{"id":2965,"date":"2023-04-09T22:06:07","date_gmt":"2023-04-09T15:06:07","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=2965"},"modified":"2023-04-10T18:01:25","modified_gmt":"2023-04-10T11:01:25","slug":"ky-thuat-tao-hinh-day-chang-cheo-sau-gan-dien-bam-chay","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/ky-thuat-tao-hinh-day-chang-cheo-sau-gan-dien-bam-chay\/","title":{"rendered":"K\u1ef9 thu\u1eadt t\u1ea1o h\u00ecnh d\u00e2y ch\u1eb1ng ch\u00e9o sau g\u1eafn di\u1ec7n b\u00e1m ch\u00e0y"},"content":{"rendered":"

Ph\u1eabu thu\u1eadt t\u1ea1o h\u00ecnh d\u00e2y ch\u1eb1ng ch\u00e9o sau (DCCS) g\u1eafn di\u1ec7n b\u00e1m ch\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1eb1ng c\u00e1ch m\u1ed5 m\u1edf \u0111\u1ebf g\u1eafn di\u1ec7n b\u00e1m ch\u00e0y c\u1ee7a DCCS ho\u1eb7c th\u1ef1c hi\u1ec7n ho\u00e0n to\u00e0n qua n\u1ed9i soi. Nh\u1eefng ph\u1eabu thu\u1eadt vi\u00ean \u1ee7ng h\u1ed9 k\u1ef9 thu\u1eadt n\u00e0y cho r\u00e0ng \u01b0u \u0111i\u1ec3m c\u1ee7a ph\u1eabu thu\u1eadt t\u1ea1o h\u00ecnh DCCS k\u1ef9 thu\u1eadt g\u1eafn di\u1ec7n b\u00e1m ch\u00e0y l\u00e0 c\u00f3 th\u1ec3 g\u1eafn v\u1eefng ch\u1eafc di\u1ec7n b\u00e1m ch\u00e0y c\u1ee7a m\u1ea3nh gh\u00e9p v\u00e0o v\u1ecb tr\u00ed gi\u00e3i ph\u1eabu c\u1ee7a DCCS m\u00e0 tr\u00e1nh \u0111\u01b0\u1ee3c s\u1ef1 chuy\u1ec3n h\u01b0\u1edbng \u0111\u1ed9t ng\u1ed9t c\u1ee7a d\u00e2y ch\u1eb1ng th\u01b0\u1eddng \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 \u201cs\u1ef1 chuy\u1ec3n h\u01b0\u1edbng ch\u1ebft ch\u00f3c\u201d c\u1ee7a ph\u1eabu thu\u1eadt t\u1ea1o h\u00ecnh DCCS k\u1ef9 thu\u1eadt d\u00f9ng \u0111\u01b0\u1eddng h\u1ea7m xuy\u00ean ch\u00e0y<\/strong><\/p>\n

1. K\u1ef9 thu\u1eadt t\u1ea1o h\u00ecnh d\u00e2y ch\u1eb1ng ch\u00e9o sau g\u1eafn di\u1ec7n b\u00e1m ch\u00e0y kinh \u0111i\u1ec3n (m\u1ed5 m\u1edf c\u00f3 n\u1ed9i soi h\u1ed7 tr\u1ee3)<\/h2>\n

T\u1ea1o \u0111\u01b0\u1eddng h\u1ea7m x\u01b0\u01a1ng<\/p>\n

Ph\u1eabu thu\u1eadt n\u00e0y \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 b\u1edfi Eugene E.Berg. Khoan \u0111\u01b0\u1eddng h\u1ea7m x\u01b0\u01a1ng \u0111\u00f9i c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n d\u1ec5 d\u00e0ng qua l\u1ed1i v\u00e0o tr\u01b0\u1edbc ngo\u00e0i v\u00e0 tr\u01b0\u1edbc trong khi n\u1ed9i soi kh\u1edbp g\u1ed1i ho\u1eb7c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n qua \u0111\u01b0\u1eddng ch\u00e8. C\u00e1c k\u1ef9 thu\u1eadt t\u1ea1o ch\u00e0y.<\/p>\n

