{"id":3348,"date":"2023-04-10T12:47:00","date_gmt":"2023-04-10T05:47:00","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=3348"},"modified":"2023-04-10T14:10:23","modified_gmt":"2023-04-10T07:10:23","slug":"rach-chop-xoay-nguyen-nhan-phan-loai-tien-trien","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/10\/rach-chop-xoay-nguyen-nhan-phan-loai-tien-trien\/","title":{"rendered":"\u0110\u1eb7c \u0111i\u1ec3m t\u1ed5n th\u01b0\u01a1ng r\u00e1ch ch\u00f3p xoay"},"content":{"rendered":"<p><strong><i>R\u00e1ch ch\u00f3p xoay l\u00e0 hi\u1ec7n t\u01b0\u1ee3ng t\u1ed5n th\u01b0\u01a1ng v\u1ecb tr\u00ed h\u1ed9i t\u1ee5 c\u1ee7a nh\u00f3m g\u00e2n c\u01a1. R\u00e1ch ch\u00f3p xoay l\u00e0 lo\u1ea1i b\u1ec7nh l\u00fd hay g\u1eb7p \u1edf kh\u1edbp vai, \u0111\u1eb7c bi\u1ec7t \u1edf nh\u1eefng ng\u01b0\u1eddi trong \u0111\u1ed9 tu\u1ed5i trung ni\u00ean, \u0111\u1eb7c \u0111i\u1ec3m l\u00e0 r\u00e1ch ch\u00f3p xoay kh\u00f4ng th\u1ec3 t\u1ef1 l\u00e0nh \u0111\u01b0\u1ee3c, n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n v\u00e0 kh\u00e2u l\u1ea1i s\u1edbm. H\u00e3y c\u00f9ng ch\u00fang t\u00f4i t\u00ecm hi\u1ec3u v\u1ec1 c\u1ea5u tr\u00fac gi\u1ea3i ph\u1eabu c\u1ee7a ch\u00f3p xoay, nguy\u00ean nh\u00e2n, ph\u00e2n lo\u1ea1i, v\u00e0 ti\u1ebfn tri\u1ec3n c\u1ee7a b\u1ec7nh, t\u1eeb \u0111\u00f3 c\u00f3 nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p <a href=\"https:\/\/www.vinmec.com\/vi\/co-xuong-khop\/suc-khoe-thuong-thuc\/chan-doan-va-dieu-tri-rach-chop-xoay-vung-vai\/\">\u0111i\u1ec1u tr\u1ecb<\/a> t\u1ed1t nh\u1ea5t.<\/i><\/strong><\/p>\n<p>&nbsp;<\/p>\n<p><b>Nh\u00f3m t\u00e1c gi\u1ea3: <\/b>PGS.TS. Tr\u1ea7n Trung D\u0169ng<\/p>\n<p><span style=\"font-weight: 400;\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0ThS. Tr\u1ea7n \u0110\u1ee9c Tu\u1ea5n<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0BSCKII. V\u0169 Quang Ngh\u0129a <\/span>Nguy\u1ec5n H\u1eefu M\u1ea1nh<\/p>\n<p><span style=\"font-weight: 400;\">Ng\u00e0y ph\u00e1t h\u00e0nh:\u00a0<\/span><\/p>\n<h2><b>I. \u0110\u1ea0I C\u01af\u01a0NG<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Ch\u00f3p xoay l\u00e0 m\u1ed9t thu\u1eadt ng\u1eef gi\u1ea3i ph\u1eabu h\u1ecdc d\u00f9ng \u0111\u1ec3 ch\u1ec9 n\u01a1i h\u1ed9i t\u1ee5 c\u1ee7a m\u1ed9t nh\u00f3m g\u00e2n c\u01a1 c\u00f3 ph\u1ea7n g\u00e2n b\u00e1m v\u00e0o \u0111\u1ea7u tr\u00ean x\u01b0\u01a1ng c\u00e1nh tay, bao g\u1ed3m b\u1ed1n c\u01a1 {theo th\u1ee9 t\u1ef1 t\u1eeb tr\u01b0\u1edbc ra sau) \u0111\u00f3 l\u00e0 c\u01a1 d\u01b0\u1edbi vai, c\u01a1 tr\u00ean gai, c\u01a1 d\u01b0\u1edbi gai v\u00e0 c\u01a1 tr\u00f2n b\u00e9. C\u00e1c c\u01a1 n\u00e0y ph\u1ed1i h\u1ee3p v\u1edbi nhau nh\u1ecbp nh\u00e0ng l\u00e0m cho kh\u1edbp vai th\u1ef1c hi\u1ec7n c\u00e1c \u0111\u1ed9ng t\u00e1c d\u1ea1ng, kh\u00e9p, xoay trong, xoay ngo\u00e0i, \u0111\u01b0a c\u00e1nh tay ra tr\u01b0\u1edbc, ra sau v\u00e0 gi\u1eef v\u1eefng kh\u1edbp vai.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">R\u00e1ch ch\u00f3p xoay l\u00e0 lo\u1ea1i b\u1ec7nh l\u00fd hay g\u1eb7p \u1edf kh\u1edbp vai, \u0111\u1eb7c bi\u1ec7t \u1edf nh\u1eefng ng\u01b0\u1eddi trong \u0111\u1ed9 tu\u1ed5i trung ni\u00ean. M\u1ed9t khi \u0111\u00e3 c\u00f3 th\u01b0\u01a1ng t\u1ed1n ch\u00f3p xoay s\u1ebd l\u00e0m cho b\u1ec7nh nh\u00e2n \u0111au \u0111\u1edbn, h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng kh\u1edbp vai, v\u00ec th\u1ec3 g\u00e2y \u1ea3nh h\u01b0\u1edfng r\u1ea5t nhi\u1ec1u \u0111\u1ebfn c\u00e1c ho\u1ea1t \u0111\u1ed9ng sinh ho\u1ea1t th\u01b0\u1eddng ng\u00e0y nh\u01b0 kh\u00f4ng th\u1ec3 t\u1ef1 \u0111\u00e1nh r\u0103ng, ch\u1ea3i \u0111\u1ea7u, c\u00e0i \u00e1o ng\u1ef1c hay v\u1edbi tay l\u1ea5y \u0111\u1ed3 v\u1eadt \u1edf tr\u00ean cao&#8230; d\u1eabn \u0111\u1ebfn suy gi\u1ea3m nghi\u00eam tr\u1ecdng ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh, c\u1ea7n ph\u1ea3i nh\u1eadn \u0111\u1ecbnh r\u1eb1ng b\u1ec7nh l\u00fd n\u00e0y kh\u00f4ng kh\u00f3 \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n nh\u01b0ng c\u00f3 \u0111i\u1ec1u l\u00e0 ng\u01b0\u1eddi th\u1ea7y thu\u1ed1c c\u00f3 bi\u1ebft \u0111\u1ebfn \u0111\u1ec3 th\u1ef1c hi\u1ec7n kh\u00e1m v\u00e0 ch\u1ec9 \u0111\u1ecbnh c\u1eadn l\u00e2m s\u00e0ng chu\u1ea9n x\u00e1c hay kh\u00f4ng. \u0110i\u1ec1u n\u00e0y c\u00f3 \u00fd ngh\u0129a quan tr\u1ecdng v\u00ec b\u1ec7nh l\u00fd r\u00e1ch ch\u00f3p xoay c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n v\u00e0 x\u1eed tr\u00ed s\u1edbm do \u0111\u1eb7c \u0111i\u1ec3m c\u1ee7a t\u1ed5n th\u01b0\u01a1ng r\u00e1ch\u00a0<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400;\">ch\u00f3p xoay l\u00e0 kh\u00f4ng th\u1ec3 t\u1ef1 l\u00e0nh \u0111\u01b0\u1ee3c, n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n v\u00e0 kh\u00e2u l\u1ea1i s\u1edbm th\u00ec ti\u1ebfn tri\u1ec3n c\u1ee7a ch\u1ed3 g\u00e2n r\u00e1ch \u0111\u00f3 s\u1ebd l\u00e0 ng\u00e0y c\u00e0ng to\u00e1c r\u1ed9ng \u0111\u1ebfn m\u1ee9c kh\u00f4ng th\u1ec3 kh\u00e2u ph\u1ee5c h\u1ed3i \u0111\u01b0\u1ee3c n\u1eefa.