{"id":1069,"date":"2023-04-04T12:34:54","date_gmt":"2023-04-04T05:34:54","guid":{"rendered":"https:\/\/bsvothanhtoan.com\/?post_type=bai-giang&#038;p=1069"},"modified":"2023-04-02T13:19:12","modified_gmt":"2023-04-02T06:19:12","slug":"trat-khop-vai-khuyu-hang","status":"publish","type":"bai-giang","link":"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/trat-khop-vai-khuyu-hang\/","title":{"rendered":"Shoulder, Elbow, Hip Dislocation"},"content":{"rendered":"<h2>TR\u1eacT KH\u1edaP KHU\u1ef6U<\/h2>\n<h3>\u0110\u1ea0I C\u01af\u01a0NG<\/h3>\n<p>Khu\u1ef7u l\u00e0 m\u1ed9t kh\u1edbp v\u1eefng, nh\u01b0ng tr\u1eadt kh\u1edbp th\u01b0\u1eddng x\u1ea3y ra v\u00e0 tr\u1eadt kh\u1edbp t\u00e1i h\u1ed3i th\u00ec hi\u1ebfm. \u0110\u00e2y l\u00e0 lo\u1ea1i tr\u1eadt kh\u1edbp ph\u1ed5 bi\u1ebfn nh\u1ea5t sau tr\u1eadt kh\u1edbp vai v\u00e0 <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-xuong-ban-ngon-tay-gay-xuong-ban-tay\/\">ng\u00f3n tay<\/a>.<\/p>\n<p>T\u1ec9 l\u1ec7 m\u1eafc ph\u1ea3i cao nh\u1ea5t \u1edf tu\u1ed5i 12 \u2013 30 v\u00e0 th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/tiep-can-benh-nhan-chan-thuong-the-thao\/\">ch\u1ea5n th\u01b0\u01a1ng th\u1ec3 thao<\/a>.<\/p>\n<h4>\u0110\u1ecbnh ngh\u0129a<\/h4>\n<p>Tr\u1eadt kh\u1edbp khu\u1ef7u l\u00e0 khi c\u1ea3 hai \u0111\u1ea7u x\u01b0\u01a1ng tr\u1ee5, x\u01b0\u01a1ng quay \u0111\u1ec1u r\u1eddi ra kh\u1ecfi \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng c\u00e1nh tay. N\u1ebfu x\u01b0\u01a1ng quay c\u00f2n \u1edf v\u1ecb tr\u00ed b\u00ecnh th\u01b0\u1eddng th\u00ec khu\u1ef7u tr\u1eadt kh\u00f4ng ho\u00e0n to\u00e0n ho\u1eb7c ch\u1ecfm quay b\u1ecb tr\u1eadt trong khi m\u1ecfm v\u1eb9t k\u1eb9t d\u01b0\u1edbi r\u00f2ng r\u1ecdc c\u0169ng \u0111\u01b0\u1ee3c xem nh\u01b0 tr\u1eadt khu\u1ef7u kh\u00f4ng ho\u00e0n to\u00e0n.<\/p>\n<h4>Gi\u1ea3i ph\u1eabu h\u1ecdc<\/h4>\n<p>Kh\u1edbp khu\u1ef7u l\u00e0 kh\u1edbp duy nh\u1ea5t g\u1ed3m ba kh\u1edbp trong m\u1ed9t khoang ho\u1ea1t m\u1ea1c bao kh\u1edbp d\u00e2y ch\u1eb1ng: kh\u1edbp c\u00e1nh tay tr\u1ee5 (r\u00f2ng r\u1ecdc m\u1ecfm khu\u1ef7u), kh\u1edbp c\u00e1nh tay quay (l\u1ed3i c\u1ea7u ngo\u00e0i ch\u1ecfm quay) v\u00e0 kh\u1edbp quay tr\u1ee5 tr\u00ean (h\u1ed1 sigma b\u00e9 vi\u1ec1n quay).<\/p>\n<p>Nh\u1eefng m\u1ed1c x\u01b0\u01a1ng c\u1ee7a m\u1ecfm khu\u1ef7u: m\u1ecfm tr\u00ean l\u1ed3i c\u1ea7u ngo\u00e0i, m\u1ecfm tr\u00ean r\u00f2ng r\u1ecdc, m\u1ecfm khu\u1ef7u s\u1edd th\u1ea5y \u0111\u01b0\u1ee3c d\u01b0\u1edbi da.<\/p>\n<h4>C\u01a1 sinh h\u1ecdc<\/h4>\n<ul>\n<li>Morrey v\u00e0 c\u1ed9ng s\u1ef1 cho r\u1eb1ng bi\u00ean \u0111\u1ed9 h\u1eefu \u00edch (sinh l\u00fd) c\u1ee7a kh\u1edbp khu\u1ef7u:\n<ul>\n<li>G\u1ea5p \u2013 du\u1ed7i: 120\u00b0 \u2013 20\u00b0<\/li>\n<li>S\u1ea5p \u2013 ng\u1eeda c\u1eb3ng tay: \u0111\u1ec1u 50\u00b0.<\/li>\n<\/ul>\n<\/li>\n<li>S\u1ef1 v\u1eefng c\u1ee7a kh\u1edbp khu\u1ef7u nh\u1edd c\u00e1c th\u00e0nh ph\u1ea7n gi\u1eef v\u1eefng t\u0129nh v\u00e0 \u0111\u1ed9ng.<\/li>\n<\/ul>\n<h3>PH\u00c2N LO\u1ea0I<\/h3>\n<p>Ph\u00e2n lo\u1ea1i d\u1ef1a tr\u00ean v\u1ecb tr\u00ed t\u01b0\u01a1ng \u0111\u1ed1i c\u1ee7a m\u1ecfm khu\u1ef7u v\u1edbi x\u01b0\u01a1ng c\u00e1nh tay sau ch\u1ea5n th\u01b0\u01a1ng. Theo Howard S.A c\u00f3 th\u1ec3 ph\u00e2n lo\u1ea1i nh\u01b0 sau:<\/p>\n<ul>\n<li>Tr\u1eadt c\u1ea3 x\u01b0\u01a1ng quay v\u00e0 tr\u1ee5: ra sau, b\u00ean tr\u1ee5, b\u00ean quay, tr\u01b0\u1edbc, ph\u00e2n k\u1ef3 (tr\u01b0\u1edbc sau hay t\u00e1ch \u0111\u00f4i)<\/li>\n<li>Ch\u1ec9 tr\u1eadt x\u01b0\u01a1ng quay: tr\u01b0\u1edbc, sau, b\u00ean ngo\u00e0i<\/li>\n<li>Ch\u1ec9 tr\u1eadt x\u01b0\u01a1ng tr\u1ee5: tr\u01b0\u1edbc, sau.<\/li>\n<\/ul>\n<p><img fetchpriority=\"high\" decoding=\"async\" width=\"848\" height=\"590\" class=\"wp-image-1070 aligncenter\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-1.jpeg\" alt=\"\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-1.jpeg 848w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-1-300x209.jpeg 300w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-1-768x534.jpeg 768w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-1-18x12.jpeg 18w\" sizes=\"(max-width: 848px) 100vw, 848px\" \/><\/p>\n<p style=\"text-align: center;\"><strong>H\u00ecnh 10.1. <\/strong>Ph\u00e2n lo\u1ea1i tr\u1eadt kh\u1edbp khu\u1ef7u<\/p>\n<p style=\"text-align: center;\">A. Tr\u1eadt khu\u1ef7u ra sau, B. Tr\u1eadt khu\u1ef7u ra tr\u01b0\u1edbc, C. Tr\u1eadt khu\u1ef7u sang b\u00ean ngo\u00e0i, D. Tr\u1eadt khu\u1ef7u sang b\u00ean trong, E. Tr\u1eadt khu\u1ef7u ph\u00e2n k\u1ef3 [1]<\/p>\n<h3>C\u01a0 CH\u1ebe CH\u1ea4N TH\u01af\u01a0NG<\/h3>\n<ul>\n<li>Th\u01b0\u1eddng tr\u1eadt khu\u1ef7u ra sau do t\u00e9 ch\u1ed1ng b\u00e0n tay ho\u1eb7c c\u1ed5 tay trong khi c\u1eb3ng tay du\u1ed7i v\u00e0 d\u1ea1ng.<\/li>\n<li>V\u1ecb tr\u00ed d\u1ec5 b\u1ecb tr\u1eadt khu\u1ef7u nh\u1ea5t l\u00e0 du\u1ed7i qu\u00e1 m\u1ee9c. Khi l\u1ef1c \u0111\u01b0\u1ee3c truy\u1ec1n t\u1eeb c\u1eb3ng tay (ch\u1ed1ng tay) \u0111\u1ebfn khu\u1ef7u m\u1edf r\u1ed9ng d\u1ea1ng khu\u1ef7u, l\u1ef1c ph\u00eda tr\u01b0\u1edbc b\u1ea9y x\u01b0\u01a1ng tr\u1ee5 ra kh\u1ecfi r\u00f2ng r\u1ecdc. Khi kh\u1edbp ti\u1ebfp t\u1ee5c t\u1edbi du\u1ed7i qu\u00e1 m\u1ee9c, bao kh\u1edbp ph\u00eda tr\u01b0\u1edbc v\u00e0 <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/ton-thuong-day-chang-ben\/\">d\u00e2y ch\u1eb1ng b\u00ean<\/a> ngo\u00e0i b\u1ecb c\u0103ng qu\u00e1 m\u1ee9c d\u1eabn t\u1edbi tr\u1eadt kh\u1edbp t\u1eeb ngo\u00e0i v\u00e0o trong.<\/li>\n<li>C\u01a1 ch\u1ebf v\u1eb9o ngo\u00e0i th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n khi c\u1eb3ng tay s\u1ea5p.<\/li>\n<li>Tr\u1eadt kh\u1edbp ra tr\u01b0\u1edbc hi\u1ebfm v\u00e0 \u0111\u01b0\u1ee3c g\u1eafn cho t\u00e1c \u0111\u1ed9ng tr\u00ean c\u1eb3ng tay \u1edf ph\u00eda sau l\u00fac c\u1eb3ng tay g\u1ea5p nh\u1eb9, th\u01b0\u1eddng k\u00e8m g\u00e3y m\u1ecfm khu\u1ef7u.<\/li>\n<li>B\u00f3 tr\u01b0\u1edbc c\u1ee7a d\u00e2y ch\u1eb1ng b\u00ean trong quan tr\u1ecdng nh\u1ea5t trong gi\u1eef v\u1eefng khu\u1ef7u sau n\u1eafn.<\/li>\n<\/ul>\n<h3>CH\u1ea8N \u0110O\u00c1N<\/h3>\n<h4>L\u00e2m s\u00e0ng<\/h4>\n<h5>Tri\u1ec7u ch\u1ee9ng \u0111\u1eb7c hi\u1ec7u<\/h5>\n<ul>\n<li>Bi\u1ebfn d\u1ea1ng:\n<ul>\n<li>Khu\u1ef7u g\u1eadp nh\u1eb9 40 \u2013 50\u00b0, kh\u00f4ng du\u1ed7i th\u1eb3ng \u0111\u01b0\u1ee3c<\/li>\n<li>Nh\u00ecn nghi\u00eang: d\u1ea5u nh\u00e1t r\u00ecu sau khu\u1ef7u, \u0111\u01b0\u1eddng v\u1ebd theo tr\u1ee5c d\u1ecdc x\u01b0\u01a1ng c\u00e1nh tay qua m\u1ecfm tr\u00ean l\u1ed3i c\u1ea7u ngo\u00e0i kh\u00f4ng qua m\u1ecfm khu\u1ef7u v\u00e0 ch\u1ecfm quay<\/li>\n<li>S\u1edd th\u1ea5y \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng c\u00e1nh tay n\u1eb1m \u1edf ph\u00eda tr\u01b0\u1edbc khu\u1ef7u, thay \u0111\u1ed5i c\u00e1c m\u1ed1c x\u01b0\u01a1ng c\u1ee7a tam gi\u00e1c Hueter (Nelaton, Malgaine).