1.1 M\u1ea3nh gh\u00e9p \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong t\u1ea1o h\u00ecnh DCCS<\/h3>\n

M\u1ea3nh gh\u00e9p th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1ee9 d\u1ee5ng trong t\u1ea1o h\u00ecnh DCCS k\u1ef9 thu\u1eadt g\u00e1n \u0111i\u1ec7n b\u00e1m ch\u00e0y l\u00e0 m\u1ea3nh gh\u00e9p g\u00e2n b\u00e1nh ch\u00e8, g\u00e2n t\u1ee9 \u0111\u1ea7u t\u1ef1 th\u00e2n ho\u1eb7c m\u1ea3nh gh\u00e9p g\u00e2n b\u00e1nh ch\u00e8 ho\u1eb7c Achilles \u0111\u1ed3ng lo\u1ea1i. M\u1ea3nh gh\u00e9p c\u1ea7n c\u00f3 n\u00fat x\u01b0\u01a1ng v\u1edbi k\u00edch th\u01b0\u1edbc \u0111\u1ee7 l\u1edbn \u0111\u1ec3 c\u00f3 th\u1ec3 b\u1eaft \u0111\u01b0\u1ee3c v\u00edt c\u1ed1 \u0111\u1ecbnh m\u00e1nh gh\u00e9p v\u00e0o m\u00e2m ch\u00e0y. V\u1edbi m\u00e0nh gh\u00e9p n\u00e0y, ph\u1ea7n x\u01b0\u01a1ng c\u1ee7a m\u1ea3nh gh\u00e9p g\u00e2n b\u00e1nh ch\u00e8 ho\u1eb7c g\u00e2n Achilles \u0111\u1ed3ng lo\u1ea1i \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 g\u1eafn v\u00e0o di\u1ec7n b\u00e1m ch\u00e0y c\u1ee7a DCCS th\u01b0\u1eddng c\u00f3 k\u00edch th\u01b0\u1edbc chi\u1ec1u r\u1ed9ng kho\u1ea3ng l0 mm v\u00e0 chi\u1ec1u d\u00e0i 20 – 30mm, ph\u1ea7n x\u01b0\u01a1ng c\u1ee7a m\u1ea3nh gh\u00e9p g\u00e2n b\u00e1nh ch\u00e8 t\u1ef1 th\u00e2n ho\u1eb7c g\u00e2n t\u1ee9 \u0111\u1ea7u t\u1ef1 th\u00e2n th\u01b0\u1eddng c\u00f3 k\u00edch th\u01b0\u1edbc nh\u1ecf h\u01a1n. \u0110\u1ec3 ch\u1ee7 \u0111\u1ed9ng ki\u1ec3m so\u00e1t n\u00fat x\u01b0\u01a1ng d\u00f9ng \u0111\u1ec3 g\u1eafn di\u1ec7n b\u00e1m ch\u00e0y c\u1ee7a m\u1ea3nh gh\u00e9p v\u00e0o m\u00e2m ch\u00e0y m\u1ed9t c\u00e1ch ch\u1eafc ch\u1eafn, nhi\u1ec1u t\u00e1c gi\u1ea3 \u1ee7ng h\u1ed9 vi\u1ec7c s\u1eed d\u1ee5ng m\u1ea3nh gh\u00e9p g\u00e2n b\u00e1nh ch\u00e8 ho\u1eb7c g\u00e2n Achilles \u0111\u1ed3ng lo\u1ea1i.<\/p>\n

B\u1ed9c l\u1ed9 r\u00f5 di\u1ec7n b\u00e1m \u0111\u00f9i c\u1ee7a DCCS. \u0110\u01b0\u1eddng h\u1ea7m x\u01b0\u01a1ng \u0111\u00f9i c\u1ee7a DCCS th\u01b0\u1eddng \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh \u1edf v\u1ecb tr\u00ed 1 h \u0111\u1ed1i v\u1edbi kh\u1edbp g\u1ed1i ph\u1ea3i ho\u1eb7c 11 h \u0111\u1ed1i v\u1edbi kh\u1edbp g\u1ed1i tr\u00e1i. T\u00e2m c\u1ee7a \u0111\u01b0\u1eddng h\u1ea7m x\u01b0\u01a1ng \u0111\u00f9i th\u01b0\u1eddng c\u00e1ch b\u1edd tr\u01b0\u1edbc c\u1ee7a s\u1ee5n kh\u1edbp kho\u1ea3ng c\u00e1ch 8mm \u0111\u1ec3 sau khi khoan xong \u0111\u01b0\u1eddng h\u1ea7m x\u01b0\u01a1ng \u0111\u00f9i, kho\u1ea3ng c\u00e1ch t\u1eeb b\u1edd c\u1ee7a \u0111\u01b0\u1eddng h\u1ea7m \u0111\u1ebfn b\u1edd c\u1ee7a s\u1ee5n kh\u1edbp c\u00f2n \u0111\u01b0\u1ee3c 2-3 mm \u0111\u1ec3 tr\u00e1nh bi\u1ebfn ch\u1ee9ng ho\u1ea1i t\u1eed v\u00f4 m\u1ea1ch s\u1ee5n kh\u1edbp l\u1ed3i c\u1ea7u \u0111\u00f9i sau t\u1ea1o h\u00ecnh DCCS. Khoan \u0111\u01b0\u1eddng h\u1ea7m x\u01b0\u01a1ng \u0111\u00f9i c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n t\u1eeb ngo\u00e0i v\u00e0o ho\u1eb7c t\u1eeb trong ra nh\u01b0 \u0111\u00e3 m\u00f4 t\u1ea3 \u1edf trong k\u1ef9 thu\u1eadt t\u1ea1o h\u00ecnh DCCS v\u1edbi \u0111\u01b0\u1eddng h\u1ea7m xuy\u00ean ch\u00e0y. Lu\u1ed3n ch\u1ec9 ch\u1edd \u0111\u1ec3 k\u00e9o m\u1ea3nh gh\u00e9p v\u00e0o trong \u0111\u01b0\u1eddng h\u1ea7m x\u01b0\u01a1ng \u0111\u00f9i \u1edf th\u00ec sau.<\/p>\n