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">v\u1ec1 \u0111i\u1ec1u tr\u1ecb th\u00ec c\u00e1c ph\u01b0\u01a1ng ph\u00e1p<\/span> <span style=\"font-weight: 400;\">b\u1ea3o t\u1ed3n b\u1eb1ng thu\u1ed1c, v\u1eadt l\u00fd tr\u1ecb li\u1ec7u c\u0169ng nh\u01b0 ti\u00eam cortico\u00efde v\u00e0o khoang d\u01b0\u1edbi m\u1ecfm c\u00f9ng c\u00f3 th\u1ec3 \u0111em l\u1ea1i k\u1ebft qu\u1ea3 t\u1ed1t cho b\u1ec7nh nh\u00e2n \u1edf giai \u0111o\u1ea1n s\u1edbm. Khi \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n th\u1ea5t b\u1ea1i th\u00ec ph\u1eabu thu\u1eadt kh\u00e2u l\u1ea1i ch\u1ed7 r\u00e1ch c\u1ee7a ch\u00f3p xoay c\u00f3 t\u00e1c d\u1ee5ng gi\u1ea3m \u0111au, ph\u1ee5c h\u1ed3i l\u1ea1i t\u1ea7m v\u1eadn \u0111\u1ed9ng c\u0169ng nh\u01b0 s\u1ef1 v\u1eefng ch\u1eafc c\u1ee7a kh\u1edbp s\u1ebd tr\u00e1nh \u0111\u01b0\u1ee3c bi\u1ebfn ch\u1ee9ng v\u1ec1 l\u00e2u d\u00e0i l\u00e0 tho\u00e1i h\u00f3a kh\u1edbp.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Nh\u1eefng n\u0103m g\u1ea7n \u0111\u00e2y c\u00f9ng v\u1edbi s\u1ef1 ph\u00e1t tri\u1ec3n khoa h\u1ecdc k\u1ef9 thu\u1eadt v\u00e0 c\u00e1c \u01b0u \u0111i\u1ec3m n\u1ed5i b\u1eadt c\u1ee7a n\u1ed9i soi th\u00ec ph\u1eabu thu\u1eadt n\u1ed9i soi kh\u1edbp vai \u0111\u00e3 chi\u1ebfm h\u1eb3n \u01b0u th\u1ebf so v\u1edbi m\u1ed5 m\u1edf v\u1ec1 kh\u1ea3 n\u0103ng \u0111\u00e1nh gi\u00e1 ch\u00ednh x\u00e1c t\u1ed5n th\u01b0\u01a1ng, \u00edt x\u00e2m l\u1ea5n h\u01a1n n\u00ean \u0111\u1edd \u0111au sau m\u1ed5, t\u1ea1o \u0111i\u1ec1u ki\u1ec7n \u0111\u1ec3 b\u1ec7nh nh\u00e2n t\u1eadp v\u1eadn \u0111\u1ed9ng \u0111\u01b0\u1ee3c s\u1edbm h\u01a1n, c\u00f9ng nh\u01b0 tr\u00e1nh \u0111\u01b0\u1ee3c bi\u1ebfn ch\u1ee9ng teo c\u01a1 Delta. Ch\u00ednh v\u00ec v\u1eady n\u00ean ng\u00e0y c\u00e0ng nhi\u1ec1u ph\u1eabu thu\u1eadt vi\u00ean \u0111\u00e3 \u1ee9ng d\u1ee5ng k\u1ef9 thu\u1eadt kh\u00e2u ch\u00f3p xoay qua n\u1ed9i soi v\u1edbi k\u1ebft qu\u1ea3 ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng t\u1ed1t \u0111\u1ea1t \u0111\u1ebfn h\u01a1n 90%.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<h2><b>II. Gi\u1ea3i ph\u1eabu<\/b><b><br \/>\n<\/b><\/h2>\n<p><b><\/b><br \/>\n<span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<p><span style=\"font-weight: 400;\">C\u00e1c c\u01a1 ch\u00f3p xoay \u0111\u01b0\u1ee3c c\u01a1 Delta bao ph\u1ee7 b\u00ean ngo\u00e0i, g\u1ed3m c\u1ecf 4 c\u01a1: c\u01a1 d\u01b0\u1edbi vai \u1edf ph\u00eda tr\u01b0\u1edbc, c\u01a1 tr\u00ean gai \u1edf tr\u00ean, c\u01a1 d\u01b0\u1edbi gai \u1edf sau tr\u00ean v\u00e0 c\u01a1 tr\u00f2n b\u00e9 \u1edf sau. Nh\u1eefng c\u01a1 n\u00e0y kh\u00f4ng ho\u1ea1t \u0111\u1ed9ng ri\u00eang r\u1ebd m\u00e0 ph\u1ed1i h\u1ee3p nh\u1ecbp nh\u00e0ng \u0111\u1ec3 t\u1ea1o n\u00ean c\u00e1c \u0111\u1ed9ng t\u00e1c xoay c\u1ee7a ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay, gi\u1eef v\u1eefng ch\u1ecfm n\u1eb1m c\u00e2n b\u1eb1ng trong \u00f4 ch\u1ea3o.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_3367\" aria-describedby=\"caption-attachment-3367\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/339372265_190615880415470_599909476694265596_n.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-3367\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/339372265_190615880415470_599909476694265596_n-300x160.png\" alt=\"\u1ea3nh minh h\u1ecda gi\u1ea3i ph\u1eabu c\u01a1 ch\u00f3p xoay\" width=\"300\" height=\"160\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/339372265_190615880415470_599909476694265596_n-300x160.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/339372265_190615880415470_599909476694265596_n.png 612w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-3367\" class=\"wp-caption-text\"><em>C\u00e1c g\u00e2n ch\u00f3p xoay.<\/em><br \/><em>Ngu\u1ed3n: Netter FH (1997), Atlas giai ph\u1eabu ng\u01b0\u1eddi<\/em><\/figcaption><\/figure>\n<p><b>C\u01a1 d\u01b0\u1edbi vai: <\/b><span style=\"font-weight: 400;\">nguy\u00ean \u1ee7y t\u1eeb h\u1ed1 d\u01b0\u1edbi \u00a0 vai (m\u1eb7t tr\u01b0\u1edbc c\u1ee7a x\u01b0\u01a1ng b\u1ea3 vai) b\u00e1m t\u1eadn v\u00e0o c\u1ee7 b\u00e9 x\u01b0\u01a1ng c\u00e1nh tay. C\u01a1 n\u00e0y c\u00f3 t\u00e1c d\u1ee5ng l\u00e0m xoay trong c\u00e1nh tay v\u00e0 gi\u1eef cho ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay \u1edf v\u1ecb tr\u00ed trung t\u00e2m c\u1ee7a \u1ed5 ch\u1ea3o m\u00e0 kh\u00f4ng b\u1ecb tr\u01b0\u1ee3t ra tr\u01b0\u1edbc.