<\/li>\n<\/ul>\n<\/li>\n<li>D\u1ea5u hi\u1ec7u l\u00f2 xo (+)<\/li>\n<li>D\u1ea5u hi\u1ec7u \u1ed5 kh\u1edbp r\u1ed7ng (+)<\/li>\n<li>C\u1ea7n ch\u00fa \u00fd kh\u00e1m th\u1ea7n kinh m\u1ea1ch m\u00e1u tr\u01b0\u1edbc v\u00e0 sau n\u1eafn v\u00ec hai th\u00e0nh ph\u1ea7n n\u00e0y d\u1ec5 b\u1ecb t\u1ed5n th\u01b0\u01a1ng l\u00fac tr\u1eadt khu\u1ef7u v\u00e0 khi n\u1eafn kh\u1edbp khu\u1ef7u.<\/li>\n<\/ul>\n<h4>C\u1eadn l\u00e2m s\u00e0ng<\/h4>\n<h5>X-quang<\/h5>\n<ul>\n<li><a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/x-quang-trong-chan-thuong-chinh-hinh\/\">X-quang<\/a> t\u01b0 th\u1ebf th\u1eb3ng v\u00e0 nghi\u00eang kinh \u0111i\u1ec3n th\u01b0\u1eddng \u0111\u1ee7 \u0111\u1ec3 ph\u00e2n lo\u1ea1i v\u00e0 \u0111\u00e1nh gi\u00e1 c\u00e1c t\u1ed5n th\u01b0\u01a1ng \u0111i k\u00e8m<\/li>\n<li>X-quang gi\u00fap x\u00e1c \u0111\u1ecbnh tr\u1eadt kh\u1edbp, c\u00e1c t\u1ed5n th\u01b0\u01a1ng x\u01b0\u01a1ng k\u00e8m theo.<\/li>\n<\/ul>\n<h5>C\u00e1c c\u1eadn l\u00e2m s\u00e0ng kh\u00e1c<\/h5>\n<ul>\n<li>MRI h\u1eefu \u00edch trong \u0111\u00e1nh gi\u00e1 t\u1ed5n th\u01b0\u01a1ng ph\u1ea7n m\u1ec1m nh\u01b0 d\u00e2y ch\u1eb1ng<\/li>\n<li>CT-scan gi\u00fap \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c m\u1ee9c \u0111\u1ed9 g\u00e3y c\u0169 ch\u1ecfm quay v\u00e0 l\u1ed3i c\u1ea7u x\u01b0\u01a1ng c\u00e1nh tay nh\u1eb1m \u0111\u01b0a ra ph\u01b0\u01a1ng ph\u00e1p th\u00edch h\u1ee3p khi n\u1eafn h\u1edf.<\/li>\n<\/ul>\n<h4>C\u00e1c bi\u1ebfn ch\u1ee9ng c\u1ea5p<\/h4>\n<h5>M\u1ea1ch m\u00e1u<\/h5>\n<ul>\n<li>Ch\u1ea9n \u0111o\u00e1n s\u1edbm t\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u l\u00e0 b\u1eaft bu\u1ed9c<\/li>\n<li>Khi m\u1ea5t m\u1ea1ch c\u00f3 th\u1ec3 c\u1ed1 g\u1eafng n\u1eafn k\u00edn, tuy nhi\u00ean, n\u1ebfu sau n\u1eafn, b\u00e0n tay kh\u00f4ng \u0111\u01b0\u1ee3c t\u01b0\u1edbi m\u00e1u t\u1ed1t th\u00ec ph\u1ea3i chu\u1ea9n b\u1ecb m\u1ed5 t\u00e1i l\u1eadp tu\u1ea7n ho\u00e0n t\u1ee9c th\u1eddi.<\/li>\n<\/ul>\n<h5>Th\u1ea7n kinh<\/h5>\n<p>Ph\u1ea3i \u0111\u00e1nh gi\u00e1 c\u1ea3m gi\u00e1c, v\u1eadn \u0111\u1ed9ng c\u1ee7a m\u1ed7i th\u1ea7n kinh ri\u00eang l\u1ebb tr\u01b0\u1edbc v\u00e0 sau n\u1eafn: <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/di-chung-ton-thuong-than-kinh-ngoai-bien-liet-than-kinh-quay-giua-tru\/\">th\u1ea7n kinh quay<\/a> \u00edt khi t\u1ed5n th\u01b0\u01a1ng; <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/di-chung-ton-thuong-than-kinh-ngoai-bien-liet-than-kinh-quay-giua-tru\/\">th\u1ea7n kinh tr\u1ee5<\/a> hay b\u1ecb k\u1eb9t ph\u00eda tr\u01b0\u1edbc hay d\u00e3n khi di l\u1ec7ch v\u1eb9o ngo\u00e0i; <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/di-chung-ton-thuong-than-kinh-ngoai-bien-liet-than-kinh-quay-giua-tru\/\">th\u1ea7n kinh gi\u1eefa<\/a> c\u00f3 th\u1ec3 t\u1ed5n th\u01b0\u01a1ng khi tr\u1eadt kh\u1edbp hay khi k\u00e9o n\u1eafn kh\u1edbp khu\u1ef7u l\u00e0m k\u1eb9t trong kh\u1edbp.<\/p>\n<h3>M\u1ed8T S\u1ed0 TH\u1ec2 L\u00c2M S\u00c0NG TH\u01af\u1edcNG G\u1eb6P<\/h3>\n<h4>Tr\u1eadt khu\u1ef7u ra sau<\/h4>\n<h5>L\u00e2m s\u00e0ng<\/h5>\n<p>S\u01b0ng \u0111au nh\u1ee9c v\u00f9ng khu\u1ef7u sau ch\u1ea5n th\u01b0\u01a1ng, d\u1ea5u nh\u00e1t r\u00ecu sau khu\u1ef7u, d\u1ea5u l\u00f2 xo, kh\u1edbp khu\u1ef7u k\u1eb9t, kh\u00f4ng s\u1ea5p ng\u1eeda, tr\u1ee5c c\u00e1nh tay kh\u00f4ng qua m\u1ecfm khu\u1ef7u khi nh\u00ecn nghi\u00eang, thay \u0111\u1ed5i c\u00e1c \u0111\u1ec9nh c\u1ee7a tam gi\u00e1c N\u00e9laton.<\/p>\n<h5>C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb<\/h5>\n<ul>\n<li>&#8211; N\u1eafn k\u00edn:\n<ul>\n<li>Nhi\u1ec1u k\u0129 thu\u1eadt n\u1eafn tr\u1eadt kh\u1edbp khu\u1ef7u ra sau, m\u1ee5c \u0111\u00edch l\u00e0 chuy\u1ec3n d\u1ecbch m\u1ecfm khu\u1ef7u ra tr\u01b0\u1edbc.<\/li>\n<li>Pharvin cho b\u1ec7nh nh\u00e2n n\u1eb1m s\u1ea5p r\u1ed3i \u00e1p d\u1ee5ng l\u1ef1c k\u00e9o c\u1ee7a ng\u01b0\u1eddi n\u1eafn. Sau v\u00e0i ph\u00fat k\u00e9o, m\u1ecfm khu\u1ef7u tr\u01b0\u1ee3t v\u00e0o h\u1ed1 khu\u1ef7u.<\/li>\n<li>Meyn v\u00e0 Quigley c\u0169ng cho b\u1ec7nh nh\u00e2n n\u1eb1m s\u1ea5p nh\u01b0ng c\u00e1nh tay tr\u00ean m\u1eb7t b\u00e0n l\u00e0m \u0111\u1ed1i tr\u1ecdng, k\u00e9o c\u1eb3ng tay \u0111u \u0111\u01b0a h\u01a1n l\u00e0 to\u00e0n b\u1ed9 c\u00e1nh tay.<\/li>\n<li>K\u1ef9 thu\u1eadt n\u1eafn tr\u1eadt kh\u1edbp khu\u1ef7u m\u1edbi c\u1ee7a Kocher l\u00e0 \u00eam nh\u1eb9 v\u00e0 \u0111\u00fang c\u01a1 ch\u1ebf n\u1eafn kh\u1edbp khu\u1ef7u nh\u1ea5t:<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><img decoding=\"async\" width=\"1418\" height=\"793\" class=\"wp-image-1071 aligncenter\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-2.jpeg\" alt=\"\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-2.jpeg 1418w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-2-300x168.jpeg 300w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-2-1024x573.jpeg 1024w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-2-768x429.jpeg 768w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-2-18x10.jpeg 18w\" sizes=\"(max-width: 1418px) 100vw, 1418px\" \/><\/p>\n<p style=\"text-align: center;\">Pharvin Meyn v\u00e0 Quigley<\/p>\n<p style=\"text-align: center;\"><strong>H\u00ecnh 10.2. <\/strong>K\u1ef9 thu\u1eadt n\u1eafn khu\u1ef7u Pharvin v\u00e0 Meyn v\u00e0 Quigley [1]<\/p>\n<p>&nbsp;<\/p>\n<p><img decoding=\"async\" width=\"288\" height=\"355\" class=\"wp-image-1072 aligncenter\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-3.png\" alt=\"\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-3.png 288w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-3-243x300.png 243w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-3-10x12.png 10w\" sizes=\"(max-width: 288px) 100vw, 288px\" \/><\/p>\n<p style=\"text-align: center;\"><strong>H\u00ecnh 10.3. <\/strong>K\u1ef9 thu\u1eadt n\u1eafn khu\u1ef7u tr\u1eadt b\u00ean theo Kocher [2]<\/p>\n<ul>\n<li>Sau n\u1eafn ki\u1ec3m tra t\u00ecnh tr\u1ea1ng v\u1eefng sau n\u1eafn, th\u01b0\u1eddng \u00e1p d\u1ee5ng m\u1ed9t n\u1eb9p ph\u00eda sau v\u1edbi khu\u1ef7u g\u1ea5p 90\u00b0. \u0110a s\u1ed1 c\u00e1c khu\u1ef7u \u1ed5n \u0111\u1ecbnh sau n\u1eafn cho ph\u00e9p nh\u1eefng b\u00e0i t\u1eadp v\u1eadn \u0111\u1ed9ng ch\u1ee7 \u0111\u1ed9ng nh\u1eb9 nh\u00e0ng trong c\u1ea3 g\u1ea5p du\u1ed7i v\u00e0 s\u1ea5p ng\u1eeda c\u1eb3ng tay sau tu\u1ea7n \u0111\u1ea7u ti\u00ean.