\"
Khoan \u0111\u01b0\u1eddng h\u1ea7m x\u01b0\u01a1ng \u0111\u00f9i k\u1ef9 thu\u1eadt t\u1eeb ngo\u00e0i v\u00e0o (A) ho\u1eb7c k\u1ef9 thu\u1eadt t\u1eeb trong ra (B)<\/figcaption><\/figure>\n

1.2 T\u1ea1o di\u1ec7n b\u00e1m ch\u00e0y cho m\u1ea3nh gh\u00e9p, c\u1ed1 \u0111\u1ecbnh m\u1ea3nh gh\u00e9p v\u00e0o x\u01b0\u01a1ng ch\u00e0y<\/h3>\n

Thay \u0111\u1ed5i t\u01b0 th\u1ebf ng\u01b0\u1eddi b\u1ec7nh. Th\u01b0\u1eddng s\u1eed d\u1ee5ng m\u1ed9t b\u00e0n m\u1ed5 kh\u00e1c song song v\u1edbi b\u00e0n n\u1ed9i soi \u1edf th\u00ec tr\u00ean \u0111\u1ec3 thay \u0111\u1ed5i t\u01b0 th\u1ebf ng\u01b0\u1eddi b\u1ec7nh t\u1eeb n\u1eb1m ng\u1eeda sang n\u1eb1m s\u1ea5p. Ch\u00fa \u00fd m\u1ecdi c\u00f4ng t\u00e1c v\u00f4 tr\u00f9ng trong qu\u00e1 tr\u00ecnh thay \u0111\u1ed5i t\u01b0 th\u1ebf ng\u01b0\u1eddi b\u1ec7nh. Th\u00ec m\u1ed5 n\u00e0y di\u1ec5n ra trong kho\u1ea3ng 15 ph\u00fat, trong th\u1eddi gian n\u00e0y nh\u00e2n vi\u00ean ph\u00f2ng m\u1ed5 s\u1eb5n s\u00e0ng v\u1ec7 sinh b\u00e0n m\u1ed5 th\u1ee9 nh\u1ea5t \u0111\u1ec3 chuy\u1ec3n l\u1ea1i b\u1ec7nh nh\u00e2n v\u1ec1 b\u00e0n m\u1ed5 \u0111\u00f3 sau khi k\u1ebft th\u00fac th\u00ec ph\u1eabu thu\u1eadt n\u00e0y. \u0110\u01b0\u1eddng m\u1ed5 Burk c\u1ea3i ti\u1ebfn \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ti\u1ebfp c\u1eadn ph\u00eda sau c\u1ee7a m\u00e2m ch\u00e0y. M\u1ed1c c\u1ee7a \u0111\u01b0\u1eddng m\u1ed5 n\u00e0y l\u00e0 b\u1edd trong c\u1ee7a \u0111\u1ea7u tr\u00ean c\u01a1 b\u1ee5ng ch\u00e2n trong, b\u1edd ngo\u00e0i c\u1ee7a g\u00e2n c\u01a1 b\u00e1n g\u00e2n, n\u1ebfp l\u1eb1n khoeo v\u00e0 \u0111\u01b0\u1eddng gi\u1eefa c\u1ee7a \u0111\u1ea7u d\u01b0\u1edbi \u0111\u00f9i. R\u1ea1ch qua da, b\u1ed9c l\u1ed9 qua l\u1edbp c\u00e2n, ch\u00fa \u00fd b\u1ea3o v\u1ec7 nh\u00e1nh th\u1ea7n kinh v\u00e0 nh\u00e1nh t\u0129nh m\u1ea1ch hi\u1ec3n trong qu\u00e1 tr\u00ecnh m\u1ed5. Ph\u1eabu t\u00edch qua l\u1edbp c\u00e2n ph\u1ee7 \u0111\u1ea7u tr\u00ean g\u00e2n c\u01a1 khoeo \u0111\u1ec3 b\u1ed9c l\u1ed9 ph\u1ea7n g\u00e2n c\u01a1 khoeo. D\u00f9ng v\u00e9n c\u01a1 \u0111\u1ec3 v\u00e9n \u0111\u1ea7u tr\u00ean c\u01a1 b\u1ee5ng ch\u00e2n trong ra ngo\u00e0i, k\u00e8m theo \u0111\u00f3 l\u00e0 v\u00e9n c\u1ea3 b\u00f3 m\u1ea1ch khoeo v\u00e0 th\u1ea7n kinh ch\u00e0y ra ngo\u00e0i, ch\u00fa \u00fd b\u1ea3o v\u1ec7 b\u00f3 m\u1ea1ch v\u00e0 th\u1ea7n kinh n\u00e0y trong su\u1ed1t qu\u00e1 tr\u00ecnh ph\u1eabu thu\u1eadt. M\u1edf bao kh\u1edbp ph\u00eda sau c\u1ee7a kh\u1edbp g\u1ed1i theo chi\u1ec1u d\u1ecdc v\u00e0 b\u1ed9c l\u1ed9 di\u1ec7n b\u00e1m ch\u00e0y c\u1ee7a DCCS. Ph\u1ea7n m\u1ec1m v\u00e0 di t\u00edch c\u1ee7a DCCS \u0111\u01b0\u1ee3c c\u1eaft l\u1ecdc c\u1ea9n th\u1eadn \u0111\u1ebf kh\u00f4ng l\u00e0m t\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng \u0111\u00f9i s\u1ee5n ch\u00eam. \u0110\u1ec3 b\u1ed9c l\u1ed9 r\u00f2 r\u00e0ng h\u01a1n di\u1ec7n b\u00e1m ch\u00e0y c\u1ee7a DCCS n\u00ean g\u1ea5p g\u1ed1i kho\u00e1ng 20 \u0111\u1ed9 v\u00e0 xoay x\u01b0\u01a1ng ch\u00e0y ra ngo\u00e0i.<\/p>\n

