-khop-cung-don\" width=\"223\" height=\"608\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/6.1-110x300.jpg 110w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/6.1.jpg 134w\" sizes=\"(max-width: 223px) 100vw, 223px\" \/><figcaption id=\"caption-attachment-2694\" class=\"wp-caption-text\">H\u00ecnh 6.1: \u0110u\u1eddng kh\u1edbp trong m\u1eb7t ph\u0103ng \u0111\u1ee9ng d\u1ecdc r\u1ea5t thay \u0111\u00f4i [3]<\/figcaption><\/figure>Bao kh\u1edbp c\u1ee7a kh\u1edbp c\u00f9ng \u0111\u00f2n r\u1ea5t m\u1ecfng, tuy nhi\u00ean n\u00f3 \u0111\u01b0\u1ee3c t\u0103ng c\u01b0\u1eddng b\u01a1i c\u00e1c d\u00e2y ch\u1eb1ng c\u00f9ng-\u0111\u00f2n tr\u01b0\u1edbc, sau, tr\u00ean v\u00e0 d\u01b0\u1edbi. C\u00e1c s\u1ee3i c\u1ee7a c\u01a1 delta v\u00e0 c\u01a1 thang ho\u00e0 l\u1eabn v\u00e0o ph\u1ea7n tr\u00ean d\u00e2y ch\u1eb1ng c\u00f9ng \u0111\u00f2n l\u00e0m t\u0103ng \u0111\u1ed9 v\u1eefng c\u1ee7a kh\u1edbp.<\/p>\n<p>Trong kh\u1edbp c\u00f3 m\u1ed9t \u0111\u0129a s\u1ee5n h\u00ecnh ch\u00eam. Ch\u1ee9c n\u0103ng c\u1ee7a \u0111\u0129a s\u1ee5n n\u00e0y ch\u01b0a r\u00f5, c\u00f3 th\u1ec3 vai tr\u00f2 n\u00f3 gi\u1ed1ng nh\u01b0 s\u1ee5n ch\u00eam c\u1ee7a kh\u1edbp g\u1ed1i. \u0110\u0129a s\u1ee5n n\u00e0y th\u01b0\u1eddng tho\u00e1i ho\u00e1 sau tu\u1ed5i 40. Theo chi\u1ec1u ngang kh\u1edbp \u0111\u01b0\u1ee3c \u1ed5n \u0111\u1ecbnh b\u1edfi d\u00e2y ch\u1eb1ng c\u00f9ng \u0111\u00f2n, trong khi theo chi\u1ec1u d\u1ecdc kh\u1edbp \u0111\u01b0\u1ee3c gi\u1eef b\u1edfi c\u00e1c \u0111\u00e2y ch\u1eb1ng qu\u1ea1 \u0111\u00f2n (d\u00e2y ch\u1eb1ng h\u00ecnh n\u00f3n \u1edf trong, d\u00e2y ch\u1eb1ng h\u00ecnh thang \u1edf ngo\u00e0i).<\/p>\n<ul>\n<li>Kho\u1ea3ng c\u00e1ch trung b\u00ecnh gi\u1eefa x\u01b0\u01a1ng \u0111\u00f2n v\u00e0 m\u1ecfm qu\u1ea1 kho\u1ea3ng 1,1 &#8211; 1,3 cm.<\/li>\n<\/ul>\n<h2>`1.2 C\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng<\/h2>\n<ul>\n<li>C\u01a1 ch\u1ebf tr\u1ef1c ti\u1ebfp: L\u00e0 c\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng ch\u1ee7 y\u1ec3u, do ng\u01b0\u1eddi b\u1ec7nh ng\u00e3 \u0111\u1eadp vai trong t\u01b0 th\u1ebf kh\u1edbp vai kh\u00e9p, l\u00e0m m\u1ecfm c\u00f9ng vai b\u1ecb \u0111\u1ea9y v\u00e0o trongv\u00e0 xu\u1ed1ng d\u01b0\u1edbi.<\/li>\n<li>C\u01a1 ch\u1ebf gi\u00e1n ti\u1ebfp: Ng\u01b0\u1eddi b\u1ec7nh ng\u00e0 ch\u1ed1ng tay khi\u1ebfn l\u1ef1c truy\u1ec1n d\u1ecdc theo tr\u1ee5c x\u01b0\u01a1ng c\u00e1nh tay \u0111\u1ebfn kh\u1edbp c\u00f9ng \u0111\u00f2n (H\u00ecnh 6.2).<\/li>\n<\/ul>\n<figure id=\"attachment_2695\" aria-describedby=\"caption-attachment-2695\" style=\"width: 379px\" class=\"wp-caption alignnone\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-2695 \" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/6.2-300x270.jpg\" alt=\"minh-hoa-trat-khop-cung-don\" width=\"379\" height=\"341\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/6.2-300x270.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/6.2.jpg 380w\" sizes=\"(max-width: 379px) 100vw, 379px\" \/><figcaption id=\"caption-attachment-2695\" class=\"wp-caption-text\">H\u00ecnh 6,2: C\u01a1 ch\u1ebf di l\u1ec7ch trong ch\u1ea9n th\u01b0\u01a1ng gi\u00e1n ti\u1ebfp [3]<\/figcaption><\/figure>\n<h2>1.3 Ch\u1ea5n th\u01b0\u01a1ng li\u00ean quan<\/h2>\n<ul>\n<li>G\u00e3y x\u01b0\u01a1ng: x\u01b0\u01a1ng \u0111\u00f2n, m\u1ecfm qu\u1ea1, m\u00f2m c\u00f9ng vai.<\/li>\n<li>T\u1ed5n th\u01b0\u01a1ng l\u1ed3ng ng\u1ef1c (trong tr\u1eadt kh\u1edbp c\u00f9ng \u0111\u00f2n 1 ype VI).<\/li>\n<\/ul>\n<h1>2. L\u00e2m s\u00e0ng tr\u1eadt kh\u1edbp c\u00f9ng \u0111\u00f2n<\/h1>\n<ul>\n<li>\u0110au v\u00e0 h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng kh\u1edbp vai.