<\/li>\n<li>N\u1eafn h\u1edf: \u00edt khi ph\u1ea3i n\u1eafn h\u1edf tr\u1eadt kh\u1edbp khu\u1ef7u c\u1ea5p, th\u01b0\u1eddng n\u1eafn h\u1edf khi khu\u1ef7u tr\u1eadt kh\u00f4ng n\u1eafn v\u00e0o \u0111\u01b0\u1ee3c do m\u00f4 m\u1ec1m k\u1eb9t v\u00e0 kh\u00f3a kh\u1edbp, th\u1ec9nh tho\u1ea3ng m\u1ecfm tr\u00ean r\u00f2ng r\u1ecdc c\u00f3 th\u1ec3 k\u1eb9t kh\u1edbp.<\/li>\n<\/ul>\n<h4>Tr\u1eadt khu\u1ef7u ra tr\u01b0\u1edbc<\/h4>\n<h5>L\u00e2m s\u00e0ng<\/h5>\n<ul>\n<li>C\u00e1nh tay c\u00f3 v\u1ebb b\u1ecb ng\u1eafn, v\u1edbi c\u1eb3ng tay l\u1eadt ng\u1eeda<\/li>\n<li>\u0110\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng c\u00e1nh tay n\u1ed5i c\u1ed9m ph\u00eda sau khu\u1ef7u<\/li>\n<li>G\u00e2n c\u01a1 nh\u1ecb \u0111\u1ea7u c\u0103ng da tr\u01b0\u1edbc khu\u1ef7u nh\u01b0 \u201cd\u00e2y c\u0103ng l\u1ec1u\u201d<\/li>\n<li>Th\u1ec3 n\u00e0y th\u01b0\u1eddng c\u00f3 g\u00e3y m\u1ecfm khu\u1ef7u \u0111i k\u00e8m.<\/li>\n<\/ul>\n<h5>\u0110i\u1ec1u tr\u1ecb<\/h5>\n<ul>\n<li>N\u1eafn t\u1ea1m th\u1eddi khu\u1ef7u \u0111\u1ec3 <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/so-cuu-bat-dong-gay-xuong\/\">b\u1ea5t \u0111\u1ed9ng<\/a> trong n\u1eb9p treo tay:\n<ul>\n<li>K\u00e9o nh\u1eb9 nh\u00e0ng c\u1eb3ng tay \u0111\u1ec3 gi\u1ea3m <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/sinh-ly-co-co-va-bien-doi-cua-co-sau-tap-luyen-chan-thuong\/\">co c\u01a1<\/a> r\u1ed3i \u0111\u1ea9y \u0111\u1ea7u xa x\u01b0\u01a1ng c\u00e1nh tay ra tr\u01b0\u1edbc, g\u1ea5p khu\u1ef7u l\u1ea1i \u0111\u1ec3 b\u1ea5t \u0111\u1ed9ng t\u1ea1m \u1edf t\u01b0 th\u1ebf &lt; 90\u00b0.<\/li>\n<\/ul>\n<\/li>\n<li>N\u1ebfu c\u00f3 g\u00e3y m\u1ecfm khu\u1ef7u ph\u1ea3i k\u1ebft h\u1ee3p x\u01b0\u01a1ng v\u1eefng.<\/li>\n<\/ul>\n<h4>Tr\u1eadt kh\u1edbp khu\u1ef7u sang b\u00ean<\/h4>\n<ul>\n<li>Tr\u1eadt kh\u1edbp khu\u1ef7u b\u00ean tr\u1ee5 th\u01b0\u1eddng l\u00e0 b\u00e1n tr\u1eadt h\u01a1n l\u00e0 ho\u00e0n to\u00e0n.<\/li>\n<li>Khe kh\u1edbp r\u1ed9ng, chi\u1ec1u d\u00e0i t\u01b0\u01a1ng \u0111\u1ed1i c\u00e1nh tay v\u00e0 c\u1eb3ng tay b\u00ecnh th\u01b0\u1eddng.<\/li>\n<li>N\u1eafn b\u1eb1ng c\u00e1ch k\u00e9o ng\u01b0\u1ee3c hai chi\u1ec1u c\u00e1nh tay v\u00e0 k\u00e9o \u0111\u1ea7u xa x\u01b0\u01a1ng c\u1eb3ng tay trong t\u01b0 th\u1ebf khu\u1ef7u du\u1ed7i nh\u1eb9, v\u00e0 sau \u0111\u00f3 \u00e9p v\u00e0o gi\u1eefa ho\u1eb7c hai b\u00ean th\u00e0nh tr\u1eadt khu\u1ef7u ra sau.<\/li>\n<\/ul>\n<h3>BI\u1ebeN CH\u1ee8NG<\/h3>\n<ul>\n<li>V\u00f4i h\u00f3a d\u00e2y ch\u1eb1ng<\/li>\n<li>Vi\u00eam c\u01a1 h\u00f3a c\u1ed1t<\/li>\n<li>Ch\u00e8n \u00e9p th\u1ea7n kinh \u2013 m\u1ea1ch m\u00e1u<\/li>\n<li>H\u1ed9i ch\u1ee9ng <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/hoi-chung-chen-ep-khoang\/\">ch\u00e8n \u00e9p khoang<\/a><\/li>\n<li>Tr\u1eadt kh\u1edbp t\u00e1i h\u1ed3i<\/li>\n<li>C\u1ee9ng kh\u1edbp<\/li>\n<li>L\u1ecfng kh\u1edbp g\u1eb7p sau m\u1ed5 c\u1eaft khu\u1ef7u.<\/li>\n<\/ul>\n<h2>TR\u1eacT KH\u1edaP VAI<\/h2>\n<h3>GI\u1ea2I PH\u1eaaU<\/h3>\n<h4>Ph\u1ea7n x\u01b0\u01a1ng kh\u1edbp<\/h4>\n<ul>\n<li>Kh\u1edbp vai (ch\u1ecfm c\u00e1nh tay \u2013 <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/rach-sun-vien-o-chao-khop-vai\/\">\u1ed5 ch\u1ea3o<\/a> x\u01b0\u01a1ng b\u1ea3 vai) l\u00e0 m\u1ed9t kh\u1edbp \u0111\u1ed9ng ho\u00e0n to\u00e0n. \u1ed4 ch\u1ea3o nh\u1ecf h\u01a1n nhi\u1ec1u so v\u1edbi ch\u1ecfm (\u1ed5 ch\u1ea3o\/ch\u1ecfm # 0,54) c\u00e1nh tay<\/li>\n<li>Ph\u00eda tr\u00ean \u1ed5 ch\u1ea3o c\u00f3 cung c\u00f9ng qu\u1ea1, gi\u1edbi h\u1ea1n ph\u00eda tr\u00ean c\u1ee7a kh\u1edbp vai v\u00e0 ph\u00eda trong c\u1ee7a ch\u1ecfm<\/li>\n<li>S\u1ee5n vi\u1ec1n \u1ed5 ch\u1ea3o l\u00e0m \u1ed5 ch\u1ea3o s\u00e2u h\u01a1n.<\/li>\n<\/ul>\n<h4>Bao kh\u1edbp<\/h4>\n<ul>\n<li>B\u1eaft \u0111\u1ea7u t\u1eeb s\u1ee5n vi\u1ec1n \u0111\u1ebfn \u0111\u01b0\u1eddng vi\u1ec1n ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay c\u1ed5 gi\u1ea3i ph\u1eabu. D\u00e2y ch\u1eb1ng bao kh\u1edbp l\u00e0 th\u00e0nh ph\u1ea7n d\u00e0y l\u00ean c\u1ee7a bao kh\u1edbp, g\u1ed3m c\u00f3: d\u00e2y ch\u1eb1ng tr\u00ean \u2013 tr\u01b0\u1edbc, gi\u1eefa \u2013 tr\u01b0\u1edbc, d\u01b0\u1edbi \u2013 tr\u01b0\u1edbc, d\u01b0\u1edbi \u2013 sau.<\/li>\n<li>Ngo\u00e0i ra, c\u00f2n c\u00f3 d\u00e2y ch\u1eb1ng qu\u1ea1 \u2013 c\u00e1nh tay.<\/li>\n<\/ul>\n<h4>Th\u00e0nh ph\u1ea7n l\u00e2n c\u1eadn<\/h4>\n<ul>\n<li><a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/rach-chop-xoay\/\">Ch\u00f3p xoay<\/a>: c\u01a1 tr\u00ean gai, d\u01b0\u1edbi gai, tr\u00f2n b\u00e9, d\u01b0\u1edbi vai<\/li>\n<li>G\u00e2n c\u01a1 nh\u1ecb \u0111\u1ea7u \u0111i gi\u1eefa r\u00e3nh nh\u1ecb \u0111\u1ea7u b\u00e1m v\u00e0o b\u1edd tr\u00ean \u1ed5 ch\u1ea3o<\/li>\n<li>G\u00e2n c\u01a1 tam \u0111\u1ea7u b\u00e1m v\u00e0o l\u1ed3i c\u1ee7 d\u01b0\u1edbi \u1ed5 ch\u1ea3o<\/li>\n<li>B\u00f3 m\u1ea1ch m\u00e1u, th\u1ea7n kinh n\u00e1ch: \u0111i d\u01b0\u1edbi m\u1ea5u qu\u1ea1 v\u00e0o \u1ed5 n\u00e1ch, t\u00f9y h\u00e0nh c\u01a1 qu\u1ea1 \u2013 c\u00e1nh tay, ngay tr\u01b0\u1edbc \u2013 d\u01b0\u1edbi kh\u1edbp vai. Th\u1ea7n kinh c\u01a1 b\u00ec: xuy\u00ean qua c\u01a1 qu\u1ea1 c\u00e1nh tay \u0111\u1ec3 v\u00e0o v\u00f9ng c\u00e1nh tay tr\u01b0\u1edbc c\u00e1ch m\u1ecfm qu\u1ea1 2 \u2013 3 cm.<\/li>\n<\/ul>\n<h3>C\u01a0 CH\u1ebe CH\u1ea4N TH\u01af\u01a0NG<\/h3>\n<ul>\n<li>Theo Rockwood: c\u00f3 hai c\u01a1 ch\u1ebf g\u00e2y ra ch\u1ea5n th\u01b0\u01a1ng \u1edf kh\u1edbp vai:\n<ul>\n<li>Tr\u1ef1c ti\u1ebfp: l\u1ef1c t\u00e1c d\u1ee5ng \u0111\u1ea7u g\u1ea7n x\u01b0\u01a1ng c\u00e1nh tay (r\u1ea5t \u00edt)<\/li>\n<li>Gi\u00e1n ti\u1ebfp: v\u1eabn l\u00e0 th\u01b0\u1eddng g\u1eb7p nh\u1ea5t.<\/li>\n<\/ul>\n<\/li>\n<li>L\u1ef1c t\u00e1c \u0111\u1ed9ng k\u1ebft h\u1ee3p: d\u1ea1ng \u2013 du\u1ed7i \u2013 xoay ngo\u00e0i kh\u1edbp vai s\u1ebd \u0111\u01b0a \u0111\u1ebfn tr\u1eadt kh\u1edbp vai ra tr\u01b0\u1edbc.