<\/span><\/p>\n<p><b>C\u01a1 tr\u00ean gai: <\/b><span style=\"font-weight: 400;\">nguy\u00ean \u1ee7y \u1edf h\u1ed1 tr\u00ean gai, ch\u1ea1y ra tr\u01b0\u1edbc ngo\u00e0i ngay ph\u00eda d\u01b0\u1edbi c\u1ee7a cung c\u00f9ng qu\u1ea1 b\u00e1m t\u1eadn v\u00e0o c\u1ee7 l\u1edbn x\u01b0\u01a1ng c\u00e1nh tay. C\u01a1 tr\u00ean gai l\u00e0 th\u00e0nh ph\u1ea7n quan tr\u1ecdng tham gia v\u00e0o \u0111\u1ed9ng t\u00e1c d\u1ea1ng vai, ngo\u00e0i ra c\u00f2n c\u00f3 t\u00e1c d\u1ee5ng nh\u01b0 m\u1ed9t mi\u1ebfng \u0111\u1ec7m h\u1ea1n ch\u1ebf s\u1ef1 c<\/span><span style=\"font-weight: 400;\">\u1ecd s\u00e1t <\/span><span style=\"font-weight: 400;\">gi\u1eefa ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay <\/span><span style=\"font-weight: 400;\">v\u00e0 <\/span><span style=\"font-weight: 400;\">m\u1ecfm c\u00f9ng vai.<\/span><\/p>\n<p><b>C\u01a1 d\u01b0\u1edbi gai<\/b><span style=\"font-weight: 400;\">: xu\u1ea5t ph\u00e1t t\u1eeb 2\/3 trong c\u1ee7a h\u1ed1 d\u01b0\u1edbi gai b\u00e1m t\u1eadn v\u00e0o c\u1ee7 l\u1edbn ngay d\u01b0\u1edbi ch\u1ed7 b\u00e1m c\u1ee7a c\u01a1 tr\u00ean gai, c\u00f3 t\u00e1c d\u1ee5ng xoay ngo\u00e0i c\u00e1nh tay.<\/span><\/p>\n<p><b>C\u01a1 tr\u00f2n b\u00e9: <\/b><span style=\"font-weight: 400;\">nguy\u00ean u\u1ef7 <\/span><b>l\u00e0 2\/3 <\/b><span style=\"font-weight: 400;\">tr\u00ean v\u00e0 b\u1edd ngo\u00e0i x\u01b0\u01a1ng b\u1ea3 vai ch\u1ea1y b\u00e1m \u1edf v\u1ecb tr\u00ed tliap nh\u1ea5t trong kh\u1ed1i ch\u00f3p xoay v\u00e0o c\u1ee7 l\u1edbn. C\u01a1 tr\u00f2n b\u00e9 c\u0169ng c\u00f3 t\u00e1c d\u1ee5ng xoay ngo\u00e0i c\u00e1nh tay v\u00e0 \u0111\u1ecbnh t\u00e2m ch\u1ecfm.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Ph\u1ea3i kh\u1eb3ng \u0111\u1ecbnh m\u1ed9t \u0111i\u1ec1u ch\u1eafc ch\u1eafn m\u00e0 nhi\u1ec1u t\u00e1c gi\u1ea3 \u0111\u00e0 nghi\u00ean c\u1ee9u v\u00e0 \u0111\u1ed3ng nh\u1ea5t l\u00e0 kh\u00f4ng ph\u1ea3i 4 g\u00e2n n\u00e0y c\u00f3 \u0111i\u1ec3m b\u00e1m r\u1ea1ch r\u00f2i ri\u00eang r\u1ebd l\u00ean \u0111\u1ea7u tr\u00ean x\u01b0\u01a1ng c\u00e1nh tay m\u00e0 g\u00e2n tr\u00ean gai v\u00e0 d\u01b0\u1edbi gai tr\u01b0\u1edbc khi b\u00e1m t\u1eadn v\u00e0o c\u1ee7 l\u1edbn x\u01b0\u01a1ng c\u00e1nh tay thl c\u00f3 \u0111o\u1ea1n h\u00f2a l\u1eabn v\u00e0o nhau (kho\u1ea3ng 15mm); trong khi \u0111\u00f3 g\u00e2n d\u01b0\u1edbi gai v\u00e0 tr\u00f2n b\u00e9 h\u1ee3p nh\u1ea5t v\u1edbi nhau s\u1edbm h\u01a1n, \u1edf g\u1ea7n \u0111i\u1ec3m chuy\u1ec3n ti\u1ebfp gi\u1eefa g\u00e2n &#8211; c\u01a1.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Di\u1ec7n b\u00e1m c\u1ee7a c\u00e1c g\u00e2n ch\u00f3p xoay v\u00e0o c\u1ee7 l\u1edbn x\u01b0\u01a1ng c\u00e1nh tay \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 ch\u00e2n b\u00e1m, \u0111\u1ed9 r\u1ed9ng r\u1ea5t kh\u00e1c nhau \u1edf c\u00e1c g\u00e2n; trung b\u00ecnh l\u00e0 12,7 min v\u1edbi g\u00e2n tr\u00ean gai, 13,4 mm v\u1edbi g\u00e2n d\u01b0\u1edbi gai v\u00e0 17,9 mm \u0111\u1ed1i v\u1edbi g\u00e2n d\u01b0\u1edbi vai. Kho\u1ea3ng c\u00e1ch t\u1eeb ch\u00e2n b\u00e1m \u0111\u1ebfn m\u1eb7t kh\u1edbp t\u0103ng t\u1eeb kho\u1ea3ng lmm (t\u1ea1i v\u1ecb tr\u00ed m\u1eb7t tr\u01b0\u1edbc g\u00e2n tr\u00ean gai) \u0111\u1ebfn 13.9 mm <\/span><i><span style=\"font-weight: 400;\">t\u1ea1i<\/span><\/i><span style=\"font-weight: 400;\"> m\u1eb7t sau cua g\u00e2n tr\u00f2n b\u00e9)<\/span><\/p>\n<p><b>Kho\u1ea3ng gian ch\u00f3p xoay <\/b><span style=\"font-weight: 400;\">(Rotator interval), l\u00e0 m\u1ed9t v\u00e1ch li\u00ean k\u1ebft m\u1ecfng n\u1eb1m gi\u1eefa b\u1edd d\u01b0\u1edbi c\u1ee7a g\u00e2n tr\u00ean gai v\u00e0 b\u1edd tr\u00ean g\u00e2n d\u01b0\u1edbi vai \u1edf d\u01b0\u1edbi. \u0110\u00e2y l\u00e0 m\u1ed1c gi\u1ea3i ph\u1eabu \u0111\u1ec3 m\u1edf ng\u00f5 tr\u01b0\u1edbc khi v\u00e0o kh\u1edbp v\u00ec n\u00f3 an to\u00e0n, kh\u00f4ng l\u00e0m \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u00e1c c\u01a1 ch\u00f3p xoay.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<figure id=\"attachment_3378\" aria-describedby=\"caption-attachment-3378\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/unnamed-file.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-3378\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/unnamed-file-300x146.png\" alt=\"\u1ea2nh minh h\u1ecda kho\u1ea3ng tr\u1ed1ng ch\u00f3p xoay\" width=\"300\" height=\"146\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/unnamed-file-300x146.