<\/li>\n<li>Vai b\u00ean ch\u1ea5n th\u01b0\u01a1ng s\u1ec7 xu\u1ed1ng, \u0111\u1ea7u ngo\u00e0i x\u01b0\u01a1ng \u0111\u00f2n nh\u00f4 l\u00ean kh\u1ecfi m\u1ecfm c\u00f9ng vai (H\u00ecnh 6.3).<\/li>\n<li>D\u1ea5u hi\u1ec7u ph\u00edm \u0111\u00e0n: d\u1ec5 d\u00e0ng \u1ea5n x\u01b0\u01a1ng \u0111\u00f2n v\u1ec1 v\u1ecb tr\u00ed ban \u0111\u1ea7u, nh\u01b0ng khi b\u1ecf tay ra , \u0111\u1ea7u ngo\u00e0i x\u01b0\u01a1ng \u0111\u00f2n l\u1ea1i nh\u00f4 l\u00ean.<\/li>\n<\/ul>\n<figure id=\"attachment_2696\" aria-describedby=\"caption-attachment-2696\" style=\"width: 368px\" class=\"wp-caption alignnone\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-2696 \" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/6.3.jpg\" alt=\"trat-khop-cung-don-type-III\" width=\"368\" height=\"344\" \/><figcaption id=\"caption-attachment-2696\" class=\"wp-caption-text\">H\u00ecnh 6.3: H\u00ecnh \u1ea3nh l\u00e2m s\u00e0ng c\u1ee7a b\u1ec7nh nh\u00e2n tr\u1eadt kh\u1edbp c\u00f9ng \u0111\u00f2n ph\u00e1i type III [3]<\/figcaption><\/figure>\n<h1>3. Ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh tr\u1eadt kh\u1edbp c\u00f9ng \u0111\u00f2n<\/h1>\n<ul>\n<li>C\u00e1c phim X-quang kh\u1edbp vai ti\u00eau &#8211; chu\u1ea9n l\u00e0 \u0111\u1ee7 \u0111\u1ec3 ch\u1ea5n \u0111o\u00e1n tr\u1eadt kh\u1edbp c\u00f9ng \u0111\u00f2n: (X-quang vai th\u1eafng, X-quang x\u01b0\u01a1ng ba vai ch\u1eef Y v\u00e0 X-quang n\u00e1ch).<\/li>\n<li>X-quang Zanca: T\u01b0\u01a1ng t\u1ef1 nh\u01b0 X-quang vai th\u1eb3ng, nh\u01b0ng \u0111\u1ea7u ph\u00e1t tia ch\u1ebfch 10\u00b0 v\u1ec1 ph\u00eda \u0111\u1ea7u. Phim n\u00e0y gi\u00fap quan s\u00e1t \u0111\u1ea7u kh\u1edbp c\u00f9ng \u0111\u00f2n t\u1ed1t h\u01a1n (H\u00ecnh 6.4).<\/li>\n<\/ul>\n<figure id=\"attachment_2697\" aria-describedby=\"caption-attachment-2697\" style=\"width: 615px\" class=\"wp-caption alignnone\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-2697 \" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/6.4-300x136.jpg\" alt=\"X-quang-trat-khop-cung-don\" width=\"615\" height=\"279\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/6.4-300x136.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/6.4.jpg 445w\" sizes=\"(max-width: 615px) 100vw, 615px\" \/><figcaption id=\"caption-attachment-2697\" class=\"wp-caption-text\">H\u00ecnh 6.4: X-quang Zanca (.A) gi\u00fap quan s\u00e1t kh\u1edbp c\u00f9ng \u0111\u00f2n t\u1ed1t h\u01a1n so v\u1edbi phim th\u1eb3ng (B)<\/figcaption><\/figure>\n<p>\u0110\u1ec3 \u0111\u00e1nh gi\u00e1 r\u00f5 h\u01a1n t\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng qu\u1ea1 \u0111\u00f2n, c\u00f3 th\u1ec3 ch\u1ee5p phim \u201cstress\u201d (x-quang th\u1eb3ng v\u1edbi tay deo t\u1ea1 4 &#8211; 6 kg v\u00e0 so s\u00e1nh 2 b\u00ean). Tuy nhi\u00ean vi\u1ec7c n\u00e0y th\u1ef1c t\u1ebf r\u1ea5t kh\u00f3 th\u1ef1c hi\u1ec7n trong tr\u01b0\u1eddng h\u1ee3p ch\u1ea5n th\u01b0\u01a1ng c\u1ea5p t\u00ednh.<\/p>\n<h1>4. Ph\u00e2n lo\u1ea1i tr\u1eadt kh\u1edbp c\u00f9ng \u0111\u00f2n<\/h1>\n<p>T\u00e1c gi\u1ea3 Rookwood, d\u1ef1a v\u00e0o m\u1ee9c \u0111\u1ed9 di l\u1ec7ch v\u00e0 t\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng, \u0111\u00e3 chia tr\u1eadt kh\u1edbp c\u00f9ng \u0111\u00f2n ra th\u00e0nh 6 type, \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 c\u1ee5 th\u1ec3 trong B\u1ea3ng 6.1 v\u00e0 H\u00ecnh 6.6.<\/p>\n<p>&nbsp;<\/p>\n<table width=\"873\">\n<tbody>\n<tr>\n<td width=\"73\">Type<\/td>\n<td width=\"270\">T\u1ed5n th\u01b0\u01a1ng gi\u1ea3i ph\u1eabu<\/td>\n<td width=\"243\">L\u00e2m s\u00e0ng<\/td>\n<td width=\"288\">X-quang<\/td>\n<\/tr>\n<tr>\n<td width=\"73\">I<\/td>\n<td width=\"270\">&#8211; Gi\u00e3n DC c\u00f9ng \u0111\u00f2n.