<\/li>\n<\/ul>\n<h3>PH\u00c2N LO\u1ea0I TR\u1eacT KH\u1edaP VAI RA TR\u01af\u1edaC<\/h3>\n<p>Theo Rockwood ph\u00e2n lo\u1ea1i nh\u01b0 sau:<\/p>\n<ul>\n<li>Theo m\u1ee9c \u0111\u1ed9 v\u1eefng: tr\u1eadt v\u00e0 b\u00e1n tr\u1eadt<\/li>\n<li>Theo di\u1ec5n ti\u1ebfn: b\u1ea9m sinh, c\u1ea5p, m\u1ea1n \u2013 k\u1eb9t, t\u00e1i h\u1ed3i<\/li>\n<li>Theo l\u1ef1c t\u00e1c \u0111\u1ed9ng: ch\u1ea5n th\u01b0\u01a1ng, t\u1ef1 nhi\u00ean, kh\u00f4ng ch\u1ea5n th\u01b0\u01a1ng<\/li>\n<li>Theo s\u1ef1 g\u00f3p ph\u1ea7n c\u1ee7a b\u1ec7nh nh\u00e2n: t\u1ef1 \u00fd, kh\u00f4ng t\u1ef1 \u00fd<\/li>\n<li>Theo h\u01b0\u1edbng tr\u1eadt: d\u01b0\u1edbi qu\u1ea1, trong qu\u1ea1, d\u01b0\u1edbi \u0111\u00f2n, d\u01b0\u1edbi vai.<\/li>\n<\/ul>\n<h3>T\u1ed4N TH\u01af\u01a0NG QUANH KH\u1edaP<\/h3>\n<h4>T\u1ed5n th\u01b0\u01a1ng ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay<\/h4>\n<p>N\u0103m 1940, Hill-Sach m\u00f4 t\u1ea3 \u0111\u1ea7y \u0111\u1ee7: khi ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay tr\u1eadt ra tr\u01b0\u1edbc trong t\u01b0 th\u1ebf xoay ngo\u00e0i: ph\u1ea7n ngo\u00e0i \u1ed5 ch\u1ea3o s\u1ebd b\u1ecb n\u00e9n \u00e9p v\u00e0 l\u00fan tr\u1edf th\u00e0nh m\u1ed9t \u201cg\u00e3y n\u00e9n \u00e9p\u201d, l\u00fac \u0111\u00f3 b\u1edd tr\u01b0\u1edbc \u1ed5 ch\u1ea3o gi\u1ed1ng nh\u01b0 m\u1ed9t c\u00e1i g\u1edd b\u00e9n c\u1ea5n v\u00e0o x\u01b0\u01a1ng x\u1ed1p v\u00f9ng m\u1eb7t sau c\u1ed5 ph\u1eabu thu\u1eadt v\u00e0 ch\u1ecfm c\u00e1nh tay.<\/p>\n<h4>T\u1ed5n th\u01b0\u01a1ng bao kh\u1edbp tr\u01b0\u1edbc<\/h4>\n<ul>\n<li>T\u1ed5n th\u01b0\u01a1ng n\u00e0y \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 \u0111\u1ea7y \u0111\u1ee7 b\u1edfi Bankart (1939)<\/li>\n<li>T\u1ed5n th\u01b0\u01a1ng ph\u1ea7n m\u1ec1m l\u00e0 s\u1ef1 t\u00e1ch r\u1eddi nh\u1eefng c\u1ea5u tr\u00fac m\u00f4 m\u1ec1m t\u1eeb \u1ed5 ch\u1ea3o ra ph\u00eda tr\u01b0\u1edbc do s\u1ef1 di chuy\u1ec3n c\u1ee7a ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay khi tr\u1eadt.<\/li>\n<\/ul>\n<h4>T\u1ed5n th\u01b0\u01a1ng kh\u00e1c<\/h4>\n<ul>\n<li>T\u1ed5n th\u01b0\u01a1ng ch\u00f3p xoay c\u00f3 th\u1ec3 x\u1ea3y ra, ho\u1eb7c r\u00e1ch, d\u00e3n d\u00e2y ch\u1eb1ng, bao kh\u1edbp<\/li>\n<li>C\u00f3 th\u1ec3 g\u00e3y m\u1ea5u \u0111\u1ed9ng l\u1edbn do khi ch\u1ecfm c\u00e1nh tay ra tr\u01b0\u1edbc ho\u1eb7c xu\u1ed1ng d\u01b0\u1edbi, nh\u00f3m c\u01a1 \u0111\u1ed1i tr\u1ecdng v\u1eabn ho\u1ea1t \u0111\u1ed9ng gi\u1eef m\u1ea5u \u0111\u1ed9ng l\u1edbn l\u1ea1i<\/li>\n<li>T\u01b0\u01a1ng t\u1ef1, tr\u1eadt ra sau c\u00f3 th\u1ec3 g\u00e3y m\u1ea5u \u0111\u1ed9ng nh\u1ecf.<\/li>\n<\/ul>\n<h3>T\u1ea6N SU\u1ea4T<\/h3>\n<ul>\n<li>\u0110\u00e2y l\u00e0 tr\u1eadt kh\u1edbp th\u01b0\u1eddng g\u1eb7p nh\u1ea5t trong c\u00e1c kh\u1edbp \u1edf ng\u01b0\u1eddi l\u1edbn (chi\u1ebfm 45%)<\/li>\n<li>\u0110a ph\u1ea7n l\u00e0 tr\u1eadt ra tr\u01b0\u1edbc, r\u1ea5t hi\u1ebfm tr\u1eadt ra sau.<\/li>\n<\/ul>\n<h3>CH\u1ea8N \u0110O\u00c1N<\/h3>\n<h4>B\u1ec7nh s\u1eed<\/h4>\n<ul>\n<li>C\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng, t\u01b0 th\u1ebf c\u00e1nh tay, h\u01b0\u1edbng l\u1ef1c khi tai n\u1ea1n<\/li>\n<li>M\u1ee9c \u0111\u1ed9 l\u1ef1c quy\u1ebft \u0111\u1ecbnh vi\u1ec7c l\u01b0\u1ee3ng gi\u00e1 m\u1ee9c \u0111\u1ed9 ch\u1ea5n th\u01b0\u01a1ng (\u0111\u1ed9 I, II, III c\u1ee7a De Palma)<\/li>\n<li>Khai th\u00e1c t\u1eadp qu\u00e1n sinh ho\u1ea1t, l\u00e0m vi\u1ec7c c\u1ee7a b\u1ec7nh nh\u00e2n.<\/li>\n<\/ul>\n<h4>L\u00e2m s\u00e0ng<\/h4>\n<ul>\n<li>Kh\u00e1m l\u00e2m s\u00e0ng tr\u1eadt kh\u1edbp vai ra tr\u01b0\u1edbc c\u00f3 th\u1ec3 ch\u1ea9n \u0111o\u00e1n \u0111\u01b0\u1ee3c: b\u1ec7nh nh\u00e2n r\u1ea5t \u0111au, tay kh\u00f4ng th\u1ec3 bu\u00f4ng th\u00f5ng, ph\u1ea3i c\u00f3 ng\u01b0\u1eddi \u0111\u1ee1 ho\u1eb7c t\u1ef1 n\u00e2ng b\u1eb1ng tay c\u00f2n l\u1ea1i.<\/li>\n<li>Tr\u1eadt d\u01b0\u1edbi qua, d\u01b0\u1edbi \u0111\u00f2n:\n<ul>\n<li>D\u1ea5u hi\u1ec7u vai vu\u00f4ng, \u201cnh\u00e1t r\u00ecu\u201d m\u1ea5t r\u00e3nh delta-ng\u1ef1c. \u1ed4 kh\u1edbp r\u1ed7ng.<\/li>\n<li>D\u1ea5u \u201cl\u00f2 xo\u201d (+). C\u00e1nh tay h\u01a1i d\u1ea1ng, xoay ngo\u00e0i.<\/li>\n<\/ul>\n<\/li>\n<li>C\u00f3 th\u1ec3 t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh, m\u1ea1ch m\u00e1u<\/li>\n<\/ul>\n<p>Tr\u1eadt d\u01b0\u1edbi n\u00e1ch: t\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u th\u1ea7n kinh m\u0169 nhi\u1ec1u h\u01a1n.<\/p>\n<h5>L\u01b0u \u00fd th\u00eam<\/h5>\n<ul>\n<li>Nh\u1eefng test \u0111\u00e1nh gi\u00e1 tr\u1eadt t\u00e1i h\u1ed3i:\n<ul>\n<li>Stress test, (<a href=\"https:\/\/www.youtube.com\/watch?v=hy7zgoEsbzQ\" target=\"_blank\" rel=\"noopener\">Crank apprehension<\/a>) t\u01b0 th\u1ebf s\u1ee3 tr\u1eadt kh\u1edbp; Fulcrum test: tr\u1eadt ra tr\u01b0\u1edbc, b\u00e1n tr\u1eadt th\u01b0\u1eddng tr\u1ef1c<\/li>\n<li>Feagin\u2019s, Sulcus\u2019s test \u2013 tr\u1eadt xu\u1ed1ng d\u01b0\u1edbi. \u1ede t\u01b0 th\u1ebf d\u1ea1ng nh\u1ea5t \u0111\u1ecbnh.<\/li>\n<\/ul>\n<\/li>\n<li>Nh\u1eefng t\u1ed5n th\u01b0\u01a1ng k\u00e8m theo c\u1ea7n \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 c\u1ea9n th\u1eadn:\n<ul>\n<li>T\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh (\u0111\u1eb7c bi\u1ec7t th\u1ea7n kinh m\u0169, th\u1ea7n kinh c\u01a1 b\u00ec) b\u1eb1ng kh\u00e1m v\u1eadn \u0111\u1ed9ng, c\u1ea3m gi\u00e1c v\u00f9ng vai<\/li>\n<li>T\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u: c\u1ea7n \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c c\u00e1c t\u1ed5n th\u01b0\u01a1ng m\u1ee9c \u0111\u1ed9 nh\u1ecf ho\u1eb7c ngh\u1ebdn t\u1eafc \u0111\u1ed9ng m\u1ea1ch n\u00e1ch<\/li>\n<li>T\u1ed5n th\u01b0\u01a1ng x\u01b0\u01a1ng (m\u1ea5u \u0111\u1ed9ng l\u1edbn) v\u00e0 ch\u00f3p xoay, b\u1edd tr\u01b0\u1edbc \u1ed5 ch\u1ea3o, k\u1eb9t kh\u1edbp.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h4>X-quang<\/h4>\n<ul>\n<li>C\u00e1c t\u01b0 th\u1ebf X-quang \u0111\u00e1nh gi\u00e1:\n<ul>\n<li>X-quang tr\u01b0\u1edbc \u2013 sau: b\u00ecnh di\u1ec7n th\u1eb3ng kh\u1edbp vai<\/li>\n<li>X-quang tr\u01b0\u1edbc sau th\u1eadt: th\u1ea5y r\u00f5 khe kh\u1edbp.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>(\u0110\u1ea7u \u0111\u00e8n trung t\u00e2m h\u01b0\u1edbng ra ngo\u00e0i 45\u00b0, phim ph\u00eda sau vai th\u1eb3ng g\u00f3c \u0111\u1ea7u \u0111\u00e8n).<\/p>\n<p>B\u00ecnh di\u1ec7n nghi\u00eang h\u1ed1c n\u00e1ch: kh\u1ea3o s\u00e1t h\u01b0\u1edbng tr\u1eadt, \u1ed5 ch\u1ea3o: b\u1ec7nh nh\u00e2n d\u1ea1ng tay, tia v\u00e0o h\u1ed1c n\u00e1ch, phim \u0111\u1ea7u vai ho\u1eb7c phim cong tia t\u1eadp trung v\u00e0o m\u1ea5u c\u00f9ng vai.