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/unnamed-file.png 535w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-3378\" class=\"wp-caption-text\"><em>Kho\u1ea3ng tr\u1ed1ng ch\u00f3p xoay Ngu\u1ed3n: Ronald p, Karzel (2003). SLAP lesions, Operative Arthroscopy edition, Lipp &#8216;scott Williams Wilkins<\/em><\/figcaption><\/figure>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">D\u1ea7u d\u00e0i g\u00e2n c\u01a1 nh\u1ecb \u0111\u1ea7u: c\u0169ng l\u00e0 m\u1ed9t th\u00e0nh t\u1ed5 quan tr\u1ecdng trong vi\u1ec7c gi\u1eef v\u1eefng kh\u1edbp vai v\u00e0 li\u00ean h\u1ec7 m\u1eadt thi\u1ebft v\u1edbi nh\u00f3m ch\u00f3p xoay, n\u1ebfu nh\u01b0 kh\u00f4ng mu\u1ed1n n\u00f3i l\u00e0 (c\u00f3 t\u00e1c gi\u1ea3 cho r\u1eb1ng) n\u00f3 thu\u1ed9c th\u00e0nh ph\u1ea7n c\u1ee7a ch\u00f3p xoay. C\u01a1 c\u00f3 nguy\u00ean u\u1ef7 b\u00e1m v\u00e0o b\u1edd tr\u00ean \u00f4 ch\u1ea3o, ch\u1ea1y xu\u1ed1ng qua r\u00e3nh nh\u1ecb \u0111\u1ea7u. \u0110\u1ea7u d\u00e0i c\u1ee7a g\u00e2n nh\u1ecb \u0111\u1ea7u c\u00f2n c\u00f3 t\u00e1c d\u1ee5ng gi\u1ea3m t\u1ea3i cho d\u00e2y ch\u1eb1ng \u1ed5 ch\u1ea3o c\u00e1nh tay d\u01b0\u1edbi v\u00e0 tham gia v\u00e0o c\u00e1c \u0111\u1ed9ng t\u00e1c n\u00e9m ho\u1eb7c \u0111\u01b0a tay qu\u00e1 \u0111\u1ea7u.<\/span><\/p>\n<figure id=\"attachment_3380\" aria-describedby=\"caption-attachment-3380\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/uhi.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-3380\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/uhi-300x188.png\" alt=\"\u1ea2nh minh h\u1ecda: \u0110\u1ea7u d\u00e0i g\u00e2n c\u01a1 nh\u1ecb\" width=\"300\" height=\"188\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/uhi-300x188.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/uhi.png 320w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-3380\" class=\"wp-caption-text\"><em>\u0110\u1ea7u d\u00e0i g\u00e2n c\u01a1 nh\u1ecb \u0111\u1ea7u Ngu\u1ed3n: Brian J. Cole (1999). Glenohumeral instability. Disorders of shoulder: diagnosis and treatment, Lippincott William and Wilkins<\/em><\/figcaption><\/figure>\n<p><span style=\"font-weight: 400;\">M\u1ed9t ph\u1ea7n g\u00e2n tr\u00ean gai k\u1ebft h\u1ee3p v\u1edbi gi\u1eefa m\u00e1i v\u00e0 s\u00e0n l\u00e0 d\u00e0nh cho \u0111\u1ea7u d\u00e0i<\/span><\/p>\n<p><span style=\"font-weight: 400;\">g\u00e2n d\u01b0\u1edbi vai ph\u00f9 l\u00ean m\u1eb7t tr\u00ean c\u1ee7a<\/span> <span style=\"font-weight: 400;\">r\u00e3nh nh\u1ecb \u0111\u1ea7u n\u00ean \u0111\u01b0\u1ee3c h\u00ecnh dung gi\u1ed1ng m\u00e1i nh\u00e0, c\u00f2n ph\u1ea7n sau c\u1ee7a g\u00e2n d\u01b0\u1edbi vai <\/span><span style=\"font-weight: 400;\">\u00a0<\/span><span style=\"font-weight: 400;\">l\u00f3t<\/span> <b>\u00a0<\/b><span style=\"font-weight: 400;\">ph\u00eda d\u01b0\u1edbi r\u00e3nh nh\u1ecb \u0111\u1ea7u th\u00ec gi\u1ed1ng nh\u01b0 s\u00e0n nh\u00e0; kho\u1ea3ng kh\u00f4ng g\u00e2n nh\u1ecb \u0111\u1ea7u ch\u1ea1y trong r\u00e3nh. Ch\u00ednh m\u1ed1i li\u00ean quan n\u00e0y \u0111\u00e3 gi\u1ea3i th\u00edch cho vi\u1ec7c th\u1ea5y s\u1ef1 tr\u00f9ng h\u1ee3p khi m\u00e0 r\u00e1ch g\u00e2n d\u01b0\u1edbi vai th\u00ec th\u1ea5y c\u00f3 tr\u1eadt \u0111\u1ea7u d\u00e0i\u00a0 nh\u1ecb \u0111\u1ea7u ra kh\u00f3i r\u00e3nh.<\/span><\/p>\n<h2><b>III.\u00a0 Nguy\u00ean nh\u00e2n &#8211; C\u01a1 ch\u1ebf b\u1ec7nh sinh.<\/b><\/h2>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400;\">Nguy\u00ean nh\u00e2n d\u1eabn \u0111\u1ebfn r\u00e1ch ch\u00f3p xoay l\u00e0 do \u0111a y\u1ebfu t\u1ed1 g\u00e2y n\u00ean, bao g\u1ed3m c\u1ea3 nh\u00f3m nguy\u00ean nh\u00e2n n\u1ed9i t\u1ea1i v\u00e0 ngo\u1ea1i lai.<\/span><\/p>\n<h3><b>1. Nguy\u00ean nh\u00e2n b\u00ean trong<\/b><\/h3>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400;\">\u0110\u01b0\u1ee3c \u0111\u1ec1 xu\u1ea5t \u0111\u1ea7u ti\u00ean b\u1edfi Codman v\u00e0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">g\u1ea7n \u0111\u00e2y nh\u1ea5t l\u00e0 \u0111\u01b0\u1ee3c s\u1ef1 \u1ee7ng h\u1ed9 t\u1eeb Nirschl, c\u00e1c y\u1ebfu t\u1ed5 \u0111\u01b0\u1ee3c t\u00e1c gi\u1ea3 n\u00eau ra g\u1ed3m: nh\u1eefng thay \u0111\u1ed5i c\u00f3 li\u00ean quan \u0111\u1ebfn<\/span><\/p>\n<p><span style=\"font-weight: 400;\">y\u1ebfu t\u1ed1 tu\u1ed5i t\u00e1c v\u1ec1 r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a, thi\u1ebfu m\u00e1u nu\u00f4i d\u01b0\u1ee1ng, gi\u1ea3m s\u1ed1 l\u01b0\u1ee3ng t\u1ebf b\u00e0o, m\u1ecfng b\u00f3 s\u1ee3i collagen, t\u00edch t\u1ee5 <\/span><span style=\"font-weight: 400;\">m\u00f4 <\/span><span style=\"font-weight: 400;\">h\u1ea1t v\u00e0 v\u00f4i h\u1ecfa. Nh\u1eefng thay \u0111\u1ed5i n\u00e0y c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn \u201cr\u00e1ch tho\u00e1i h\u00f3a\u201d trong khi \u0111\u00f3 l\u1ef1c x\u00e9 do stress c\u00f3 th\u1ec3 g\u00f3p ph\u1ea7n l\u00e0m r\u00e1ch n\u1ed9i g\u00e2n, g\u1ed3m c\u1ea3 t\u1ed5n th\u01b0\u01a1ng t\u00e1ch l\u1edbp.