<\/td>\n<td width=\"243\">&#8211; \u0110au kh\u1edbp c\u00f9ng \u0111\u00f2n, h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng vai<\/p>\n<p>Kh\u00f4ng \u0111au v\u00f9ng gian qu\u1ea1-\u0111\u00f2n.<\/td>\n<td width=\"288\">&#8211; Kh\u00f4ng th\u1ea5y b\u1ea5t th\u01b0\u1eddng<\/td>\n<\/tr>\n<tr>\n<td width=\"73\">II<\/td>\n<td width=\"270\">&#8211; \u0110\u1ee9t DC c\u00f9ng \u0111\u00f2n, gi\u00e3n DC qu\u1ea1 \u0111\u00f2n<\/td>\n<td width=\"243\">&#8211;\u00a0 \u0110\u1ea7u ngo\u00e0i x\u01b0\u01a1ng \u0111\u00f2n nh\u00f4 l\u00ean m\u1ed9t ch\u00fat so v\u1edbi m\u1ecfm c\u00f9ng vai<\/p>\n<p>&#8211;\u00a0 D\u1ea5u hi\u1ec7u ph\u00edm \u0111\u00e0n (+)<\/p>\n<p>&#8211;\u00a0 \u1ea4n \u0111au v\u00f9ng gian qu\u1ea1-\u0111\u00f2n<\/td>\n<td width=\"288\">&#8211;\u00a0 \u0110\u1ea7u ngo\u00e0i x\u01b0\u01a1ng \u0111\u00f2n h\u01a1i nh\u00f4 cao, kh\u1edbp c\u00f9ng \u0111\u00f2n gi\u00e3n r\u1ed9ng<\/p>\n<p>&#8211;\u00a0 X-quang stress: kh\u00f4ng th\u1ea5y thay \u0111\u1ed5i so v\u1edbi b\u00ean l\u00e0nh<\/td>\n<\/tr>\n<tr>\n<td width=\"73\">III<\/td>\n<td width=\"270\">&#8211; \u0110\u1ee9t DC qu\u1ea1 \u0111\u00f2n, kh\u1edbp c\u00f9ng \u0111\u00f2n tr\u1eadt ho\u00e0n to\u00e0n.<\/td>\n<td width=\"243\">\u0110\u1ea7u ngo\u00e0i x\u01b0\u01a1ng \u0111\u00f2n nh\u00f4 l\u00ean r\u00f5 r\u1ec7t h\u01a1n type II, g\u1ed3 l\u00ean m\u1eb7t da<\/td>\n<td width=\"288\">&#8211;\u00a0\u00a0\u00a0 \u0110\u1ea7u ngo\u00e0i x\u01b0\u01a1ng \u0111\u00f2n nh\u00f4 cao so v\u1edbi m\u1ecfm c\u00f9ng vai<\/p>\n<p>&#8211;\u00a0 X-quang stress: kho\u00e1ng gian qu\u1ea1- \u0111\u00f2n t\u0103ng l\u00ean 25% &#8211; 100% so v\u1edbi b\u00ean l\u00e0nh<\/td>\n<\/tr>\n<tr>\n<td width=\"73\">IV<\/td>\n<td width=\"270\">&#8211; \u0110\u1ea7u ngo\u00e0i x\u01b0\u01a1ng \u0111\u00f2n tr\u1eadt ra sau, v\u00e0o ho\u1eb7c xuy\u00ean qua c\u01a1 thang<\/td>\n<td width=\"243\">&#8211; BN \u0111au h\u01a1n type III, \u0111\u1ea7u ngo\u00e0i x\u01b0\u01a1ng \u0111\u00f2n tr\u1eadt ra sau so v\u1edbi m\u1ecfm c\u00f9ng vai<\/td>\n<td width=\"288\">&#8211; X-quang n\u00e1ch ho\u1eb7c CT-scan: \u0111\u1ea7u ngo\u00e0i x\u01b0\u01a1ng \u0111\u00f2n di l\u1ec7ch ra sau<\/td>\n<\/tr>\n<tr>\n<td width=\"73\">V<\/td>\n<td width=\"270\">&#8211; Tr\u1eadt kh\u1edbp c\u00f9ng \u0111\u00f2n, \u0111\u1ea7u ngo\u00e0i x\u01b0\u01a1ng \u0111\u00f2n di l\u1ec7ch l\u00ean tr\u00ean r\u1ea5t nhi\u1ec1u.<\/td>\n<td width=\"243\">&#8211; T\u01b0\u01a1ng t\u1ef1 type III, m\u1ee9c \u0111\u1ed9 n\u1eb7ng h\u01a1n.<\/p>\n<p>&#8211; Da b\u1ecb g\u1ed3 l\u00ean r\u1ea5t nhi\u1ec1u<\/td>\n<td width=\"288\">&#8211; Kho\u1ea3ng gian qu\u1ea1-\u0111\u00f2n t\u0103ng l\u00ean 100%&#8211; 300% so v\u1edbi b\u00ean l\u00e0nh.<\/p>\n<p>&nbsp;<\/td>\n<\/tr>\n<tr>\n<td width=\"73\">VI<\/td>\n<td width=\"270\">&#8211; Tr\u1eadt kh\u1edbp c\u00f9ng \u0111\u00f2n v\u1edbi x\u01b0\u01a1ng \u0111\u00f2n di l\u1ec7ch xu\u1ed1ng d\u01b0\u1edbi m\u1ecfm c\u00f9ng vai ho\u1eb7c m\u1ecfm qu\u1ea1.<\/p>\n<p>Kho\u1ea3ng gian qu\u1ea1-\u0111\u00f2n thu h\u1eb9p so v\u1edbi b\u00ean l\u00e0nh.<\/td>\n<td width=\"243\">&#8211; Vai ph\u1eb3ng, m\u1ecfm c\u00f9ng vai l\u1ed3i r\u00f5 l\u00ean.<\/p>\n<p>&#8211; C\u00f3 th\u1ec3 c\u00f3 g\u00e3y x\u01b0\u01a1ng \u0111\u00f2n, x\u01b0\u01a1ng s\u01b0\u1eddn ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng \u0111\u00e1m r\u1ed1i c\u00e1nh tay k\u00e8m theo<\/td>\n<td width=\"288\">C\u00f3 2 tr\u01b0\u1eddng h\u1ee3p: \u0111\u1ea7u ngo\u00e0i x\u01b0\u01a1ng \u0111\u00f2n tr\u1eadt n\u1eb1m d\u01b0\u1edbi m\u1ecfm c\u00f9ng vai v\u00e0 d\u01b0\u1edbi m\u1ecfm qu\u1ea1.