<\/p>\n<p>B\u00ecnh di\u1ec7n nghi\u00eang cho th\u1ea5y h\u01b0\u1edbng tr\u1eadt v\u00e0 b\u1edd \u1ed5 ch\u1ea3o, c\u1ed5 \u1ed5 ch\u1ea3o: b\u1ec7nh nh\u00e2n \u0111\u1ee9ng, t\u1ef1a v\u00e0o t\u01b0\u1eddng, s\u00e1t phim. Tia X ph\u00eda sau, song song v\u1edbi x\u01b0\u01a1ng b\u1ea3 vai t\u1eeb tr\u00ean \u0111\u1ea7u \u0111\u1ebfn ph\u00eda tr\u01b0\u1edbc t\u1eadp trung v\u00e0o ch\u1ecfm c\u00e1nh tay).<\/p>\n<ul>\n<li>X-quang th\u1eb3ng kh\u1edbp vai xoay trong t\u1ed1i \u0111a \u0111\u00e1nh gi\u00e1 t\u1ed5n th\u01b0\u01a1ng Hill \u2013 Sachs. (C\u00e1nh tay xoay trong, s\u00e1t ng\u01b0\u1eddi).<\/li>\n<\/ul>\n<p>\u0110\u1ea7u \u0111\u00e8n nghi\u00eang ngo\u00e0i 15\u00b0; c\u00e1nh tay xoay trong b\u00e0n tay \u0111\u1ec3 sau l\u01b0ng. \u0110\u1ea7u \u0111\u00e8n th\u1eb3ng (t\u01b0 th\u1ebf Hermodson) t\u1eeb ph\u00eda tr\u01b0\u1edbc.<\/p>\n<p>Ngo\u00e0i ra, c\u00f2n nhi\u1ec1u t\u01b0 th\u1ebf kh\u00e1c \u0111\u1ec3 kh\u1ea3o s\u00e1t h\u1ebft c\u00e1c t\u1ed5n th\u01b0\u01a1ng v\u00f9ng vai.<\/p>\n<h4>MRI v\u00e0 CT-scan<\/h4>\n<p>Ngo\u00e0i t\u1ed5n th\u01b0\u01a1ng x\u01b0\u01a1ng, CT-scan v\u00e0 MRI c\u00f2n gi\u00fap cho vi\u1ec7c kh\u1ea3o s\u00e1t ch\u00f3p xoay, s\u1ee5n vi\u1ec1n.<\/p>\n<h3>\u0110I\u1ec0U TR\u1eca<\/h3>\n<h4>Kh\u00f4ng ph\u1eabu thu\u1eadt<\/h4>\n<ul>\n<li>\u0110a s\u1ed1 tr\u01b0\u1eddng h\u1ee3p tr\u1eadt c\u1ea5p t\u00ednh do ch\u1ea5n th\u01b0\u01a1ng \u0111\u1ec1u c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n b\u1eb1ng n\u1eafn tr\u1eadt v\u00e0 b\u1ea5t \u0111\u1ed9ng.<\/li>\n<li>C\u00f3 v\u00f4 s\u1ed1 ph\u01b0\u01a1ng ph\u00e1p n\u1eafn kh\u00e1c nhau v\u00e0 \u0111\u01b0\u1ee3c ghi nh\u1eadn r\u1ea5t s\u1edbm (v\u00e0i ng\u00e0n n\u0103m tr\u01b0\u1edbc C\u00f4ng nguy\u00ean, tr\u00ean gi\u1ea5y Papyrus). V\u00ed d\u1ee5: Hippocrates, Galen, Kocher, Milch \u2013 Lacey, Stimpson,&#8230;<\/li>\n<li>D\u00f9 l\u00e0 ph\u01b0\u01a1ng ph\u00e1p n\u00e0o th\u00ec vi\u1ec7c n\u1eafn tr\u1eadt kh\u1edbp c\u0169ng ph\u1ea3i d\u1ef1a v\u00e0o c\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng, chi\u1ec1u h\u01b0\u1edbng tr\u1eadt kh\u1edbp. T\u01b0 th\u1ebf b\u1ec7nh nh\u00e2n, l\u1ef1c t\u00e1c \u0111\u1ed9ng c\u1ee7a ng\u01b0\u1eddi n\u1eafn, \u0111\u1ed1i tr\u1ecdng c\u1ee7a ng\u01b0\u1eddi ph\u1ee5, h\u00ecnh th\u1ee9c n\u1eafn s\u1ebd ph\u1ee5 thu\u1ed9c c\u00e1c y\u1ebfu t\u1ed1 tr\u00ean. S\u1ef1 b\u1ea5t \u0111\u1ed9ng kh\u1edbp vai ng\u1eafn hay d\u00e0i ng\u00e0y (2 \u2013 4 tu\u1ea7n) t\u00f9y thu\u1ed9c v\u00e0o c\u00e1c t\u1ed5n th\u01b0\u01a1ng c\u1ee7a tr\u1eadt kh\u1edbp vai. <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/phuc-hoi-chuc-nang-benh-nhan-cut-chi\/\">Ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng<\/a> kh\u1edbp vai quy\u1ebft \u0111\u1ecbnh vi\u1ec7c tr\u00e1nh \u0111\u01b0\u1ee3c tr\u1eadt kh\u1edbp vai t\u00e1i h\u1ed3i.<\/li>\n<\/ul>\n<h4>N\u1eafn tr\u1eadt kh\u1edbp vai ra tr\u01b0\u1edbc<\/h4>\n<h5>Ph\u01b0\u01a1ng ph\u00e1p Hippoccrate<\/h5>\n<p>B\u1ec7nh nh\u00e2n n\u1eb1m ng\u1eeda tr\u00ean s\u00e0n nh\u00e0 ho\u1eb7c gi\u01b0\u1eddng th\u1ea5p. Ng\u01b0\u1eddi n\u1eafn d\u00f9ng hai tay k\u00e9o c\u1eb3ng tay b\u1ec7nh nh\u00e2n theo tr\u1ee5c c\u00e1nh tay trong t\u01b0 th\u1ebf dang. L\u1ef1c <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/keo-lien-tuc-trong-chan-thuong\/\">k\u00e9o li\u00ean t\u1ee5c<\/a> t\u0103ng d\u1eabn, \u0111\u1ed3ng th\u1eddi d\u00f9ng g\u00f3t ch\u00e2n \u0111\u1eb7t v\u00e0o h\u00f5m n\u00e1ch b\u1ec7nh nh\u00e2n l\u00e0m \u0111i\u1ec3m t\u1ef1a l\u00f2ng b\u00e0n ch\u00e2n \u00f4m l\u1ed3ng ng\u1ef1c b\u1ec7nh nh\u00e2n. Sau m\u1ed9t l\u00fac k\u00e9o \u0111\u1ec3 ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay xu\u1ed1ng g\u1ea7n b\u1edd \u1ed5 ch\u1ea3o, cho kh\u00e9p c\u00e1nh tay b\u1ec7nh nh\u00e2n v\u00e0o, \u0111\u1ed3ng th\u1eddi d\u00f9ng g\u00f3t \u0111\u01b0a ch\u1ecfm v\u00e0o \u1ed5 ch\u1ea3o, khi kh\u1edbp v\u00e0o, s\u1ebd nghe ti\u1ebfng \u201cc\u1ee5p\u201d (v\u00ec ch\u1ecfm ph\u1ea3i tr\u01b0\u1ee3t qua b\u1edd \u1ed5 ch\u1ea3o) v\u00e0 b\u1ec7nh nh\u00e2n c\u1ea3m th\u1ea5y d\u1ec5 ch\u1ecbu, n\u1ebfu b\u1ec7nh nh\u00e2n t\u1ec9nh, kh\u00f4ng g\u00e2y t\u00ea \u1edf kh\u1edbp. Ki\u1ec3m tra l\u1ea1i kh\u00f4ng c\u00f2n th\u1ea5y d\u1ea5u hi\u1ec7u tr\u1eadt kh\u1edbp.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" width=\"240\" height=\"236\" class=\"wp-image-1073 aligncenter\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-4.jpeg\" alt=\"\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-4.jpeg 240w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-4-12x12.jpeg 12w\" sizes=\"(max-width: 240px) 100vw, 240px\" \/><\/p>\n<p style=\"text-align: center;\"><strong>H\u00ecnh 10.4. <\/strong>N\u1eafn tr\u1eadt kh\u1edbp vai theo Hippoccrate [3]<\/p>\n<h5>Ph\u01b0\u01a1ng ph\u00e1p Kocher<\/h5>\n<p>T\u01b0 th\u1ebf b\u1ec7nh nh\u00e2n: ng\u1ed3i, khu\u1ef7u g\u1ea5p. G\u1ed3m b\u1ed1n b\u01b0\u1edbc:<\/p>\n<ul>\n<li>B\u01b0\u1edbc l: k\u00e9o li\u00ean t\u1ee5c c\u00e1nh tay \u1edf t\u01b0 th\u1ebf dang nh\u1eb9 (t\u01b0 th\u1ebf k\u1eb9t l\u00f2 xo)<\/li>\n<li>B\u01b0\u1edbc 2: xoay ngo\u00e0i c\u00e1nh tay nh\u1eb9 nh\u00e0ng cho t\u1edbi 80\u00b0, v\u1eabn k\u00e9o li\u00ean t\u1ee5c<\/li>\n<li>B\u01b0\u1edbc 3: gi\u1eef c\u00e1nh tay \u1edf t\u01b0 th\u1ebf xoay ngo\u00e0i, \u0111\u01b0a khu\u1ef7u ra tr\u01b0\u1edbc v\u00e0o g\u1ea7n \u0111\u01b0\u1eddng gi\u1eefa c\u01a1 th\u1ec3, v\u1eabn k\u00e9o li\u00ean t\u1ee5c<\/li>\n<li>B\u01b0\u1edbc 4: xoay trong c\u00e1nh tay sao cho b\u00e0n tay \u0111\u1eb7t l\u00ean vai b\u00ean kia. B\u1ec7nh nh\u00e2n c\u1ea3m nh\u1eadn kh\u1edbp \u0111\u00e3 n\u1eafn, th\u1ea5y d\u1ec5 ch\u1ecbu, h\u1ebft \u0111au, h\u1ebft tri\u1ec7u ch\u1ee9ng l\u00f2 xo. Ki\u1ec3m tra kh\u1edbp vai c\u00f3 tr\u1eadt l\u1ea1i d\u1ec5 d\u00e0ng hay kh\u00f4ng.<\/li>\n<\/ul>\n<p><img loading=\"lazy\" decoding=\"async\" width=\"1508\" height=\"1564\" class=\"wp-image-1074 aligncenter\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-5.jpeg\" alt=\"\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-5.jpeg 1508w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-5-289x300.jpeg 289w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-5-987x1024.jpeg 987w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-5-768x797.jpeg 768w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-5-1481x1536.jpeg 1481w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-5-12x12.jpeg 12w\" sizes=\"(max-width: 1508px) 100vw, 1508px\" \/><\/p>\n<p style=\"text-align: center;\"><strong>H\u00ecnh 10.5. <\/strong>N\u1eafn tr\u1eadt kh\u1edbp vai theo Kocher [4]<\/p>\n<h4>Ph\u1eabu thu\u1eadt<\/h4>\n<ul>\n<li>Ch\u1ec9 \u0111\u1ecbnh:\n<ul>\n<li>Khi c\u00f3 t\u00ecnh tr\u1ea1ng k\u1eb9t kh\u1edbp kh\u00f4ng n\u1eafn k\u00edn \u0111\u01b0\u1ee3c<\/li>\n<li>Ho\u1eb7c tr\u1eadt kh\u1edbp vai t\u00e1i h\u1ed3i.