<\/span><b><\/b><\/p>\n<h3><b>2. Nguy\u00ean nh\u00e2n b\u00ean ngo\u00e0i<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">\u0110\u00e2y c\u00f3 th\u1ec3 l\u00e0 nguy\u00ean ph\u00e1t d\u1eabn \u0111\u1ebfn r\u00e1ch, nh\u01b0ng c\u0169ng c\u00f3 th\u1ec3 l\u00e0 th\u1ee9 ph\u00e1t.<\/span><\/p>\n<h4><i><span style=\"font-weight: 400;\">2.1. Nguy\u00ean nh\u00e2n nguy\u00ean ph\u00e1t<\/span><\/i><\/h4>\n<p><span style=\"font-weight: 400;\">V\u1edbi c\u0103n nguy\u00ean do h\u1ed9i ch\u1ee9ng ch\u00e8n \u00e9p d\u01b0\u1edbi m\u1ecfm c\u00f9ng vai \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 \u0111\u1ea7u ti\u00ean b\u1edfi t\u00e1c gi\u1ea3 Neer, h\u1ed9i ch\u1ee9ng n\u00e0y xu\u1ea5t hi\u1ec7n khi kho\u1ea3ng c\u00e1ch c\u1ee7a m\u1eb7t tr\u00ean ch\u1ecfm x\u01b0\u01a1ng c\u1ea3nh tay t\u1ecfi m\u1eb7t d\u01b0\u1edbi m\u1ecfm c\u00f9ng vai b\u1ecb thu h\u1eb9p ho\u1eb7c c\u00f3 ph\u1ea7n l\u1ed3i l\u00ean, ho\u1eb7c ph\u00ec \u0111\u1ea1i d\u00e2y ch\u1eb1ng c\u00f9ng qu\u1ea1, t\u00fai ho\u1ea1t d\u1ecbch khi b\u1ecb vi\u00eam s\u1ebd d\u00e0y l\u00ean d\u1eabn \u0111\u1ebfn h\u1eadu qu\u00e1 l\u00e0 m\u00f2n ch\u00f3p xoay khi \u0111\u01b0a c\u00e1nh tay l\u00ean cao. \u0110\u1ea7u ti\u00ean s\u1ebd r\u00e1ch m\u1eb7t ho\u1ea1t d\u1ecbch c\u1ee7a ch\u00f3p xoay, v\u1ecb tr\u00ed r\u00e1ch th\u00ec c\u00f3 th\u1ec3 n\u1eb1m \u1edf b\u1ea5t k\u1ef3 \u0111\u00e2u &#8211; t\u1eeb \u0111i\u1ec3m b\u00e1m \u0111\u1ebfn v\u00f9ng gi\u1eefa g\u00e2n; sau \u0111\u1ecf ch\u1ed7 r\u00e1ch s\u1ed7 lan d\u1ea7n ra t\u1edbi r\u00e1ch to\u00e0n b\u1ec1 d\u00e0y.<\/span><\/p>\n<h4><i><span style=\"font-weight: 400;\">2.2. Nguy\u00ean nh\u00e2n th\u1ee9 ph\u00e1t<\/span><\/i><\/h4>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u00a0S\u1ef1 m\u1ea5t v\u1eefng c\u1ee7a kh\u1edbp \u1ed5 ch\u1ea3o &#8211; c\u00e1nh tay (sau khi tr\u1eadt kh\u1edbp vai nhi\u1ec1u l\u1ea7n d\u1eabn \u0111\u1ebfn r\u00e1ch th\u1ee9 ph\u00e1t ch\u00f3p xoay).<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ch\u1ea5n th\u01b0\u01a1ng c\u1ea5p t\u00ednh: ng\u1eafn trong t\u01b0 th\u1ebf d\u1ea1ng tay.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ch\u1ea5n th\u01b0\u01a1ng m\u1ea1n t\u00ednh (vi ch\u1ea9n th\u01b0\u01a1ng): nguy\u00ean nh\u00e2n do s\u1ef1 l\u1eb7p \u0111i l\u1eb7p l\u1ea1i c\u1ee7a m\u1ed9t \u0111\u1ed9ng t\u00e1c kh\u1edbp vai nhi\u1ec1u l\u1ea7n (\u0111\u1eb7c bi\u1ec7t l\u00e0 \u0111\u1ed9ng t\u00e1c quay tay, \u0111\u01b0a tay qu\u00e1 \u0111\u1ea7u), hay m\u1ed9t r\u1ed1i lo\u1ea1n v\u1eadn \u0111\u1ed9ng c\u1ee7a x\u01b0\u01a1ng vai ho\u1eb7c m\u1ecfm c\u00f9ng vai. C\u00f3 th\u1ec3 th\u1ea5y r\u00f5 nguy\u00ean nh\u00e2n n\u00e0y \u1edf nh\u1eefng v\u1eadn vi\u00ean b\u01a1i l\u1ed9i, c\u1eed t\u1ea1 hay nh\u1eefng ng\u01b0\u1eddi l\u00e0m vi\u1ec7c ch\u00e2n tay, khi m\u00e0 lu\u00f4n ph\u1ea3i th\u01b0\u1eddng xuy\u00ean \u0111\u01b0a tay l\u00ean qu\u00e1 \u0111\u1ea7u d\u1eabn \u0111\u1ebfn ch\u00e8n \u00e9p c\u01a1 h\u1ecdc c\u1ee7a ch\u00f3p xoay v\u1edbi m\u1ecfm c\u00f9ng vai.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">C\u1ea7n ph\u1ea3i n\u00f3i th\u00eam r\u1eb1ng v\u1edbi y\u1ebfu t\u1ed1 ngo\u1ea1i lai th\u00ec s\u1ef1 hi\u1ec3u bi\u1ebft v\u1ec1 gi\u1ea3i ph\u1eabu h\u00ecnh d\u1ea1ng m\u1ecfm c\u00f9ng vai \u0111\u1ecfng vai tr\u00f2 quan tr\u1ecdng, \u0111\u1eb7c bi\u1ec7t l\u00e0 d\u1ea1ng m\u1ecfm c\u00f9ng vai type 2 v\u00e0 3 (\u0111\u00e0 n\u00eau trong b\u00e0i b\u1ec7nh l\u00fd h\u1eb9p khoang d\u01b0\u1edbi m\u1ecfm c\u00f9ng vai), Ch\u00ednh v\u00ec v\u1eady m\u00e0 t\u1ea7n su\u1ea5t g\u1eb7p t\u1ed5n th\u01b0\u01a1ng g\u00e2n tr\u00ean gai l\u00e0 nhi\u1ec1u nh\u1ea5t do 1\/3 tr\u01b0\u1edbc ngo\u00e0i c\u1ee7a m\u1ecfm c\u00f9ng vai c\u00e1c tu\u00fdp 2,3 c\u1ecd x\u00e1t g\u00e2y m\u00f2n ch\u00f3p v\u1ecb tr\u00ed tr\u01b0\u1edbc ngo\u00e0i (t\u01b0\u01a1ng \u1ee9ng v\u1edbi g\u00e2n tr\u00ean gai, th\u1ee9 \u0111\u1ebfn l\u00e0 g\u00e2n d\u01b0\u1edbi gai)<\/span><\/p>\n<p><span style=\"font-weight: 400;\">C\u00f3 th\u1ec3 n\u00f3i b\u1ec7nh ]\u00fd ch\u00f3p xoay gia t\u0103ng t\u1ec9 l\u1ec7 thu\u1eadn v\u1edbi tu\u1ed5i, \u0111\u1eb7c bi\u1ec7t l\u00e0 v\u1edbi nh\u1eefng ng\u01b0\u1eddi tr\u00ean 50. R\u1ea5t nhi\u1ec1u nh\u01b0ng v\u1ebft r\u00e1ch i\u0129 ti v\u00e0 kh\u00f4ng tri\u1ec7u ch\u1ee9ng \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y \u1edf nh\u1eefng ng\u01b0\u1eddi trong \u0111\u1ed9 tu\u1ed5i n\u00e0y, do v\u1eady m\u00e0 h\u1ecd ch\u1eb3ng c\u00f3 l\u00fd do n\u00e0o \u0111\u1ec3 t\u00ecm \u0111\u1ebfn c\u01a1 s\u1edf y t\u1ebf nh\u1eb1m t\u00ecm, ph\u00e1t hi\u1ec7n ra t\u1ed5n th\u01b0\u01a1ng. Th\u1eadm ch\u00ed l\u00e0 c\u1ea3 v\u1ebft r\u00e1ch b\u00e1n ph\u1ea7n ch\u00f3p xoay (\u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh ch\u1eafc ch\u1eafn qua n\u1ed9i soi) c\u0169ng kh\u00f4ng nh\u1ea5t thi\u1ebft li\u00ean quan \u0111\u1ebfn tri\u1ec7u ch\u1ee9ng ban \u0111\u1ea7u khi b\u1ec7nh nh\u00e2n t\u00ecm \u0111\u1ebfn nh\u00e2n vi\u00ean y t\u1ebf.