<\/p>\n<p>&nbsp;<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>B\u1ea3ng 6.1: Ph\u00e2n lo\u1ea1i tr\u1eadt kh\u1edbp c\u00f9ng \u0111\u00f2n theo Rockwood [3]<\/p>\n<h1>5. \u0110i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n tr\u1eadt kh\u1edbp c\u00f9ng \u0111\u00f2n<\/h1>\n<h2>5.1 Ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n tr\u1eadt kh\u1edbp c\u00f9ng \u0111\u00f2n:<\/h2>\n<ul>\n<li>Type I, type II.<\/li>\n<li>Type III: \u0111\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n c\u00f3 nhu c\u00e2u v\u1eadn \u0111\u1ed9ng \u00edt.<\/li>\n<\/ul>\n<h2>5.2 Ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n tr\u1eadt kh\u1edbp c\u00f9ng \u0111\u00f2n<\/h2>\n<ul>\n<li>Ngh\u1ec9 ng\u01a1i, ch\u01b0\u1eddm \u0111\u00e1.<\/li>\n<li>\u0110eo t\u00fai treo tay 4 &#8211; 6 tu\u1ea7n.<\/li>\n<li>T\u1eadp ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng: 4 &#8211; 6 tu\u1ea7n \u0111\u1ea7u t\u1eadp t\u1ea7m v\u1eadn \u0111\u1ed9ng th\u1ee5 \u0111\u1ed9ng kh\u1edbp vai, sau \u0111\u00f3 t\u1eadp t\u1ea7m v\u1eadn \u0111\u1ed9ng ch\u1ee7 \u0111\u1ed9ng, t\u0103ng s\u1ee9c c\u01a1.<\/li>\n<\/ul>\n<h1>6. \u0110i\u1ec1u tr\u1ecb ph\u1eabu thu\u1eadt tr\u1eadt kh\u1edbp c\u00f9ng \u0111\u00f2n:<\/h1>\n<h2>6.1 Ch\u1ec9 \u0111\u1ecbnh<\/h2>\n<ul>\n<li>Type III: \u0111\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n tr\u1ebb tu\u1ed5i, c\u00f3 nhu c\u1ea7u v\u1eadn \u0111\u1ed9ng nhi\u1ec1u.<\/li>\n<li>Type IV, V,VI.<\/li>\n<\/ul>\n<h2>6.2 C\u00e1c ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt tr\u1eadt kh\u1edbp c\u00f9ng \u0111\u00f2n<\/h2>\n<h3><em>6.2.1 C\u1ed1<\/em><em> \u0111\u1ecbnh kh\u1edbp c\u00f9ng \u0111\u00f2n<\/em><\/h3>\n<p>+ C\u1ed1 \u0111\u1ecbnh b\u1eb1ng \u0111inh Kirschner, ho\u1eb7c \u0111inh Kirschner k\u1ebft h\u1ee3p ch\u1ec9 th\u00e9p: hi\u1ec7n \u00edt \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng do c\u1ed1 \u0111\u1ecbnh kh\u00f4ng v\u1eefng v\u00e0 bi\u1ebfn ch\u1eedng tr\u1ed3i \u0111inh (H\u1ec9nh 6.7).<\/p>\n<p>+ C\u1ed1 \u0111\u1ecbnh b\u1eb1ng n\u1eb9p m\u00f3c (Hook plate).<\/p>\n<figure id=\"attachment_2700\" aria-describedby=\"caption-attachment-2700\" style=\"width: 428px\" class=\"wp-caption alignnone\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-2700 \" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/6.7-300x200.jpg\" alt=\"minh-hoa-co-dinh-trat-khop-cung-don\" width=\"428\" height=\"285\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/6.7-300x200.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/6.7.jpg 334w\" sizes=\"(max-width: 428px) 100vw, 428px\" \/><figcaption id=\"caption-attachment-2700\" class=\"wp-caption-text\">H\u00ecnh 6.7: C\u1ed1 \u00a0\u0111\u1ecbnh kh\u1edbp c\u00f9ng \u0111\u00f2n b\u1eb1ng \u0111inh Kirschner<\/figcaption><\/figure>\n<h3>\u00a0 \u00a0 \u00a06.2.2 C\u1ed1 \u0111\u1ecbnh x\u01b0\u01a1ng \u0111\u00f2n v\u00e0o m\u1ecfm qu\u1ea1<\/h3>\n<p>+ B\u1eaft v\u00edt qu\u1ea1 \u0111\u00f2n (k\u1ef9 thu\u1eadt Bosvvorth)<\/p>\n<p>+ C\u1ed1 \u0111\u1ecbnh qu\u1ea1-\u0111\u00f2n b\u1eb1ng ch\u1ec9: m\u1ed5 m\u1edf ho\u1eb7c n\u1ed9i soi.<\/p>\n<figure id=\"attachment_2701\" aria-describedby=\"caption-attachment-2701\" style=\"width: 535px\" class=\"wp-caption alignnone\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-2701 \" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/6.8.jpg\" alt=\"co-dinh-xuong-vao-mom-qua\" width=\"535\" height=\"461\" \/><figcaption id=\"caption-attachment-2701\" class=\"wp-caption-text\">H\u00ecnh 6.8: Ph\u1eabu thu\u1eadt c\u1ed5 \u0111\u1ecbnh x\u01b0\u01a1ng \u0111\u00f2n &#8211; m\u1ecfm qu\u1ea1 b\u1eb1ng v\u00edt c\u1ee7a Bosworth<\/figcaption><\/figure>\n<h3>6.2.3 T\u00e1i t\u1ea1o d\u00e2y ch\u1eb1ng qu\u1ea1 \u0111\u00f2n<\/h3>\n<p>+ T\u00e1i t\u1ea1o d\u00e2y ch\u1eb1ng qu\u1ea1 \u0111\u00f2n b\u1eb1ng g\u00e2n t\u1ef1 th\u00e2n ho\u1eb7c g\u00e2n \u0111\u1ed3ng lo\u1ea1i.