<\/li>\n<\/ul>\n<\/li>\n<li>Khi n\u1eafn m\u1edf c\u1ea7n ph\u1ee5c h\u1ed3i c\u01a1 d\u01b0\u1edbi vai, d\u01b0\u1edbi gai, bao kh\u1edbp.<\/li>\n<li>Ph\u1eabu thu\u1eadt \u0111i\u1ec1u tr\u1ecb tr\u1eadt kh\u1edbp vai t\u00e1i h\u1ed3i d\u1ef1a tr\u00ean c\u01a1 s\u1edf t\u00e1i t\u1ea1o nh\u1eefng c\u1ea5u tr\u00fac gi\u1ea3i ph\u1eabu h\u1ecdc b\u1ecb t\u1ed5n th\u01b0\u01a1ng.<\/li>\n<li>C\u00e1c ph\u01b0\u01a1ng ph\u00e1p c\u00f3 th\u1ec3 k\u1ec3 \u0111\u1ebfn:\n<ul>\n<li>Ph\u1eabu thu\u1eadt Bankart: ph\u1ee5c h\u1ed3i bao kh\u1edbp tr\u01b0\u1edbc v\u00e0 d\u00e2y ch\u1eb1ng s\u1ee5n vi\u1ec1n tr\u01b0\u1edbc<\/li>\n<li>Ph\u1eabu thu\u1eadt Jobe: s\u1eeda ch\u1eefa l\u1ea1i bao kh\u1edbp \u2013 v\u1edbi c\u1eaft v\u00e0 kh\u00e2u bao kh\u1edbp theo ch\u1eef T<\/li>\n<li>Ph\u1eabu thu\u1eadt Du Toit kh\u00e2u bao kh\u1edbp hai l\u1edbp v\u1edbi kim ch\u1ec9 \u0111\u1eb7c bi\u1ec7t<\/li>\n<li>Ph\u1eabu thu\u1eadt Putti \u2013 Platt: t\u00e1i t\u1ea1o c\u01a1 d\u01b0\u1edbi vai ho\u1eb7c d\u1eddi v\u1ecb tr\u00ed b\u00e1n g\u00e2n c\u01a1 d\u01b0\u1edbi vai<\/li>\n<li>Ph\u1eabu thu\u1eadt Magnuson \u2013 Stack: chuy\u1ec3n ch\u1ed7 b\u00e1m g\u00e2n c\u01a1 d\u01b0\u1edbi vai \u0111\u01a1n thu\u1ea7n<\/li>\n<li>Ph\u1eabu thu\u1eadt Eden \u2013 Hybbinette: ch\u00eam x\u01b0\u01a1ng v\u00e0o b\u1edd tr\u01b0\u1edbc \u1ed5 ch\u1ea3o b\u1ecb khuy\u1ebft h\u1ed5ng b\u1eb1ng x\u01b0\u01a1ng ch\u00e0y, m\u00e0o ch\u1eadu<\/li>\n<li>Ph\u1eabu thu\u1eadt Connolly: chuy\u1ec3n n\u01a1i b\u00e1m g\u00e2n c\u01a1 d\u01b0\u1edbi gai v\u00e0o ch\u1ed7 khuy\u1ebft c\u1ee7a \u0111\u1ea7u tr\u00ean x\u01b0\u01a1ng c\u00e1nh tay ho\u1eb7c khuy\u1ebft do t\u1ed5n th\u01b0\u01a1ng Hill \u2013 Sach\u2019s<\/li>\n<li>Ph\u1eabu thu\u1eadt Trillat (Coracoid transfer): chuy\u1ec3n m\u1ecfm qu\u1ea1 xu\u1ed1ng d\u01b0\u1edbi v\u00e0 ra ngo\u00e0i tr\u00e1m v\u00e0o b\u1edd tr\u01b0\u1edbc \u1ed5 ch\u1ea3o b\u1ecb khuy\u1ebft h\u1ed5ng<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>Ngo\u00e0i ra, c\u00f2n nhi\u1ec1u ph\u1eabu thu\u1eadt kh\u00e1c: Bristow \u2013 Helfet, Latarjet, Nicola, Gallie, Saha, Boytcher,&#8230; ph\u1eabu thu\u1eadt Bristow \u2013 Latarjet l\u00e0 \u0111\u01a1n gi\u1ea3n h\u01a1n c\u1ea3.<\/p>\n<h3>BI\u1ebeN CH\u1ee8NG<\/h3>\n<h4>Bi\u1ebfn ch\u1ee9ng khi tr\u1eadt kh\u1edbp vai<\/h4>\n<ul>\n<li>T\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh:\n<ul>\n<li>M\u1ee9c \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng: ba nh\u00f3m\n<ul>\n<li>D\u1eadp ph\u00f9 th\u1ea7n kinh (neuropraxia): c\u00f3 th\u1ec3 h\u1ed3i ph\u1ee5c ho\u00e0n to\u00e0n 1 \u2013 2 th\u00e1ng<\/li>\n<li>D\u00e3n th\u1ea7n kinh (axonotmesis): bao s\u1ee3i tr\u1ee5c c\u00f2n n\u00ean t\u1ef1 h\u1ed3i ph\u1ee5c 1 mm\/ng\u00e0y<\/li>\n<li>\u0110\u1ee9t th\u1ea7n kinh (neurotmesis): c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c c\u1eaft v\u00e0 kh\u00e2u n\u1ed1i ph\u1ee5c h\u1ed3i th\u1ea7n kinh.<\/li>\n<\/ul>\n<\/li>\n<li>R\u1ea5t nhi\u1ec1u ghi nh\u1eadn v\u1ec1 m\u1ee9c \u0111\u1ed9 v\u00e0 t\u1ea7n su\u1ea5t t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh.<\/li>\n<li>C\u00f3 th\u1ec3 li\u1ec7t h\u1ebft \u0111\u00e1m r\u1ed1i nh\u01b0ng t\u1ea7n su\u1ea5t th\u01b0\u1eddng g\u1eb7p nh\u1ea5t l\u00e0 d\u00e2y n\u00e1ch, k\u1ebf \u0111\u1ebfn l\u00e0 d\u00e2y c\u01a1 b\u00ec ngo\u00e0i.<\/li>\n<\/ul>\n<\/li>\n<li>T\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u: c\u00f3 nhi\u1ec1u m\u1ee9c \u0111\u1ed9: \u0111\u1ee9t nh\u00e1nh nh\u1ecf, t\u1eafc m\u1ea1ch do c\u1ee5c m\u00e1u \u0111\u00f4ng, t\u1ed5n th\u01b0\u01a1ng n\u1ed9i m\u1ea1c ho\u1eb7c \u0111\u1ee9t.<\/li>\n<\/ul>\n<h4>Bi\u1ebfn ch\u1ee9ng ngay khi n\u1eafn<\/h4>\n<ul>\n<li>V\u00f9ng t\u1ed5n th\u01b0\u01a1ng sau ngo\u00e0i c\u1ee7a ch\u1ecfm x\u01b0\u01a1ng (t\u1ed5n th\u01b0\u01a1ng Hill \u2013 Sach\u2019s)<\/li>\n<li>Ngo\u00e0i ra, m\u00f4 m\u1ec1m c\u00f3 th\u1ec3 ch\u00e8n v\u00e0o m\u1eb7t kh\u1edbp nh\u01b0 g\u00e2n c\u01a1 hai \u0111\u1ea7u, ph\u1ea7n r\u1eddi c\u1ee7a m\u1ea5u \u0111\u1ed9ng l\u1edbn, c\u01a1 d\u01b0\u1edbi vai, s\u1ee5n vi\u1ec1n v\u00e0 bao kh\u1edbp.<\/li>\n<\/ul>\n<h4>Bi\u1ebfn ch\u1ee9ng sau \u0111i\u1ec1u tr\u1ecb<\/h4>\n<p>Tr\u1eadt t\u00e1i h\u1ed3i n\u1ebfu b\u1ea5t \u0111\u1ed9ng kh\u00f4ng \u0111\u00fang v\u00e0 thi\u1ebfu v\u1eadt l\u00fd tr\u1ecb li\u1ec7u \u0111\u1ec3 ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng kh\u1edbp vai. C\u00f3 th\u1ec3 tr\u1eadt t\u00e1i h\u1ed3i d\u00f9 \u0111\u00e3 b\u1ea5t \u0111\u1ed9ng \u0111\u00fang do m\u1ee9c \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng t\u1ea1i ch\u1ecfm x\u01b0\u01a1ng v\u00e0 bao kh\u1edbp, ch\u1ecfm c\u00e1nh tay v\u00e0 \u1ed5 ch\u1ea3o.<\/p>\n<h4>Bi\u1ebfn ch\u1ee9ng kh\u00e1c<\/h4>\n<p>Vi\u00eam quanh vai, <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/thoai-hoa-khop\/\">tho\u00e1i h\u00f3a kh\u1edbp<\/a>, v\u00f4i h\u00f3a quanh kh\u1edbp, c\u1ee9ng kh\u1edbp, h\u1ed9i ch\u1ee9ng vai \u2013 b\u00e0n tay.<\/p>\n<h2>TR\u1eacT KH\u1edaP H\u00c1NG<\/h2>\n<h3>\u0110\u1ea0I C\u01af\u01a0NG<\/h3>\n<ul>\n<li>Tr\u1eadt kh\u1edbp h\u00e1ng \u00edt g\u1eb7p, chi\u1ebfm d\u01b0\u1edbi 5% t\u1ed5ng s\u1ed1 tr\u1eadt kh\u1edbp. T\u1ec9 l\u1ec7 nam:n\u1eef l\u00e0 5:1.<\/li>\n<li>Kh\u1edbp h\u00e1ng v\u1eefng, ph\u00eda tr\u01b0\u1edbc v\u00e0 ph\u00eda sau c\u00f3 c\u00e1c c\u1ed9t x\u01b0\u01a1ng ch\u1eadu n\u1eb1m \u1edf quanh h\u00f5m, c\u00e1c c\u1ed9t n\u00e0y r\u1ea5t kh\u1ecfe n\u00ean l\u1ef1c ch\u1ea5n th\u01b0\u01a1ng ph\u1ea3i m\u1ea1nh.<\/li>\n<li>Khi ch\u1ecfm tr\u1eadt, th\u00fac v\u1ee1 b\u1edd sau tr\u00ean h\u00f5m kh\u1edbp, g\u00e2y t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh h\u00f4ng to, tr\u1eadt ra tr\u01b0\u1edbc c\u00f2n l\u00e0m th\u01b0\u01a1ng t\u1ed5n th\u1ea7n kinh \u0111\u00f9i b\u1ecbt.<\/li>\n<li>Hay k\u00e8m th\u01b0\u01a1ng t\u1ed5n g\u1ed1i c\u00f9ng b\u00ean nh\u1ea5t l\u00e0 b\u1ecb v\u1ee1 <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/trat-xuong-banh-che\/\">x\u01b0\u01a1ng b\u00e1nh ch\u00e8<\/a>, r\u00e1ch d\u00e2y ch\u1eb1ng g\u1ed1i.