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Khi n\u1eafm r\u00f5 nguy\u00ean nh\u00e2n &#8211; b\u1ec7nh sinh th\u00ec ta m\u1edbi hi\u1ec3u s\u00e2u s\u1eafc r\u0103ng:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">B\u1ec7nh l\u00fd r\u00e1ch ch\u00f3p xoay l\u00e0 s\u1ef1 ph\u1ed1i h\u1ee3p c\u1ee7a nhi\u1ec1u y\u1ebfu t\u1ed1: c\u01a1 h\u1ecdc, thi\u1ebfu m\u00e1u nu\u00f4i, tho\u00e1i h\u00f3a; v\u00ec v\u1eady kh\u00f4ng ch\u1ec9 c\u00f3 ph\u1eabu thu\u1eadt l\u00e0 gi\u1ea3i quy\u1ebft \u0111\u01b0\u1ee3c tri\u1ec7t \u0111\u1ec3 b\u1ec7nh m\u00e1u nu\u00f4i \u0111\u01b0\u1eddng t\u1ed3n t\u1ea1i th\u00ec khi kh\u00e2u ch\u00f3p xoay t\u1ec9 l\u1ec7 l\u00e0nh g\u00e2n s\u1ebd kh\u00f4ng \u0111\u1ea1t \u0111\u01b0\u1ee3c 100%.<\/span><\/li>\n<\/ul>\n<h2><strong>IV. Ph\u00e2n lo\u1ea1i<\/strong><\/h2>\n<p><span style=\"font-weight: 400;\">Nhi\u1ec1u ki\u1ec3u ph\u00e2n lo\u1ea1i r\u00e1ch ch\u00f3p xoay, t\u00f9y theo s\u1eed d\u1ee5ng ph\u00e2n lo\u1ea1i nh\u1eb1m m\u1ee5c \u0111\u00edch g\u00ec, ch\u00fang t\u00f4i xin cung c\u1ea5p m\u1ed9t s\u1ed1 ph\u00e2n lo\u1ea1i c\u01a1 b\u1ea3n th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng.<\/span><\/p>\n<h3><b>1. Theo v\u1ecb tr\u00ed<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">D\u1ef1a v\u00e0o \u0111i\u1ec3m r\u00e1ch n\u1eb1m \u1edf c\u01a1 n\u00e0o, tr\u00ean gai, d\u01b0\u1edbi gai, tr\u00f2n b\u00e9, d\u01b0\u1edbi vai hay l\u00e0 r\u00e1ch c\u1ea3 2 g\u00e2n, 3 g\u00e2n c\u1ea1nh nhau.<\/span><\/p>\n<h3><b>2. Theo \u0111\u1ed9 d\u00e0y<\/b><\/h3>\n<h4><b><i>2.1.\u00a0 R\u00e1ch b\u00e1n ph\u1ea7n<\/i><\/b><\/h4>\n<p><span style=\"font-weight: 400;\">G\u1ed3m c\u00e1c lo\u1ea1i: r\u00e1ch b\u00e1n ph\u1ea7n m\u1eb7t kh\u1edbp, r\u00e1ch b\u00e1n ph\u1ea7n m\u1eb7t ho\u1ea1t d\u1ecbch d\u01b0\u1edbi m\u1ecfm c\u00f9ng vai, r\u00e1ch n\u1ed9i g\u00e2n. Cho \u0111\u1ebfn nay \u0111o m\u1ee9c \u0111\u1ed9 r\u00e1ch b\u00e1n ph\u1ea7n ng\u01b0\u1eddi ta v\u1eabn s\u1eed d\u1ee5ng ph\u00e2n lo\u1ea1i c\u1ee7a Elle man v\u1edbi c\u00e1ch t\u00ednh k\u00edch th\u01b0\u1edbc t\u1eeb ch\u00e2n b\u00e1m \u0111\u1ebfn ch\u1ed7 r\u00e1ch xa nh\u1ea5t c\u1ee7a g\u00e2n:<\/span><\/p>\n<figure id=\"attachment_3389\" aria-describedby=\"caption-attachment-3389\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/2-4.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-3389\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/2-4-300x161.png\" alt=\"\u1ea2nh minh h\u1ecda: r\u00e1ch m\u1eb7t kh\u1edbp\" width=\"300\" height=\"161\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/2-4-300x161.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/2-4.png 385w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-3389\" class=\"wp-caption-text\"><em>R\u00e1ch b\u00e1n ph\u1ea7n g\u00e2n<\/em><br \/><em>Ngu\u1ed3n: David w Stoller (2007). Magnetic Resonance Imaging in Orthopaedics and Sports Medicine, Chapter 8 The shoulder, 3rd, Lippincott<\/em><br \/><em>Williams &amp; Wilkins<\/em><\/figcaption><\/figure>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u0110\u1ed9 1: k\u00edch th\u01b0\u1edbc r\u00e1ch &lt; 3mm<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u0110\u1ed9 2: k\u00edch th\u01b0\u1edbc r\u00e1ch t\u1eeb 3 <\/span><b>&#8211; 6mm<\/b><\/li>\n<li><span style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">\u00a0\u0110\u1ed9 3: k\u00edch th\u01b0\u1edbc r\u00e1ch &gt; 6mm<\/span><\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_3395\" aria-describedby=\"caption-attachment-3395\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/33.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-3395\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/33-300x184.png\" alt=\"\u1ea2nh minh h\u1ecda: Ph\u00e2n lo\u1ea1i r\u00e1ch b\u1ee7n ph\u1ea5n\" width=\"300\" height=\"184\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/33-300x184.