\"B\u1ed9c
B\u1ed9c l\u1ed9 di\u1ec7n b\u00e1m ch\u00e0y c\u1ee7a DCCS b\u1eb1ng \u0111\u01b0\u1eddng r\u1ea1ch da h\u00ecnh ch\u1eeb Z, v\u00e9n \u0111\u1ea7u trong c\u01a1 b\u1ee5ng ch\u00e2n ra ngo\u00e0i<\/figcaption><\/figure>\n

D\u00f9ng \u0111\u1ee5c \u0111\u1ec3 m\u1edf m\u1ed9t c\u1eeda s\u1ed5 x\u01b0\u01a1ng t\u1ea1i v\u00ed tr\u00ed di\u1ec7n b\u00e1m c\u1ee7a DCCS c\u00f3 k\u00edch th\u01b0\u1edbc b\u1eb1ng v\u1edbi n\u00fat x\u01b0\u01a1ng \u0111\u00e3 \u0111\u01b0\u1ee3c chu\u1ea9n b\u1ecb c\u1ee7a m\u1ea3nh gh\u00e9p. M\u1ea3nh gh\u00e9p \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o tr\u01b0\u1eddng m\u1ed5, \u0111\u1ea7u tr\u00ean c\u1ee7a m\u1ea3nh gh\u00e9p \u0111\u01b0\u1ee3c lu\u1ed3n qua di\u1ec7n gian l\u1ed3i c\u1ea7u x\u01b0\u01a1ng \u0111\u00f9i t\u1eeb sau ra tr\u01b0\u1edbc v\u00e0 v\u00e0o \u0111\u01b0\u1eddng h\u1ea7m x\u01b0\u01a1ng \u0111\u00f9i b\u1eb1ng ch\u1ec9 ch\u1edd. \u0110\u1ea7u d\u01b0\u1edbi c\u1ee7a m\u1ea3nh gh\u00e9p \u0111\u01b0\u1ee3c c\u1ed1 \u0111\u1ecbnh v\u00e0o x\u01b0\u01a1ng ch\u00e0y b\u1eb1ng v\u00edt. C\u00f3 th\u1ec3 d\u00f9ng v\u00edt \u0111\u01b0\u1eddng k\u00ednh 6,5mm ho\u1eb7c v\u00edt \u0111\u01b0\u1eddng k\u00ednh 4,5mm \u0111\u1ebf c\u1ed1 \u0111\u1ecbnh \u0111\u1ea7u d\u01b0\u1edbi c\u1ee7a m\u1ea3nh gh\u00e9p v\u00e0o x\u01b0\u01a1ng ch\u00e0y t\u00f9y thu\u1ed9c v\u00e0o k\u00edch c\u1edd c\u1ee7a n\u00fat x\u01b0\u01a1ng c\u1ee7a m\u1ea3nh gh\u00e9p \u0111\u00e3 \u0111\u01b0\u1ee3c chu\u00e2n b\u1ecb. Trong qu\u00e1 tr\u00ecnh c\u1ed1 \u0111\u1ecbnh \u0111\u1ea7u d\u01b0\u1edbi c\u1ee7a m\u1ea3nh gh\u00e9p v\u00e0o x\u01b0\u01a1ng ch\u00e0y, n\u00ean k\u00e9o c\u0103ng \u0111\u1ea7u tr\u00ean c\u1ee7a m\u1ea3nh gh\u00e9p \u0111\u1ec3 c\u00f3 th\u1ec3 c\u1ed1 \u0111\u1ecbnh \u0111\u1ea7u d\u01b0\u1edbi c\u1ee7a m\u1ea3nh gh\u00e9p ch\u1eb7t \u1edd m\u1ee9c v\u1eeba \u0111\u1ee7. C\u00f3 th\u1ec3 s\u1eed d\u1ee5ng m\u00e0n t\u0103ng s\u00e1ng \u0111\u1ebf ki\u1ebfm tra trong m\u00f4. Sau khi c\u1ed1 \u0111\u1ecbnh \u0111\u1ea7u d\u01b0\u1edbi m\u1ea3nh gh\u00e9p v\u00e0o x\u01b0\u01a1ng \u0111\u00f9i, \u0111\u00f3ng l\u1ea1i bao kh\u1edbp v\u00e0 kh\u00e2u ph\u1ee5c h\u1ed3i ph\u1ea7n m\u1ec1m theo gi\u1ea3i ph\u1eabu. C\u1ed1 \u0111\u1ecbnh m\u00e0nh gh\u00e9p v\u00e0o \u0111\u01b0\u1eddng h\u1ea7m \u0111\u00f9i<\/p>\n