<\/p>\n<p>+ Chuy\u1ec3n d\u00e2y ch\u1eb1ng qu\u1ea1 c\u00f9ng th\u00e0nh d\u00e2y ch\u1eb1ng qu\u1ea1 \u0111\u00f2n.<\/p>\n<h2>6.4 K\u1ef9 thu\u1eadt n\u1ed9i soi c\u1ed1 \u0111\u1ecbnh qu\u1ea1-\u0111\u00f2n<\/h2>\n<ul>\n<li>Ph\u01b0\u01a1ng ti\u1ec7n c\u1ed1 \u0111\u1ecbnh: N\u00fat treo \u0111i\u1ec1u ch\u1ec9nh \u0111\u1ed9 d\u00e0i TightRope 2 \u0111\u1ea7u(Arthrex)<\/li>\n<li>T\u01b0 th\u1ebf B\u1ec7nh nh\u00e2n:<\/li>\n<li>N\u1eb1m ng\u1eeda ho\u1eb7c Beach Chair<\/li>\n<li>B\u1edd trong x\u01b0\u01a1ng b\u1ea3 vai s\u00e1t m\u00e9p b\u00e0n m\u1ed5. K\u00ea g\u1ed1i nh\u1ecf b\u00ean d\u01b0\u1edbi.<\/li>\n<li>V\u00f4 c\u1ea3m: G\u00e2y m\u00ea n\u1ed9i kh\u00ed qu\u1ea3n.<\/li>\n<li>Ng\u00f5 v\u00e0o: S\u1eed d\u1ee5ng 2 ng\u00f5 v\u00e0o:<\/li>\n<\/ul>\n<p>&#8211; Ng\u00f5 sau ti\u00eau chu\u1ea9n: T\u1eeb g\u00f3c sau ngo\u00e0i m\u1ecfm c\u00f9ng vai, xu\u1ed1ng 2 cm v\u00e0 v\u00e0o trong 1cm. M\u1edf ng\u00f5 n\u00e0y \u0111\u1ea7u ti\u00ean s\u1eed d\u1ee5ng \u0111\u1ec3 l\u00e0m ng\u00f5 quan s\u00e1t (H\u00ecnh 6.9)<\/p>\n<p>&#8211; Ng\u00f5 tr\u01b0\u1edbc: Ngay ph\u00eda ngo\u00e0i m\u1ecfm qu\u1ea1, v\u00e0o kho\u1ea3ng gian ch\u00f3p xoay. S\u1eed d\u1ee5ng m\u1ed9t kim tu\u1ef7 s\u1ed1ng \u0111\u1ec3 \u0111\u1ecbnh v\u1ecb ng\u00f5 v\u00e0o (H\u00ecnh 6.9).<\/p>\n<p>\u0110\u01b0\u1eddng r\u1ea1ch da: R\u1ea1ch da m\u1ed9t \u0111\u01b0\u1eddng d\u00e0i 2 cm m\u1eb7t tr\u00ean \u0111\u1ea7u ngo\u00e0i x\u01b0\u01a1ng \u0111\u00f2n, vu\u00f4ng g\u00f3c v\u1edbi tr\u1ee5c x\u01b0\u01a1ng \u0111\u00f2n, c\u00e1ch kh\u1edbp c\u00f9ng \u0111\u00f2n kho\u1ea3ng 3 cm (t\u01b0\u01a1ng \u1ee9ng v\u1edbi v\u1ecb tr\u00ed c\u1ee7a d\u00e2y ch\u1eb1ng qu\u1ea1 \u0111\u00f2n). B\u00f3c t\u00e1ch ph\u1ea7n m\u1ec1m d\u01b0\u1edbi da b\u1ed9c l\u1ed9 m\u1eb7t tr\u00ean x\u01b0\u01a1ng \u0111\u00f2n. c\u1ea7n b\u1ed9c l\u1ed9 r\u00f5 b\u1edd tr\u01b0\u1edbc v\u00e0 b\u1edd sau c\u1ee7a x\u01b0\u01a1ng \u0111\u00f2n (H\u00ecnh 6.9).<\/p>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_2702\" aria-describedby=\"caption-attachment-2702\" style=\"width: 406px\" class=\"wp-caption alignnone\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-2702 \" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/6.9.jpg\" alt=\"cac-ngo-vao\" width=\"406\" height=\"313\" \/><figcaption id=\"caption-attachment-2702\" class=\"wp-caption-text\">H\u00ecnh 6.9: C\u00e1c ng\u00f5 v\u00e0o s\u1eed d\u1ee5ng trong n\u1ed9i soi c\u1ed1 \u0111\u1ecbnh qu\u1ea1 &#8211; \u0111\u00f2n<\/figcaption><\/figure>\n<p>Ngu\u1ed3n: t\u00e1c gi\u1ea3<\/p>\n<p>K\u1ef9 thu\u1eadt:<\/p>\n<ul>\n<li>V\u00e0o kh\u1edbp vai b\u1eb1ng ng\u00f5 sau \u0111\u1ec3 quan s\u00e1t. Ng\u00f5 tr\u01b0\u1edbc (ng\u00f5 thao t\u00e1c) \u0111\u01b0\u1ee3c m\u1edf d\u01b0\u1edbi h\u01b0\u1edbng d\u1eabn c\u1ee7a kim tu\u1ef7 s\u1ed1ng, v\u00e0o kho\u1ea3ng gian ch\u00f3p xoay gi\u1eefa g\u00e2n c\u01a1 tr\u00ean gai v\u00e0 d\u01b0\u1edbi vai.<\/li>\n<li>S\u1eed d\u1ee5ng l\u01b0\u1ee1i b\u00e0o v\u00e0 \u0111\u1ea7u \u0111\u1ed1t n\u1ed9i soi \u0111\u1ec3 \u0111\u1ecbnh v\u1ecb v\u00e0 b\u1ed9c l\u1ed9 m\u1eb7t d\u01b0\u1edbi g\u1ed1c m\u1ecfm qu\u1ea1 (H\u00ecnh 6.1 OA), c\u1ea7n b\u1ed9c l\u1ed9 g\u1ed1c m\u1ecfm qu\u1ea1 th\u1eadt r\u00f5 r\u00e0ng \u0111\u1ec3 gi\u00fap vi\u1ec7c \u0111\u1ecbnh v\u1ecb v\u00e0 khoan \u0111\u01b0\u1eddng h\u1ea7m thu\u1eadn l\u1ee3i h\u01a1n.