<\/li>\n<li>Hay c\u00f3 c\u00e1c di ch\u1ee9ng mu\u1ed9n:\n<ul>\n<li><a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/hoai-tu-vo-mach-chom-xuong-dui\/\">Ho\u1ea1i t\u1eed ch\u1ecfm x\u01b0\u01a1ng \u0111\u00f9i<\/a> v\u00f4 m\u1ea1ch<\/li>\n<li><a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/viem-xuong-tuy\/\">Vi\u00eam kh\u1edbp<\/a> h\u00e1ng sau ch\u1ea5n th\u01b0\u01a1ng<\/li>\n<\/ul>\n<\/li>\n<li>C\u1ea7n n\u1eafn c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t. \u0110\u1ec3 mu\u1ed9n gi\u1edd n\u00e0o th\u00eam nhi\u1ec1u di ch\u1ee9ng h\u01a1n gi\u1edd \u1ea5y.<\/li>\n<\/ul>\n<h3>PH\u00c2N LO\u1ea0I<\/h3>\n<p>Ph\u00e2n lo\u1ea1i chung: theo Stewart c\u00f3 hai c\u00e1ch ph\u00e2n lo\u1ea1i:<\/p>\n<h4>Theo ki\u1ec3u tr\u1eadt<\/h4>\n<ul>\n<li>Tr\u1eadt ra sau: r\u1ea5t ph\u1ed5 bi\u1ebfn, \u0111\u1ebfn 4\/5 t\u1ed5ng s\u1ed1 tr\u1eadt g\u1ed3m:\n<ul>\n<li>Tr\u1eadt ra sau, l\u00ean tr\u00ean: ki\u1ec3u hay g\u1eb7p nh\u1ea5t<\/li>\n<li>Tr\u1eadt ra sau, xu\u1ed1ng d\u01b0\u1edbi: ki\u1ec3u ng\u1ed3i<\/li>\n<\/ul>\n<\/li>\n<li>Tr\u1eadt ra tr\u01b0\u1edbc: \u00edt g\u1eb7p\n<ul>\n<li>Tr\u1eadt ra tr\u01b0\u1edbc, l\u00ean tr\u00ean: ki\u1ec3u mu<\/li>\n<li>Tr\u1eadt ra tr\u01b0\u1edbc, xu\u1ed1ng d\u01b0\u1edbi: ki\u1ec3u b\u1ecbt.<\/li>\n<\/ul>\n<\/li>\n<li>Tr\u1eadt trung t\u00e2m: \u1ed5 c\u1ed1i x\u01b0\u01a1ng ch\u1eadu v\u1ee1, ch\u1ecfm l\u00fan s\u00e2u v\u00e0o \u0111\u00e1y h\u00f5m. Nguy\u00ean nh\u00e2n: do tai n\u1ea1n xe \u00f4 t\u00f4, xe va d\u1eebng \u0111\u1ed9t ng\u1ed9t, \u0111\u1ea7u g\u1ed1i va m\u1ea1nh v\u00e0o th\u00e0nh xe, ch\u1ecfm th\u00fac m\u1ea1nh v\u00e0o \u1ed5 c\u1ed1i l\u00e0m v\u1ee1 \u1ed5 c\u1ed1i.<\/li>\n<\/ul>\n<h4>Theo \u0111\u1ed9 n\u1eb7ng<\/h4>\n<ul>\n<li>\u0110\u1ed9 1: Tr\u1eadt \u0111\u01a1n thu\u1ea7n, \u1ed5 c\u1ed1i c\u00f2n nguy\u00ean v\u1eb9n.<\/li>\n<li>\u0110\u1ed9 2: \u1ed4 c\u1ed1i s\u1ee9t hay v\u1ee1 m\u00e0nh nh\u1ecf c\u00f2n v\u1eefng.<\/li>\n<li>\u0110\u1ed9 3: \u1ed4 c\u1ed1i v\u1ee1 mi\u1ebfng to, n\u1eafn v\u00e0o d\u1ec5, kh\u1edbp kh\u00f4ng v\u1eefng, d\u1ec5 b\u1eadt ra l\u1ea1i.<\/li>\n<li>\u0110\u1ed9 4: Tr\u1eadt k\u00e8m g\u00e3y ch\u1ecfm hay <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-xuong-chi-duoi\/\">g\u00e3y c\u1ed5 x\u01b0\u01a1ng \u0111\u00f9i<\/a>.<\/li>\n<\/ul>\n<h3>C\u00c1C D\u1ea4U HI\u1ec6U L\u00c2M S\u00c0NG CHUNG<\/h3>\n<p>B\u1ecb tr\u1eadt kh\u1edbp lu\u00f4n c\u00f3 d\u1ea5u hi\u1ec7u kh\u00e1ng c\u1ef1 \u0111\u00e0n h\u1ed3i (d\u1ea5u l\u00f2 xo). N\u00f3i chung:<\/p>\n<ul>\n<li>Tr\u1eadt ra sau: \u0111\u00f9i kh\u00e9p<\/li>\n<li>Tr\u1eadt ra tr\u01b0\u1edbc: \u0111\u00f9i d\u1ea1ng<\/li>\n<li>Tr\u1eadt l\u00ean tr\u00ean: \u0111\u00f9i g\u1ea5p nh\u1eb9<\/li>\n<li>Tr\u1eadt xu\u1ed1ng d\u01b0\u1edbi: \u0111\u00f9i g\u1ea5p nhi\u1ec1u.<\/li>\n<\/ul>\n<p><img loading=\"lazy\" decoding=\"async\" width=\"514\" height=\"455\" class=\"wp-image-1075 aligncenter\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-6.png\" alt=\"\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-6.png 514w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-6-300x266.png 300w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-6-14x12.png 14w\" sizes=\"(max-width: 514px) 100vw, 514px\" \/><\/p>\n<p style=\"text-align: center;\"><strong>H\u00ecnh 10.6. <\/strong>C\u00e1c th\u1ec3 l\u00e2m s\u00e0ng tr\u1eadt kh\u1edbp h\u00e1ng [5]<\/p>\n<p>Nh\u01b0 v\u1eady, v\u00ed d\u1ee5, ki\u1ec3u tr\u1eadt ra sau l\u00ean tr\u00ean, ki\u1ec3u ch\u1eadu r\u1ea5t ph\u1ed5 bi\u1ebfn ta th\u1ea5y \u0111\u00f9i kh\u00e9p, g\u1ed1i g\u1ea5p nh\u1eb9. Tr\u1eadt ki\u1ec3u mu: \u0111\u00f9i d\u1ea1ng, h\u00e1ng g\u1ea5p,&#8230; n\u1ebfu c\u00f3 k\u00e8m g\u00e3y c\u1ed5, g\u00e3y <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-xuong-chi-duoi\/\">th\u00e2n x\u01b0\u01a1ng \u0111\u00f9i<\/a> th\u00ec tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng s\u1ebd kh\u00f4ng r\u00f5.<\/p>\n<p>D\u1ea5u hi\u1ec7u <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/di-chung-ton-thuong-than-kinh-ngoai-bien-liet-than-kinh-quay-giua-tru\/\">li\u1ec7t th\u1ea7n kinh<\/a>:<\/p>\n<ul>\n<li>Li\u1ec7t th\u1ea7n kinh h\u00f4ng to: t\u00ea b\u00ec \u1edf gan ch\u00e2n<\/li>\n<li>Li\u1ec7t th\u1ea7n kinh \u0111\u00f9i: t\u00ea b\u00ec m\u1eb7t tr\u01b0\u1edbc trong \u0111\u00f9i.<\/li>\n<\/ul>\n<p>Khi b\u1ecb <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/da-chan-thuong-choang-chan-thuong\/\">\u0111a ch\u1ea5n th\u01b0\u01a1ng<\/a>, s\u1ed1c nhi\u1ec1u ph\u1ea3i lo h\u1ed3i s\u1ee9c chung, tr\u1eddi r\u00e9t ph\u1ea3i \u0111\u1eafp ch\u0103n n\u00ean d\u1ec5 b\u1ecf s\u00f3t th\u01b0\u01a1ng t\u1ed5n. M\u00e0 \u0111\u1ec3 s\u00f3t n\u1eafn mu\u1ed9n th\u00ec k\u1ebft qu\u00e1 r\u1ea5t x\u1ea5u. N\u00f3i chung, b\u1ecb \u0111a ch\u1ea5n th\u01b0\u01a1ng, khi \u0111\u01b0a \u0111i ch\u1ee5p s\u1ecd ng\u1ef1c, b\u1ee5ng n\u00ean y\u00eau c\u1ea7u ch\u1ee5p th\u00eam:<\/p>\n<ul>\n<li>Kh\u1edbp h\u00e1ng hai b\u00ean<\/li>\n<li>C\u1ed9t s\u1ed1ng \u0111o\u1ea1n ng\u1ef1c th\u1eaft l\u01b0ng.<\/li>\n<\/ul>\n<h3>N\u1eaeN TR\u1eacT KH\u1edaP H\u00c1NG<\/h3>\n<h4>Nguy\u00ean t\u1eafc chung<\/h4>\n<ul>\n<li>Ch\u1ea5n th\u01b0\u01a1ng c\u00e0ng n\u1eb7ng k\u1ebft qu\u1ea3 xa c\u00e0ng k\u00e9m<\/li>\n<li>C\u1ea7n n\u1eafn v\u00e0o s\u1edbm tr\u01b0\u1edbc 12 gi\u1edd, d\u00f9 n\u1eafn k\u00edn hay c\u00f3 m\u1ed5<\/li>\n<li>Ch\u1ec9 n\u1eafn 1 \u2013 2 l\u1ea7n m\u00e0 th\u00f4i. V\u00f4 c\u1ea3m, m\u1ec1m c\u01a1 n\u1eafn cho nh\u1eb9 nh\u00e0ng. N\u1eafn th\u00f4 b\u1ea1o l\u00e0m h\u1ecfng s\u1ee5n ch\u1ecfm, g\u00e2y g\u00e3y c\u1ed5 x\u01b0\u01a1ng \u0111\u00f9i.<\/li>\n<li>N\u1eafn kh\u00f4ng \u0111\u1ea1t th\u00ec m\u1ed5 n\u1eafn.<\/li>\n<\/ul>\n<h4>C\u00e1c b\u01b0\u1edbc ti\u1ebfn h\u00e0nh<\/h4>\n<ul>\n<li>Ch\u1ee5p CT-scan tr\u01b0\u1edbc m\u1ed5 th\u1ea5y r\u00f5 th\u01b0\u01a1ng t\u1ed5n x\u01b0\u01a1ng song n\u00ean n\u1eafn v\u00e0o tr\u01b0\u1edbc \u0111\u00e3, kh\u00f4ng ch\u1edd k\u1ebft qu\u1ea3 CT l\u00e0m m\u1ea5t th\u1eddi gian qu\u00fd b\u00e1u.<\/li>\n<li>N\u00ean g\u00e2y m\u00ea k\u1ec3 c\u1ea3 cho d\u00e3n c\u01a1 (c\u1ea7n th\u1ea7y thu\u1ed1c g\u00e2y m\u00ea) cho m\u1ec1m c\u01a1. N\u1eafn \u1edf ph\u00f2ng m\u1ed5 th\u00ec t\u1ed1t.<\/li>\n<li>N\u1eafn xong, kh\u00e1m l\u1ea1i th\u1ea7n kinh h\u00f4ng to, \u0111\u00f4i khi th\u1ea7n kinh b\u1ecb li\u1ec7t khi n\u1eafn.<\/li>\n<li>Ch\u1ee5p ki\u1ec3m tra sau n\u1eafn, c\u1ea7n xem ch\u1ecfm v\u00e0o h\u00f5m kh\u1edbp c\u00f3 \u0111\u00fang kh\u00f4ng, \u0111\u01b0\u1eddng s\u00e1ng<\/li>\n<\/ul>\n<p>vi\u1ec1n ch\u1ecfm c\u00f3 \u0111\u1ec1u kh\u00f4ng. Ch\u1ec9 h\u01a1i l\u1ec7ch t\u00e2m, c\u00f3 khe s\u00e1ng h\u01a1i r\u1ed9ng l\u00e0 ngh\u0129 ngay t\u1edbi c\u00f3 m\u1ea3nh x\u01b0\u01a1ng s\u1ee5n nh\u1ecf, m\u1ea3nh r\u00e1ch \u1edf vi\u1ec1n \u1ed5 c\u1ed1i k\u1eb9t v\u00e0o khe kh\u1edbp.