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/33.png 490w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-3395\" class=\"wp-caption-text\">Ph\u00e2n lo\u1ea1i r\u00e1ch b\u1ee7n ph\u1ea5n theo Ellman Ngu\u1ed3n: H. Ellman (1987). Arthroscopic subacromial decompression: analysis of one- to three-year results, Arthroscopy<\/figcaption><\/figure>\n<h4><b><i>2.2 R\u00e1ch ho\u00e0n to\u00e0n (hay r\u00e1ch to\u00e0n b\u1ec1 d\u00e0y)<\/i><\/b><\/h4>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_3402\" aria-describedby=\"caption-attachment-3402\" style=\"width: 228px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/kk.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-3402\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/kk.png\" alt=\"\u1ea3nh minh h\u1ecda: R\u00e1ch ho\u00e0n to\u00e0n g\u00e2n c\u01a1 tr\u00ean gai \" width=\"228\" height=\"201\" \/><\/a><figcaption id=\"caption-attachment-3402\" class=\"wp-caption-text\">R\u00e1ch ho\u00e0n to\u00e0n g\u00e2n c\u01a1 tr\u00ean gai Ngu\u1ed3n: H. Ellian (1987). Arthroscopic subacromial decompression: analysis of one- to three-year results. Arthroscopy<\/figcaption><\/figure>\n<p><i><span style=\"font-weight: 400;\">\u00a0<\/span><\/i><\/p>\n<h4><b>2.3 Theo k\u00edch th\u01b0\u1edbc<\/b><\/h4>\n<p><span style=\"font-weight: 400;\">Khi \u0111\u00e3 x\u00e1c \u0111\u1ecbnh r\u00e1ch ho\u00e0n to\u00e0n th\u00ec ng\u01b0\u1eddi ta ph\u00e2n lo\u1ea1i ti\u1ebfp k\u00edch th\u01b0\u1edbc \u0111\u01b0\u1eddng k\u00ednh ch\u1ed7 r\u00e1ch l\u1edbn nh\u1ea5t<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; R\u00e1ch nh\u1ecf: k\u00edch th\u01b0\u1edbc ch\u1ed7 r\u00e1ch &gt; 1 cm<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; R\u00e1ch v\u1eeba: k\u00edch th\u01b0\u1edbc ch\u1ed7 r\u00e1ch 1 &#8211; 3cm<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; R\u00e1ch l\u1edbn: k\u00edch th\u01b0\u1edbc ch\u1ed7 r\u00e1ch 3 &#8211; 5cm<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; R\u00e1ch r\u1ea5t l\u1edbn (massive tear): k\u00edch th\u01b0\u1edbc ch\u1ed7 r\u00e1ch &gt; 5cm<\/span><\/p>\n<p><span style=\"font-weight: 400;\">V\u00e0 cu\u1ed1i c\u00f9ng l\u00e0 lo\u1ea1i r\u00e1ch kh\u00f4ng th\u1ec3 kh\u00e2u ph\u1ee5c h\u1ed3i \u0111\u01b0\u1ee3c (irreparable)<\/span><\/p>\n<h4><b>2.4 Theo h\u00ecnh d\u1ea1ng<\/b><\/h4>\n<p><span style=\"font-weight: 400;\">V\u1edbi r\u00e1ch ho\u00e0n to\u00e0n:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">H\u00ecnh <\/span><b>c<\/b><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">H\u00ecnh <\/span><b>u<\/b><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">H\u00ecnh L<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">R\u00e1ch r\u1ea5t l\u1edbn<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/li>\n<\/ul>\n<figure id=\"attachment_3404\" aria-describedby=\"caption-attachment-3404\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/k.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-3404\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/k-300x88.png\" alt=\"\u1ea3nh minh h\u1ecda: C\u00e1c h\u00ecnh d\u1ea1ng r\u00e1ch ho\u00e0n to\u00e0n ch\u00f3p xoay \" width=\"300\" height=\"88\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/k-300x88.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/k.png 540w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-3404\" class=\"wp-caption-text\"><em>C\u00e1c h\u00ecnh d\u1ea1ng r\u00e1ch ho\u00e0n to\u00e0n ch\u00f3p xoay Ngu\u1ed3n: Burkhart s.s, et al (2006), Lippincott Williams &lt;&amp; Wilkins Philadelphia<\/em><\/figcaption><\/figure>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<h4><b>2.5 Theo m\u1ee9c <\/b><b>\u0111\u1ed9 co <\/b><b>r\u00fat <\/b><b>g\u00e2n c\u01a1.<\/b><\/h4>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u0110\u1ed9 1 : v\u1ecb tr\u00ed g\u00e2n co r\u00fat nam \u1edf ngo\u00e0i ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay<\/span><\/li>\n<\/ul>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u0110\u1ed9 2: \u0111\u1ec9nh g\u00e2n co r\u00fat n\u1eb1m \u1edf \u0111\u1ec9nh ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\">\u0110\u1ed9 3: g\u00e2n co r\u00fat n\u1eb1m \u1edf ngang m\u1ee9c <\/span><span style=\"font-weight: 400;\">0 <\/span><span style=\"font-weight: 400;\">ch\u1ea3o x\u01b0\u01a1ng b\u1ea3 vai<\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_3406\" aria-describedby=\"caption-attachment-3406\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/339070212_2018187145044679_2057276200996086425_n.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-3406\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/339070212_2018187145044679_2057276200996086425_n-300x107.png\" alt=\"\u1ea3nh minh h\u1ecda: Ph\u00e2n lo\u1ea1i Patte v\u1ec1 m\u1ee9c \u0111\u1ed9 co r\u00fat g\u00e2n \" width=\"300\" height=\"107\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/339070212_2018187145044679_2057276200996086425_n-300x107.