B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c chuy\u1ebfn sang b\u00e0n m\u1ed5 m\u1edbi \u0111\u1ec3 ti\u1ebfp t\u1ee5c qu\u00e1 tr\u00ecnh n\u1ed9i soi kh\u1edbp g\u1ed1i. Ch\u00fa \u00fd \u0111\u1ea3m b\u1ea3o c\u00f4ng t\u00e1c v\u00f4 tr\u00f9ng cho ng\u01b0\u1eddi b\u1ec7nh trong qu\u00e1 trinh thay \u0111\u1ed1i t\u01b0 th\u1ebf. N\u1ed9i soi kh\u1edbp g\u1ed1i \u0111\u1ec3 quan s\u00e1t r\u00f5 ph\u1ea7n \u0111\u1ea7u tr\u00ean c\u1ee7a m\u1ea3nh gh\u00e9p \u0111\u01b0\u1ee3c lu\u1ed3n v\u00e0o \u0111\u01b0\u1eddng h\u1ea7m \u0111\u00f9i. \u0110\u1ec3 g\u1ed1i g\u1ea5p 80- 90 \u0111\u1ed9, th\u1ef1c hi\u1ec7n nghi\u1ec7m ph\u00e1p ng\u0103n k\u00e9o tr\u01b0\u1edbc, k\u00e9o c\u0103ng \u0111\u1ea7u tr\u00ean c\u1ee7a m\u1ea3nh gh\u00e9p v\u00e0o trong \u0111\u01b0\u1eddng h\u1ea9m x\u01b0\u01a1ng \u0111\u00f9i, T\u00f9y thu\u1ed9c v\u00e0o m\u1ea3nh gh\u00e9p l\u00e0 m\u1ea3nh gh\u00e9p g\u00e2n b\u1ea3nh ch\u00e8 hay g\u00e2n Achille hay g\u00e2n t\u1ee9 \u0111\u1ea7u m\u00e0 l\u1ef1a ch\u1ecdn c\u00e1ch c\u1ed1 \u0111\u1ecbnh m\u1ea3nh gh\u00e9p v\u00e0o \u0111\u1ea7u tr\u00ean x\u01b0\u01a1ng \u0111\u00f9i m\u1ed9t c\u00e1ch ph\u00f9 h\u1ee3p. Th\u00f4ng th\u01b0\u1eddng c\u00e1c ph\u1eabu thu\u1eadt vi\u00ean hay s\u1eed d\u1ee5ng v\u00edt ch\u1eb9n \u0111\u1ec3 c\u1ed1 \u0111\u1ecbnh \u0111\u1ea7u tr\u00ean c\u1ee7a m\u00e1nh gh\u00e9p v\u00e0o x\u01b0\u01a1ng \u0111\u00f9i. Sau khi c\u1ed1 \u0111\u1ecbnh m\u1ea3nh gh\u00e9p v\u00e0o \u0111\u01b0\u1eddng h\u1ea7m x\u01b0\u01a1ng \u0111\u00f9i c\u1ea7n ki\u1ec3m tra l\u1ea1i bi\u00ean \u0111\u1ed9 v\u1eadn \u0111\u1ed9ng c\u1ee7a kh\u1edbp g\u1ed1i, s\u1ef1 di l\u1ec7ch ra sau c\u1ee7a x\u01b0\u01a1ng ch\u00e0y so v\u1edbi x\u01b0\u01a1ng \u0111\u00f9i \u0111\u01b0\u1ee3c h\u1ed3i ph\u1ee5c tr\u01b0\u1edbc khi \u0111\u00f3ng l\u1ea1i v\u1ebft m\u1ed5 theo gi\u1ea3i ph\u1eabu.<\/p>\n