<\/p>\n<p>Nghi ng\u1edd n\u00ean ch\u1ee5p CT ki\u1ec3m tra sau n\u1eafn. C\u00f3 k\u1eb9t m\u1ea3nh v\u00e0o khe kh\u1edbp n\u00ean m\u1ed5 l\u1ea5y, \u0111\u1ed1i v\u1edbi m\u1ea3nh k\u1eb9t nh\u1ecf c\u00f3 th\u1ec3 m\u1ed5 tr\u00ec ho\u00e3n kh\u00f4ng c\u1ea7n m\u1ed5 c\u1ea5p c\u1ee9u t\u1ee9c th\u00ec.<\/p>\n<h4>Ph\u01b0\u01a1ng ph\u00e1p n\u1eafn<\/h4>\n<ul>\n<li>N\u1eafn k\u00edn:\n<ul>\n<li>Tr\u1eadt ra sau: n\u1eafn theo Allis, Bigelow<\/li>\n<li>Tr\u1eadt ra tr\u01b0\u1edbc:\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li>Ki\u1ec3u mu: k\u00e9o th\u1eb3ng<\/li>\n<li>Ki\u1ec3u b\u1ecbt: K\u00e9o \u2013 G\u1eadp d\u1ea7n \u2013 Xoay v\u00e0o \u2013 K\u00e9o \u0111\u00f9i t\u1eeb trong ra ngo\u00e0i Allis<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>N\u1eafn theo Allis (tr\u1eadt kh\u1edbp h\u00e1ng ra sau) (H\u00ecnh 10.7) l\u00e0 th\u01b0\u1eddng d\u00f9ng nh\u1ea5t: b\u1ec7nh nh\u00e2n n\u1eb1m ng\u1eeda, g\u00e2y m\u00ea d\u00e3n c\u01a1, c\u1ed1 \u0111\u1ecbnh hai gai ch\u1eadu xu\u1ed1ng gi\u01b0\u1eddng v\u1edbi \u0111ai hay c\u00f3 ng\u01b0\u1eddi gi\u1eef \u0111\u00e8 xu\u1ed1ng. G\u1ea5p h\u00e1ng g\u1ed1i 90\u00b0, lu\u1ed3n \u0111ai v\u1ea3i s\u1ed1 8 d\u01b0\u1edbi khoeo b\u1ec7nh nh\u00e2n v\u00e0 qu\u00e0ng v\u00e0o c\u1ed5 th\u1ea7y thu\u1ed1c. Co g\u1ed1i th\u1ea7y thu\u1ed1c d\u01b0\u1edbi khoeo b\u1ec7nh nh\u00e2n l\u00e0m ch\u1ed7 t\u1ef1a \u0111\u00f2n b\u1ea9y, tay gh\u00ec nh\u1eb9 c\u1ed5 ch\u00e2n b\u1ec7nh nh\u00e2n xu\u1ed1ng d\u01b0\u1edbi, th\u1ea7y thu\u1ed1c t\u1eeb t\u1eeb ng\u01b0\u1ee1ng c\u1ed5 k\u00e9o \u0111\u00f9i th\u1eb3ng l\u00ean tr\u1eddi, c\u00f3 khi th\u00eam xoay nh\u1eb9.<\/li>\n<\/ul>\n<p><img loading=\"lazy\" decoding=\"async\" width=\"440\" height=\"801\" class=\"wp-image-1076\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-7.png\" alt=\"\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-7.png 440w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-7-165x300.png 165w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1069-7-7x12.png 7w\" sizes=\"(max-width: 440px) 100vw, 440px\" \/><\/p>\n<p><strong>H\u00ecnh 10.7. <\/strong>N\u1eafn tr\u1eadt kh\u1edbp h\u00e1ng theo Allis [6]<\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li>Kh\u00f4ng cho t\u00ec sau n\u1eafn s\u1ee3 <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/hoai-tu-vo-mach-chom-xuong-dui\/\">ho\u1ea1i t\u1eed<\/a> ch\u1ecfm, th\u01b0\u1eddng tr\u00e1nh t\u00ec 2 \u2013 3 th\u00e1ng, c\u00f3 khi 6 th\u00e1ng th\u1ea5y ch\u1ecfm ho\u1ea1i t\u1eed, tr\u00e1nh t\u00ec nhi\u1ec1u n\u1eafn hy v\u1ecdng t\u00e1i t\u1ea1o ch\u1ecfm.<\/li>\n<li><a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/bo-bot\/\">B\u00f3 b\u1ed9t<\/a> do s\u1ee3 ho\u1ea1i t\u1eed ch\u1ecfm, s\u1ee3 tr\u1eadt l\u1ea1i. M\u1ed9t s\u1ed1 b\u00f3 b\u1ed9t 4 \u2013 8 tu\u1ea7n.<\/li>\n<li>K\u00e9o li\u00ean t\u1ee5c \u0111\u1ec3 \u0111\u1ee1 l\u1ef1c \u00e9p l\u00ean ch\u1ecfm. Xuy\u00ean \u0111inh k\u00e9o t\u1ea1 nh\u1eb9 2 \u2013 6 tu\u1ea7n.<\/li>\n<\/ul>\n<\/li>\n<li>M\u1ed5 n\u1eafn:\n<ul>\n<li>Khi ph\u1ea3i m\u1ed5 n\u1eafn, \u0111\u01b0\u1eddng r\u1ea1ch v\u00e0o ph\u00eda tr\u01b0\u1edbc, ph\u00eda sau \u0111\u1ec1u \u0111\u01b0\u1ee3c. \u0110\u01b0\u1eddng v\u00e0o ph\u00eda tr\u01b0\u1edbc hay b\u1ecb ti\u00eau ch\u1ecfm v\u00f4 m\u1ea1ch h\u01a1n.<\/li>\n<li>Th\u01b0\u1eddng n\u00ean m\u1ed5 v\u00e0o ph\u00eda sau th\u00ec h\u01a1n. \u0110\u01b0\u1eddng r\u1ea1ch Kocher Langenbeck.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3>BI\u1ebeN CH\u1ee8NG V\u00c0 TI\u00caN L\u01af\u1ee2NG<\/h3>\n<h4>Gi\u1edd n\u1eafn<\/h4>\n<p>C\u1ea7n n\u1eafn c\u1ea5p c\u1ee9u s\u1edbm t\u1eebng gi\u1edd. N\u1eafn mu\u1ed9n tr\u00ean 24 gi\u1edd k\u1ebft qu\u1ea3 x\u1ea5u v\u00ec hay b\u1ecb h\u1ecfng tu\u1ea7n ho\u00e0n nu\u00f4i ch\u1ecfm.<\/p>\n<ul>\n<li>Tr\u00ean 262 ca theo d\u00f5i cho th\u1ea5y:\n<ul>\n<li>N\u1eafn s\u1edbm tr\u01b0\u1edbc 12 gi\u1edd, b\u1ecb ho\u1ea1i t\u1eed v\u00f4 m\u1ea1ch 17,6%<\/li>\n<li>N\u1eafn mu\u1ed9n sau 12 gi\u1edd, b\u1ecb ho\u1ea1i t\u1eed v\u00f4 m\u1ea1ch 56,9%<\/li>\n<\/ul>\n<\/li>\n<li>Hougard cho bi\u1ebft:\n<ul>\n<li>N\u1eafn tr\u01b0\u1edbc 6 gi\u1edd, ho\u1ea1i t\u1eed v\u00f4 m\u1ea1ch 4%<\/li>\n<li>N\u1eafn sau 6 gi\u1edd, ho\u1ea1i t\u1eed v\u00f4 m\u1ea1ch 58%<\/li>\n<\/ul>\n<\/li>\n<li>So s\u00e1nh n\u1eafn kh\u00f4ng m\u1ed5 v\u00e0 n\u1eafn nh\u1edd m\u1ed5 th\u1ea5y:\n<ul>\n<li>N\u1eafn k\u00edn kh\u00f4ng m\u1ed5, b\u1ecb ho\u1ea1i t\u1eed v\u00f4 m\u1ea1ch 15,5%<\/li>\n<li>N\u1eafn nh\u1edd m\u1ed5, b\u1ecb ho\u1ea1i t\u1eed v\u00f4 m\u1ea1ch 40%<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h4>Kh\u00f4ng cho t\u00ec s\u1edbm v\u00ec ch\u1ecfm \u0111ang \u201c\u1ed1m\u201d<\/h4>\n<p>Tuy nhi\u00ean, s\u1edbm hay mu\u1ed9n th\u1ea5y \u00edt c\u00f3 kh\u00e1c bi\u1ec7t. Brav v\u1edbi 523 ca:<\/p>\n<ul>\n<li>Cho t\u00ec tr\u01b0\u1edbc 12 tu\u1ea7n, b\u1ecb ho\u1ea1i t\u1eed v\u00f4 m\u1ea1ch 25,7%<\/li>\n<li>Cho t\u00ec sau 12 tu\u1ea7n, b\u1ecb ho\u1ea1i t\u1eed v\u00f4 m\u1ea1ch 26,6% Khi \u0111i th\u1ea5y \u0111au, kh\u00f4ng n\u00ean cho t\u00ec.<\/li>\n<\/ul>\n","protected":false},"featured_media":1077,"comment_status":"open","ping_status":"closed","template":"","tags":[89,87,88,78],"chuyen-muc":[35],"class_list":["post-1069","bai-giang","type-bai-giang","status-publish","has-post-thumbnail","hentry","tag-khop-hang","tag-khop-khuyu","tag-khop-vai","tag-trat-khop","chuyen-muc-nhap-mon-chan-thuong-chinh-hinh"],"_links":{"self":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/1069","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang"}],"about":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/types\/bai-giang"}],"replies":[{"embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/comments?post=1069"}],"version-history":[{"count":0,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/1069\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media\/1077"}],"wp:attachment":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media?parent=1069"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/tags?post=1069"},{"taxonomy":"chuyen-muc","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-muc?post=1069"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}