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/339070212_2018187145044679_2057276200996086425_n.png 569w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-3406\" class=\"wp-caption-text\">Ph\u00e2n lo\u1ea1i Patte v\u1ec1 m\u1ee9c \u0111\u1ed9 co r\u00fat g\u00e2n Ngu\u1ed3n: David wSto\u00ecler (2007). Magnetic Resonance Imaging in Orthopaedics and Sports Medicine, Chapter 8 The shoulder, 3rd, Lippincott Williams &amp; Wilkin<\/figcaption><\/figure>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<h4><b>2.6 Theo m\u1ee9c \u0111\u1ed9 tho\u00e1i h\u00f3a m\u00f4<\/b><\/h4>\n<p><span style=\"font-weight: 400;\">\u1eda nh\u1eefng lo\u1ea1i r\u00e1ch l\u1edbn v\u00e0 r\u1ea5t l\u1edbn c\u00f3 s\u1ef1 th\u00e2m nhi\u1ec5m m\u1ee1 trong c\u01a1 khi c\u00e1c c\u01a1 n\u00e0y b\u1ecb t\u1ed5n th\u01b0\u01a1ng, l\u00e2u ng\u00e0y kh\u00f4ng v\u1eadn \u0111\u1ed9ng. Ph\u00e2n lo\u1ea1i n\u00e0y \u0111\u00e1nh gi\u00e1 tr\u00ean phim MRI<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u0110\u1ed9 0: c\u01a1 b\u00ecnh th\u01b0\u1eddng \u0110\u1ed9 k c\u1ecf m\u1ed9t v\u00e0i d\u1ea3i m\u1ee1 trong c\u01a1 \u0110\u1ed9 2: m\u1edd chi\u1ebfm &lt; 50 % c\u01a1 \u0110\u1ed9 3: t\u1ec9 l\u1ec7 m\u1edd chi\u1ebfm 50 % c\u01a1 \u0110\u1ed9 4: t\u1ef7 l\u1ec7 m\u1ee1 &gt; 50 % c\u01a1.<\/span><\/p>\n<figure id=\"attachment_3408\" aria-describedby=\"caption-attachment-3408\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/339408978_664243625415245_801394767774779291_n.png\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-3408\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/339408978_664243625415245_801394767774779291_n-300x95.png\" alt=\"\u1ea3nh minh h\u1ecda: M\u1ee9c \u0111\u1ed9 tho\u00e1i h\u00f3a m\u1ee1 trong c\u01a1 \" width=\"300\" height=\"95\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/339408978_664243625415245_801394767774779291_n-300x95.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/339408978_664243625415245_801394767774779291_n.png 629w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-3408\" class=\"wp-caption-text\">M\u1ee9c \u0111\u1ed9 tho\u00e1i h\u00f3a m\u1ee1 trong c\u01a1 theo Gouta \u00ccile Ngu\u1ed3n: D. Dutailier, J. M. Poster, J. Bemagau et a\u00ec (1994). Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan,<br \/>CUn Orthop Relat Res<\/figcaption><\/figure>\n<h2><b>V. Ti\u1ebfn tri\u1ec3n b\u1ec7nh<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Ch\u00f3p xoay r\u00e1ch th\u01b0\u1eddng kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng t\u1ef1 li\u1ec1n \u0111\u01b0\u1ee3c, ch\u1ed7 r\u00e1ch s\u1ed7 ng\u00e0y c\u00e0ng r\u00e1ch r\u1ed9ng th\u00eam. H\u1eadu qu\u1ea3 l\u00e0 l\u00e0m m\u1ea5t c\u00e2n b\u1eb1ng \u201cc\u1eb7p \u0111\u00f4i l\u1ef1c\u201d v\u00e0 l\u00e0m suy gi\u1ea3m ch\u1ee9c n\u0103ng c\u1ee7a kh\u1edbp vai, th\u1eadm ch\u00ed d\u1eabn \u0111\u1ebfn th\u1ec3 gi\u1ea3 li\u1ec7t. Kh\u1edbp vai ng\u00e0y c\u00e0ng m\u1ea5t v\u1eefng g\u00e2y ra hi\u1ec7n t\u01b0\u1ee3ng ch\u1ecfm x\u01b0\u01a1ng c\u1ea3nh tay b\u1ecb di tr\u00fa l\u00ean tr\u00ean (do c\u01a1 Delta k\u00e9o m\u00e0 kh\u00f4ng c\u00f3 n\u00fat ch\u1eb7n) ch\u1ea1m v\u00e0o m\u1ecfm c\u00f9ng vai l\u00e0m tho\u00e1i h\u00f3a kh\u1edbp vai. H\u1ec7 qu\u1ea3 l\u00e0 kh\u1edbp vai m\u1ea5t v\u1eadn \u0111\u1ed9ng, b\u1ec7nh nh\u00e2n kh\u00f4ng th\u1ec3 d\u00f9ng tay \u0111\u1ec3 th\u1ef1c hi\u1ec7n c\u00e1c sinh ho\u1ea1t \u0111\u1eddi th\u01b0\u1eddng, ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng gi\u1ea3m s\u00fat tr\u1ea7m tr\u1ecdng.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>R\u00e1ch ch\u00f3p xoay l\u00e0 hi\u1ec7n t\u01b0\u1ee3ng t\u1ed5n th\u01b0\u01a1ng v\u1ecb tr\u00ed h\u1ed9i t\u1ee5 c\u1ee7a nh\u00f3m g\u00e2n c\u01a1. R\u00e1ch ch\u00f3p xoay l\u00e0 lo\u1ea1i b\u1ec7nh l\u00fd hay g\u1eb7p \u1edf kh\u1edbp vai, \u0111\u1eb7c bi\u1ec7t \u1edf nh\u1eefng ng\u01b0\u1eddi trong \u0111\u1ed9 tu\u1ed5i trung ni\u00ean, \u0111\u1eb7c \u0111i\u1ec3m l\u00e0 r\u00e1ch ch\u00f3p xoay kh\u00f4ng th\u1ec3 t\u1ef1 l\u00e0nh \u0111\u01b0\u1ee3c, n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n v\u00e0 [&hellip;]<\/p>\n","protected":false},"author":59,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[40],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>\u0110\u1eb7c \u0111i\u1ec3m t\u1ed5n th\u01b0\u01a1ng r\u00e1ch ch\u00f3p xoay - Vinmec<\/title>\n<meta name=\"description\" content=\"R\u00e1ch ch\u00f3p xoay l\u00e0 hi\u1ec7n t\u01b0\u1ee3ng t\u1ed5n th\u01b0\u01a1ng v\u1ecb tr\u00ed h\u1ed9i t\u1ee5 c\u1ee7a nh\u00f3m g\u00e2n c\u01a1. 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