\"D\u00f9ng
D\u00f9ng \u0111\u1ee5c t\u1ea1o c\u1eeda s\u1ed1 x\u01b0\u01a1ng \u1edf di\u1ec7n b\u00e1m ch\u00e0y c\u1ee7a DCCS (A), c\u1ed1 \u0111\u1ecbnh m\u00e0nh gh\u00e9p v\u00e0o di\u1ec7n b\u00e1m ch\u00e0y c\u1ee7a DCCS (B) v\u00e0 lu\u1ed3n m\u1ea3nh gh\u00e9p v\u00e0o trong \u0111\u01b0\u1eddng h\u00e2m \u0111\u00f9i, c\u1ed3 \u0111\u1ecbnh m\u1ea3nh gh\u00e9p trong \u0111\u01b0\u1eddng h\u1ea9m \u0111\u00f9i (C)<\/figcaption><\/figure>\n

2. K\u1ef9 thu\u1eadt t\u1ea1o h\u00ecnh d\u00e2y ch\u1eb1ng ch\u00e9o sau g\u1eafn di\u1ec7n b\u00e1m ch\u00e0y ho\u00e0n to\u00e0n qua n\u1ed9i soi<\/h2>\n

K\u1ef9 thu\u1eadt t\u1ea1o h\u00ecnh DCCS g\u1eafn di\u1ec7n b\u00e1m ch\u00e0y m\u1ed5 m\u1edf c\u00f3 n\u1ed9i soi h\u1ed7 tr\u1ee3 c\u00f3 nh\u01b0\u1ee3c \u0111i\u1ec3m ph\u1ea3i thay \u0111\u1ed1i t\u01b0 th\u1ebf b\u1ec7nh nh\u00e2n kh\u00e1 ph\u1ee9c t\u1ea1p trong qu\u00e1 tr\u00ecnh ph\u1eabu thu\u1eadt, ph\u1ea3i m\u1edf bao kh\u1edbp \u0111\u1ebf b\u1ed9c l\u1ed9 v\u00e0o di\u1ec7n b\u00e1m ch\u00e0y c\u1ee7a DCCS, \u0111au nhi\u1ec1u sau m\u1ed5 v\u00e0 qu\u00e1 tr\u00ecnh ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng sau m\u1ed5 k\u00e9o d\u00e0i. \u0110\u1ec3 h\u1ea1n ch\u1ebf c\u00e1c nh\u01b0\u1ee3c \u0111i\u1ec3m c\u1ee7a k\u1ef9 thu\u1eadt n\u00e0y, m\u1ed9t s\u1ed1 t\u00e1c gi\u1ea3 \u0111\u00e3 \u0111\u1ec1 xu\u1ea5t ph\u01b0\u01a1ng ph\u00e1p m\u1ed5 t\u1ea1o h\u00ecnh DCCS k\u1ef9 thu\u1eadt g\u1eafn di\u1ec7n b\u00e1m ch\u00e0y ho\u00e0n to\u00e0n qua n\u1ed9i soi. V\u1edbi k\u1ef9 thu\u1eadt n\u00e0y, ph\u1eabu thu\u1eadt t\u1ea1o h\u00ecnh DCCS \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n ho\u00e0n to\u00e0n qua n\u1ed9i soi. Tuy nhi\u00ean ph\u1eabu thu\u1eadt y\u00eau c\u1ea7u c\u1ea7n ph\u1ea3i c\u00f3 \u0111\u1ea7y \u0111\u1ee7 d\u1ee5ng c\u1ee5 \u0111\u1ec3 th\u1ef1c hi\u1ec7n k\u1ef9 thu\u1eadt, v\u1ec1 c\u01a1 b\u00e0n k\u1ef9 thu\u1eadt n\u00e0y l\u00e0 s\u1ef1 pha tr\u1ed9n c\u1ee7a k\u1ef9 thu\u1eadt t\u1ea1o h\u00ecnh DCCS v\u1edbi \u0111\u01b0\u1eddng h\u1ea7m xuy\u00ean ch\u00e0y v\u00e0 k\u1ef9 thu\u1eadt t\u1ea1o h\u00ecnh DCCS g\u1eafn di\u1ec7n b\u00e1m ch\u00e0y kinh \u0111i\u1ec3n. Cho \u0111\u1ebfn nay c\u00f9ng v\u1edbi s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a c\u00e1c ph\u01b0\u01a1ng ti\u1ec7n c\u1ed1 \u0111\u1ecbnh m\u1ea3nh gh\u00e9p, k\u1ef9 thu\u1eadt n\u00e0y c\u0169ng c\u00f3 nhi\u1ec1u bi\u1ebfn th\u1ec3 kh\u00e1c nhau.<\/p>\n