<\/li>\n<\/ul>\n<figure id=\"attachment_2693\" aria-describedby=\"caption-attachment-2693\" style=\"width: 641px\" class=\"wp-caption alignnone\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-2693\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/6.10-300x172.jpg\" alt=\"minh-hoa-phau-thuat-trat-khop-cung-don\" width=\"641\" height=\"368\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/6.10-300x172.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/6.10.jpg 429w\" sizes=\"(max-width: 641px) 100vw, 641px\" \/><figcaption id=\"caption-attachment-2693\" class=\"wp-caption-text\">H\u00ecnh 6.10: A &#8211; B\u1ed9c l\u1ed9 m\u1ecfm qu\u1ea1. B &#8211; \u0110\u1eb7t \u0111\u1ecbnh v\u1ecb v\u00e0o m\u1eb7t d\u01b0\u1edbi g\u1ed1c m\u1ecfm qu\u1ea1. c &#8211; Khoan \u0111inh K\u1ec9rchner d\u1eabn \u0111\u01b0\u1eddng. D &#8211; N\u00fat \u0111\u1ea7u d\u01b0\u1edbi c\u1ee7a TightRope chui qua l\u00f4 khoan v\u00e0 \u0111\u01b0\u1ee3c l\u1eadt n\u1eb1m ngang . Ngu\u1ed3n t\u00e1c gi\u1ea3.<\/figcaption><\/figure>\n<p>\u0110\u1eb7t \u0111\u1ea7u \u0111\u1ecbnh v\u1ecb v\u00e0o m\u1eb7t d\u01b0\u1edbi m\u1ecfm c\u00f9ng vai (H\u00ecnh 6.10B). V\u1ecb tr\u00ed khoan \u0111\u01b0\u1eddng h\u1ea7m v\u00e0o m\u1ecfm qu\u1ea1 r\u1ea5t quan tr\u1ecdng, n\u00f3 n\u00ean n\u1eb1m ch\u00ednh gi\u1eefa g\u1ed1c m\u1ecfm qu\u1ea1, n\u1ebfu v\u00e0o trong ho\u1eb7c ra ngo\u00e0i qu\u00e1 nhi\u1ec1u c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn v\u1ee1 \u0111\u01b0\u1eddng h\u1ea7m l\u00fac khoan. T\u1ed1t nh\u1ea5t n\u00ean k\u1ebft h\u1ee3p v\u1edbi C-arm \u0111\u00ea x\u00e1c \u0111\u1ecbnh ch\u00ednh x\u00e1c v\u1ecb tr\u00ed \u0111\u01b0\u1eddng h\u1ea7m (H\u00ecnh 6.11).<\/p>\n<figure id=\"attachment_2703\" aria-describedby=\"caption-attachment-2703\" style=\"width: 416px\" class=\"wp-caption alignnone\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-2703 \" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/6.11.jpg\" alt=\"minh-hoa-su-dung-C-arm\" width=\"416\" height=\"410\" \/><figcaption id=\"caption-attachment-2703\" class=\"wp-caption-text\">H\u00ecnh 6.11: S\u1eed d\u1ee5ng C-arm trong m\u00f4 \u0111\u1ec3 ki\u1ec3m tra. <em style=\"font-size: 16px;\">\u00a0Ngu\u1ed3n t\u00e1c gi\u1ea3<\/em><\/figcaption><\/figure>\n<ul>\n<li>D\u00f9ng \u0111inh Kirschner khoan d\u1eabn \u0111\u01b0\u1eddng t\u1eeb x\u01b0\u01a1ng \u0111\u00f2n xu\u1ed1ng m\u1ecfm qu\u1ea1 (H\u00ecnh 6.9C). V\u1ecb tr\u00ed v\u00e0o c\u1ee7a \u0111\u01b0\u1eddng h\u1ea7m \u1edd m\u1eb7t tr\u00ean x\u01b0\u01a1ng \u0111\u00f2n n\u00ean ra sau m\u1ed9t ch\u00fat so v\u1edbi tr\u1ee5c x\u01b0\u01a1ng \u0111\u00f2n, Vi\u1ec7c khoan \u0111inh d\u1eabn c\u1ea7n th\u1ef1c hi\u1ec7n ch\u00ednh x\u00e1c d\u01b0\u1edbi s\u1ef1 ki\u1ec3m tra c\u1ee7a C-arm trong m\u1ed5.<\/li>\n<li>S\u1eed d\u1ee5ng m\u0169i khoan 4.0 mm khoan theo \u0111inh d\u1eabn \u0111\u01b0\u1eddng(H\u00ecnh 6.12, 6.13). M\u0169i khoan \u0111i qua 4 th\u00e0nh x\u01b0\u01a1ng c\u1ee9ng (c\u1ee7a x\u01b0\u01a1ng \u0111\u00f2n v\u00e0 m\u1ecfm qu\u1ea1).<\/li>\n<li>Lu\u1ed3n n\u00fat treo TightRope v\u00e0o qua \u0111\u01b0\u1eddng h\u1ea7m \u0111\u00e3 khoan cho t\u1edbi khi n\u00fat \u0111\u1ea7u d\u01b0\u1edbi chui ra kh\u1ecfi l\u1ed7 khoan \u1edf m\u1ecfm qu\u1ea1, l\u1eadt ngang n\u00fat \u0111\u1ea7u d\u01b0\u1edbi c\u1ee7a TightRope (H\u00ecnh 6.9D).<\/li>\n<\/ul>\n<figure id=\"attachment_2704\" aria-describedby=\"caption-attachment-2704\" style=\"width: 318px\" class=\"wp-caption alignnone\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-2704 \" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/6.12-300x118.jpg\" alt=\"\" width=\"318\" height=\"125\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/6.12-300x118.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/6.12.jpg 562w\" sizes=\"(max-width: 318px) 100vw, 318px\" \/><figcaption id=\"caption-attachment-2704\" class=\"wp-caption-text\">H\u00ecnh 6.12: \u0110\u1eb7t \u0111\u1ecbnh v\u1ecb khoan \u0111\u01b0\u1eddng h\u1ea7m<\/figcaption><\/figure>\n<figure id=\"attachment_2717\" aria-describedby=\"caption-attachment-2717\" style=\"width: 331px\" class=\"wp-caption alignnone\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-2717 \" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/6.13-300x191.jpg\" alt=\"\" width=\"331\" height=\"211\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/6.13-300x191.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/6.13.jpg 398w\" sizes=\"(max-width: 331px) 100vw, 331px\" \/><figcaption id=\"caption-attachment-2717\" class=\"wp-caption-text\">Khoan \u0111\u01b0\u1eddng h\u1ea7m t\u1eeb x\u01b0\u01a1ng \u0111\u00f2n v\u00e0o m\u1ecfm qu\u1ea1 qua \u0111inh Kirschner.<\/figcaption><\/figure>\n<ul>\n<li>D\u01b0\u1edbi m\u00e0n t\u0103ng s\u00e1ng, n\u1eafn ch\u1ec9nh kh\u1edbp c\u00f9ng \u0111\u00f2n b\u1eb1ng c\u00e1ch \u1ea5n v\u00e0o \u0111\u1ea7u ngo\u00e0i x\u01b0\u01a1ng \u0111\u00f2n. C\u00f3 th\u1ec3 gi\u1ea1ng c\u00e1nh tay \u0111\u1ec3 n\u1eafn ch\u1ec9nh d\u1ec5 d\u00e0ng h\u01a1n.<\/li>\n<li>Khi n\u1eafn ch\u1ec9nh \u0111\u1ea1t y\u00eau c\u1ea7u, r\u00fat ch\u1ec9 \u0111\u1ec3 si\u1ebft ch\u1eb7t TightRope.<\/li>\n<li>Ki\u1ec3m tra, \u0111\u00f3ng v\u1ebft m\u1ed5.<\/li>\n<\/ul>\n<h1>7. Bi\u1ebfn ch\u1ee9ng tr\u1eadt kh\u1edbp c\u00f9ng \u0111\u00f2n:<\/h1>\n<ul>\n<li>T\u1ed5n th\u01b0\u01a1ng \u0111\u00e1m r\u1ed1i th\u1ea7n kinh c\u00e1nh tay (hi\u1ebfm g\u1eb7p).<\/li>\n<li>C\u00f4t ho\u00e1 ho\u1eb7c vi\u00eam kh\u1edbp c\u00f9ng \u0111\u00f2n.<\/li>\n<li>Tu\u1ed9t \u0111inh, g\u00e3y \u0111inh trong c\u1ed1 \u0111\u1ecbnh c\u00f9ng \u0111\u00f2n b\u1ea7ng \u0111inh Kirschner.<\/li>\n<li>G\u00e3y v\u00edt c\u1ed1 \u0111\u1ecbnh qu\u1ea1 \u0111\u00f2n trong k\u1ef9 thu\u1eadt Bosworth.<\/li>\n<li>G\u00e3y x\u01b0\u01a1ng \u0111\u00f2n, g\u00e3y m\u1ecfm qu\u1ea1.<\/li>\n<li>Nhi\u1ec5m tr\u00f9ng, tr\u1eadt l\u1ea1i.<\/li>\n<\/ul>\n<h1>8. K\u1ebft lu\u1eadn:<\/h1>\n<p>Tr\u1eadt kh\u1edbp c\u00f9ng \u0111\u00f2n l\u00e0 m\u1ed9t ch\u1ea5n th\u01b0\u01a1ng hay g\u1eb7p c\u1ee7a vai. Ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb c\u1ee7a tr\u1eadt kh\u1edbp c\u00f9ng \u0111\u00f2n ph\u1ee5 thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng v\u00e0 nhu c\u1ea7u ng\u01b0\u1eddi b\u1ec7nh. V\u1edbi c\u00e1c t\u1ed5n th\u01b0\u01a1ng t\u1ef5pe I, II ho\u1eb7c \u0111\u1ed9 III \u1edf b\u1ec7nh nh\u00e2n gi\u00e0, \u00edt nhu c\u1ea7u v\u1eadn \u0111\u1ed9ng, \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed5n th\u01b0\u1eddng \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn. Ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt \u0111\u1ed1i v\u1edbi c\u00e1c t\u1ed5n th\u01b0\u01a1ng type III \u1edf ng\u01b0\u1eddi tr\u1ebb tu\u1ed5i, type IV, V v\u00e0 VI. C\u00f3 nhi\u1ec1u k\u1ef9 thu\u1eadt ph\u1eabu thu\u1eadt \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u01b0 c\u1ed1 \u0111\u1ecbnh kh\u1edbp c\u00f9ng \u0111\u00f2n, c\u1ed1 \u0111\u1ecbnh qu\u1ea1-\u0111\u00f2n, t\u00e1i t\u1ea1o d\u00e2y ch\u1eb1ng qu\u1ea1 \u0111\u00f2n. Ph\u1eabu thu\u1eadt n\u1ed9i soi trong \u0111i\u1ec1u tr\u1ecb tr\u1eadt kh\u1edbp c\u00f9ng \u0111\u00f2n c\u0169ng \u0111ang \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n v\u00e0 cho k\u1ebft qu\u1ea3 kh\u1ea3 quan.