C\u0169ng t\u01b0\u01a1ng t\u1ef1 k\u1ef9 thu\u1eadt t\u1ea1o h\u00ecnh DCCS g\u1eafn di\u1ec7n b\u00e1m ch\u00e0y kinh \u0111i\u1ec3n, trong k\u1ef9 thu\u1eadt t\u1ea1o h\u00ecnh DCCS g\u1eafn di\u1ec7n b\u00e1m ch\u00e0y ho\u00e0n to\u00e0n qua n\u1ed9i soi c\u00e1c t\u00e1c gi\u1ea3 \u01b0a d\u00f9ng m\u00e1nh gh\u00e9p g\u00e2n Achilles ho\u1eb7c g\u00e2n b\u00e1nh ch\u00e8 \u0111\u1ed3ng lo\u1ea1i v\u00ec \u01b0u \u0111i\u1ec3m ch\u1ee7 \u0111\u1ed9ng \u0111\u01b0\u1ee3c k\u00edch th\u01b0\u1edbc c\u00f9a n\u00fat x\u01b0\u01a1ng trong vi\u1ec7c t\u1ea1o s\u1ef1 g\u1eafn k\u1ebft c\u1ee7a m\u1ea3nh gh\u00e9p v\u1edbi m\u00e2m ch\u00e0y c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh. K\u1ef9 thu\u1eadt chu\u1ea9n b\u1ecb m\u1ea3nh gh\u00e9p c\u1ee7a k\u1ef9 thu\u1eadt n\u00e0y \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 nh\u01b0 h\u00ecnh \u1ea3nh d\u01b0\u1edbi \u0111\u00e2y:<\/p>\n

\"Chu\u1ea9n
Chu\u1ea9n b\u1ecb m\u1ea3nh gh\u00e9p s\u1eed d\u1ee5ng cho k\u1ef9 thu\u1eadt t\u1ea1o h\u00ecnh DCCS g\u1eafn di\u1ec7n b\u00e1m ch\u00e0y ho\u00e0n to\u00e0n qua n\u1ed9i soi k\u1ef9 thu\u1eadt m\u1ed9t b\u00f3 d\u00f9ng Graftlink<\/figcaption><\/figure>\n

N\u1ed9i soi v\u00e0o kh\u1edbp g\u1ed1i v\u1edbi 3 ng\u00f5 v\u00e0o c\u01a1 b\u1ea3n: ng\u00f5 v\u00e0o tr\u01b0\u1edbc ngo\u00e0i, ng\u00f5 v\u00e0o tr\u01b0\u1edbc trong v\u00e0 ng\u00f5 v\u00e0o sau trong. C\u00f3 th\u1ec3 s\u1eed d\u1ee5ng m\u00e0n t\u0103ng s\u00e1ng \u0111\u1ec3 \u0111\u1ecbnh v\u1ecb \u0111\u01b0\u1eddng h\u1ea7m m\u00e2m ch\u00e0y \u0111\u01b0\u1ee3c ch\u00ednh x\u00e1c h\u01a1n.<\/p>\n

Vi\u1ec7c t\u1ea1o \u0111\u01b0\u1eddng h\u1ea7m \u0111\u00f9i c\u0169ng t\u01b0\u01a1ng t\u1ef1 nh\u01b0 k\u1ef9 thu\u1eadt t\u1ea1o h\u00ecnh DCCS g\u1eafn di\u1ec7n b\u00e1m ch\u00e0y kinh \u0111i\u1ec3n ho\u1eb7c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u00e0ng m\u0169i khoan ng\u01b0\u1ee3c.<\/p>\n

Do t\u1ea1o \u0111\u01b0\u1ee3c di\u1ec7n b\u00e1m ch\u00e0y, c\u00e1c ph\u1eabu thu\u1eadt vi\u00ean d\u00f9ng m\u0169i khoan ng\u01b0\u1ee3c (Flip Cutter) \u0111\u1ec3 t\u1ea1o \u1ed5 cho di\u1ec7n b\u00e1m ch\u00e0y c\u1ee7a m\u1ea3nh gh\u00e9p. \u0110\u01b0\u1eddng k\u00ednh c\u1ee7a m\u0169i khoan ng\u01b0\u1ee3c ph\u00f9 h\u1ee3p v\u1edbi \u0111\u01b0\u1eddng k\u00ednh c\u1ee7a n\u00fat x\u01b0\u01a1ng c\u1ee7a m\u1ea3nh gh\u00e9p \u0111\u00e3 \u0111\u01b0\u1ee3c chu\u1ea9n b\u1ecb tr\u01b0\u1edbc \u0111\u00f3. Lu\u1ed3n ch\u1ec9 ch\u1edd v\u00e0o \u0111\u01b0\u1eddng h\u1ea7m v\u1eeba t\u1ea1o \u0111\u1ec3 d\u00f9ng ch\u1ec9 ch\u1edd k\u00e9o m\u1ea3nh gh\u00e9p v\u00e0o b\u00ean trong c\u1ee7a n\u00f3 trong th\u00ec sau.<\/p>\n

\"Khoan
Khoan t\u1ea1o \u1ed1 cho di\u1ec7n b\u00e1m ch\u00e0y c\u00f9a m\u00e0nh gh\u00e9p b\u1eb1ng m\u0169i khoan ng\u01b0\u1ee3c<\/figcaption><\/figure>\n

 <\/p>\n

\"Lu\u1ed3n
Lu\u1ed3n ch\u1ec9 ch\u1edd \u0111\u1ebf k\u1ebbo m\u00e0nh gh\u00e9p v\u00e0o b\u00ean trong<\/figcaption><\/figure>\n

M\u1ea3nh gh\u00e9p \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o trong kh\u1edbp g\u1ed1i qua ng\u00f5 v\u00e0o tr\u01b0\u1edbc ngo\u00e0i. D\u00f9ng ch\u1ec9 ch\u1edd \u0111\u1ec3 k\u00e9o m\u1ea3nh gh\u00e9p v\u00e0o trong \u0111\u01b0\u1eddng h\u1ea7m m\u00e2m ch\u00e0y v\u1eeba t\u1ea1o v\u00e0 c\u1ed1 \u0111\u1ecbnh m\u1ea3nh gh\u00e9p b\u1eb1ng ph\u01b0\u01a1ng ti\u1ec7n c\u1ed1 \u0111\u1ecbnh ph\u00f9 h\u1ee3p.<\/p>\n

\"lu\u1ed3n
lu\u1ed3n v\u00e0 c\u1ed1 \u0111\u1ecbnh m\u1ea3nh gh\u00e9p b\u1eb1ng GraftLink<\/figcaption><\/figure>\n

Vi\u1ec7c lu\u1ed3n v\u00e0 c\u1ed1 \u0111\u1ecbnh m\u1ea3nh gh\u00e9p b\u00e1m ch\u00e0y kinh \u0111i\u1ec3n \u0111\u00e3 \u0111\u01b0\u1ee3c tr\u00ecnh v\u00e0o \u0111\u01b0\u1eddng h\u1ea7m x\u01b0\u01a1ng \u0111\u00f9i t\u01b0\u01a1ng t\u1ef1 nh\u01b0 \u1edf tr\u00ean.<\/p>\n

Xem th\u00eam: \u0110\u1ee9t d\u00e2y ch\u1eb1ng ch\u00e9o sau, khi n\u00e0o c\u1ea7n ph\u1eabu thu\u1eadt?<\/a><\/p>\n

T\u00e0i li\u1ec7u tham kh\u1ea3o<\/strong><\/p>\n

    \n
  1. Clancy W.G.J., Shelboume K.D., Zoellner G.B., et al. (1983). Treatment of knee joint instability secondary to rupture of t|ie posterior cruciate ligament. Report of a new procedure. JBJS, 65(3), 310.<\/li>\n
  2. Fanelli G.c. (2004). Transtibial tunel posterior cruciate ligament reconstruction, Textbook of Arthroscopy, Saunders, An Imprint of Elsevier, 893- 925.<\/li>\n
  3. Ahn J,-H, and Ha c.w. (2000). Posterior trans-septal portal for arthroscopic surgery of the knee joint. Arthrose J Arthrose Relat Surg, 16(7), 774\u2014779.<\/li>\n
  4. Ahn J,H. (2006). Arthroscopic Transtibial Posterior Cruciate Ligament Reconstruction With Preservation of Posterior Cruciate Ligament Fibers: Clinical Results of Minimum 2-Year Follow-up. Am J Sports Med, 34(2), 194-204.<\/li>\n
  5. Berg E.E. Posterior cruciate ligament tibial inlay reconstruction. Arthroscopy. 1995;11: 69-76.<\/li>\n
  6. Rauh M.A., Bergfeld G.A., Wind W.M., Parker R.D (2008). Inlay posterior cruciate ligament reconstruction, Reconstructive Knee Surgery, 3rd edition, Lippincotl Williams & Wilkins, 254- 263.<\/li>\n
  7. Adler G.G. (2013). AlUInside Posterior Cruciate Ligament Reconstruction With a GraftLink. Arthrose Tech, 2(2), ell 1-el 15.<\/li>\n
  8. Slullitel D., Galan H., Ojeda v., et al. (2012). Double-Bundle \u201cAll-Inside\u201d Posterior Cruciate Ligament Reconstruction. Arthrose Tech. 1(2), e 141 e 148.<\/li>\n
  9. Stannard J.p, and Cook J.L. (2015). Tibial Iniay Posterior Cruciate Ligament Reconstruction: Advances to a New Technique. Oper Tech Spoits Med, 23(4), 298-301.<\/li>\n<\/ol>\n
    <\/div>\n
    \n

    <\/p>\n

    DCCS<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

    Ph\u1eabu thu\u1eadt t\u1ea1o h\u00ecnh d\u00e2y ch\u1eb1ng ch\u00e9o sau (DCCS) g\u1eafn di\u1ec7n b\u00e1m ch\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1eb1ng c\u00e1ch m\u1ed5 m\u1edf \u0111\u1ebf g\u1eafn di\u1ec7n b\u00e1m ch\u00e0y c\u1ee7a DCCS ho\u1eb7c th\u1ef1c hi\u1ec7n ho\u00e0n to\u00e0n qua n\u1ed9i soi. 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