<\/p>\n<p>\u0110\u1ec3 \u0111\u1eb7t l\u1ecbch kh\u00e1m t\u1ea1i vi\u1ec7n, Qu\u00fd kh\u00e1ch vui l\u00f2ng b\u1ea5m s\u1ed1\u00a0<a class=\"contact-button link-in-body\" href=\"https:\/\/vinmec.com\/vi\/co-xuong-khop\/suc-khoe-thuong-thuc\/trieu-chung-trat-khop-cung-don\/#\"><b class=\"link-in-body\">HOTLINE<\/b><\/a>\u00a0ho\u1eb7c \u0111\u1eb7t l\u1ecbch tr\u1ef1c ti\u1ebfp\u00a0<a class=\"appointment-button link-in-body\" href=\"https:\/\/vinmec.com\/vi\/co-xuong-khop\/suc-khoe-thuong-thuc\/trieu-chung-trat-khop-cung-don\/#\"><b class=\"link-in-body\">T\u1ea0I \u0110\u00c2Y<\/b><\/a>. T\u1ea3i v\u00e0 \u0111\u1eb7t l\u1ecbch kh\u00e1m t\u1ef1 \u0111\u1ed9ng tr\u00ean\u00a0<a class=\"link-in-body\" href=\"https:\/\/vinmec.com\/myvinmec\/\" target=\"_blank\" rel=\"noopener\">\u1ee9ng d\u1ee5ng MyVinmec<\/a>\u00a0\u0111\u1ec3 qu\u1ea3n l\u00fd, theo d\u00f5i l\u1ecbch v\u00e0 \u0111\u1eb7t h\u1eb9n m\u1ecdi l\u00fac m\u1ecdi n\u01a1i ngay tr\u00ean \u1ee9ng d\u1ee5ng.<\/p>\n<p>&nbsp;<\/p>\n<p>T\u00c0I LI\u1ec6U THAM KH\u1ea2O:<\/p>\n<ol>\n<li>Andreas I., Jonathan B.T., Augustus D.M., Andreas V. (2018) Atlas of advanced shoulder arthroscopy, CRC Press, 295-312.<\/li>\n<li>George Bentley (2014) <em>European surgical orthopaedics and traumatology, <\/em>Springer, 1019-1038.<\/li>\n<li>Charles M.C., James D.H., Margaret M.M., et al. (2015) Rockwoociam! Green&#8217;s fractures in adults, 8th Edition, Wolter Kluwer, 1573-1606.<\/li>\n<li>Charles A. Rockwood, Frederick A. Matsen (2008) The shoulder, 4th Edition, Saunders Elsevier, 453-526.<\/li>\n<li>Gary M. Gartsman (2009) Shoulder arthroscopy, 2nd Edition, Saunders Elsevier,<\/li>\n<\/ol>\n<p>306-315.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \\<\/p>\n<ol start=\"6\">\n<li>Ryan J. Wartli, Peter Millett (2015) Physical examination of the shoulder, Spinger, 183-207.<\/li>\n<li>Joseph P. Iannotti, Gerald R. Williams (2007) Disorder of the shoulder: Diagnosis &amp; management, 2nd Edition, Lippencott William &amp; Wilkins, 979-1053.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Tr\u1eadt kh\u1edbp c\u00f9ng \u0111\u00f2n chi\u1ebfm kho\u1ea3ng 9 &#8211; 10% ch\u1ea5n th\u01b0\u01a1ng c\u1ea5p t\u00ednh v\u00f9ng \u0111ai vai. Th\u01b0\u1eddng x\u1ea3y ra \u1edf nh\u00f3m tr\u1ebb tu\u1ed5i (10 &#8211; \u00ad20 tu\u1ed5i) v\u00e0 li\u00ean quan \u0111\u1ebfn th\u1ec3 thao. G\u1eb7p \u1edf nam nhi\u1ec1u h\u01a1n n\u1eef, (t\u1ec9 l\u1ec7 nam:n\u1eef kho\u1ea3ng 5:1). Nh\u00f3m t\u00e1c gi\u1ea3: PGS.TS. Tr\u1ea7n Trung D\u0169ng, TS. \u0110\u1ed7 V\u0103n Minh, [&hellip;]<\/p>\n","protected":false},"author":16,"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>Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb tr\u1eadt kh\u1edbp c\u00f9ng \u0111\u00f2n - Vinmec<\/title>\n<meta name=\"description\" content=\"Tr\u1eadt kh\u1edbp c\u00f9ng \u0111\u00f2n chi\u1ebfm 9 - 10% ch\u1ea5n th\u01b0\u01a1ng c\u1ea5p t\u00ednh v\u00f9ng \u0111ai vai. Th\u01b0\u1eddng x\u1ea3y ra \u1edf nh\u00f3m tr\u1ebb tu\u1ed5i (10 - \u00ad20 tu\u1ed5i) v\u00e0 li\u00ean quan \u0111\u1ebfn th\u1ec3 thao.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb tr\u1eadt kh\u1edbp c\u00f9ng \u0111\u00f2n - Vinmec\" \/>\n<meta property=\"og:description\" content=\"Tr\u1eadt kh\u1edbp c\u00f9ng \u0111\u00f2n chi\u1ebfm 9 - 10% ch\u1ea5n th\u01b0\u01a1ng c\u1ea5p t\u00ednh v\u00f9ng \u0111ai vai. 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