{"id":1949,"date":"2023-06-27T19:00:34","date_gmt":"2023-06-27T12:00:34","guid":{"rendered":"https:\/\/bsvothanhtoan.com\/?post_type=bai-giang&#038;p=1949"},"modified":"2023-07-31T17:54:08","modified_gmt":"2023-07-31T10:54:08","slug":"ton-thuong-kin-mo-mem","status":"publish","type":"bai-giang","link":"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/ton-thuong-kin-mo-mem\/","title":{"rendered":"Closed soft tissue injury"},"content":{"rendered":"<h2><strong>1. KH\u00c1I NI\u1ec6M<\/strong><\/h2>\n<p>Ch\u1ea5n th\u01b0\u01a1ng ph\u1ea7n m\u1ec1m l\u00e0 ho\u1ea1t \u0111\u1ed9ng qu\u00e1 m\u1ee9c x\u1ea3y ra \u0111\u1ed1i v\u1edbi c\u01a1, g\u00e2n ho\u1eb7c d\u00e2y ch\u1eb1ng. C\u00e1c m\u00f4 m\u1ec1m b\u1ecb th\u01b0\u01a1ng th\u01b0\u1eddng g\u1eb7p nh\u1ea5t l\u00e0 c\u01a1, g\u00e2n v\u00e0 d\u00e2y ch\u1eb1ng. Nh\u1eefng ch\u1ea5n th\u01b0\u01a1ng n\u00e0y th\u01b0\u1eddng x\u1ea3y ra trong ho\u1ea1t \u0111\u1ed9ng th\u1ec3 thao v\u00e0 t\u1eadp th\u1ec3 d\u1ee5c, \u0111\u00f4i khi c\u00e1c ho\u1ea1t \u0111\u1ed9ng \u0111\u01a1n gi\u1ea3n h\u00e0ng ng\u00e0y c\u0169ng c\u00f3 th\u1ec3 g\u00e2y ch\u1ea5n th\u01b0\u01a1ng.<\/p>\n<p><a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/bong-gan\/\">Sprains<\/a>, c\u0103ng c\u01a1 v\u00e0 b\u1ea7m t\u00edm, c\u0169ng nh\u01b0 <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/viem-gan-calci-hoa-khop-vai\/\">vi\u00eam g\u00e2n<\/a> v\u00e0 vi\u00eam bao ho\u1ea1t d\u1ecbch, l\u00e0 nh\u1eefng ch\u1ea5n th\u01b0\u01a1ng m\u00f4 m\u1ec1m ph\u1ed5 bi\u1ebfn. Ngay c\u1ea3 khi \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb th\u00edch h\u1ee3p, nh\u1eefng v\u1ebft th\u01b0\u01a1ng n\u00e0y c\u00f3 th\u1ec3 c\u1ea7n m\u1ed9t kho\u1ea3ng th\u1eddi gian d\u00e0i \u0111\u1ec3 ch\u1eefa l\u00e0nh.<\/p>\n<h2><strong>2. NGUY\u00caN NH\u00c2N<\/strong><\/h2>\n<p>T\u1ed5n th\u01b0\u01a1ng m\u00f4 m\u1ec1m \u0111\u01b0\u1ee3c chia th\u00e0nh hai lo\u1ea1i c\u01a1 b\u1ea3n: ch\u1ea5n th\u01b0\u01a1ng c\u1ea5p t\u00ednh v\u00e0 ch\u1ea5n th\u01b0\u01a1ng do v\u1eadn \u0111\u1ed9ng qu\u00e1 m\u1ee9c.<\/p>\n<ul>\n<li><em>Ch\u1ea5n th\u01b0\u01a1ng c\u1ea5p t\u00ednh<\/em> l\u00e0 do ch\u1ea5n th\u01b0\u01a1ng \u0111\u1ed9t ng\u1ed9t, ch\u1eb3ng h\u1ea1n nh\u01b0 ng\u00e3, v\u1eb7n ng\u01b0\u1eddi ho\u1eb7c b\u1ecb va \u0111\u1eadp v\u00e0o c\u01a1 th\u1ec3 (v\u00ed d\u1ee5 nh\u01b0 bong g\u00e2n, c\u0103ng c\u01a1,&#8230;)<\/li>\n<li><em>C\u00e1c ch\u1ea5n th\u01b0\u01a1ng do v\u1eadn \u0111\u1ed9ng qu\u00e1 m\u1ee9c<\/em> x\u1ea3y ra d\u1ea7n d\u1ea7n theo th\u1eddi gian khi m\u1ed9t ho\u1ea1t \u0111\u1ed9ng th\u1ec3 thao ho\u1eb7c ho\u1ea1t \u0111\u1ed9ng kh\u00e1c \u0111\u01b0\u1ee3c l\u1eb7p l\u1ea1i th\u01b0\u1eddng xuy\u00ean \u0111\u1ebfn qu\u00e1 m\u1ee9c c\u00e1c v\u00f9ng tr\u00ean c\u01a1 th\u1ec3 kh\u00f4ng c\u00f3 \u0111\u1ee7 th\u1eddi gian \u0111\u1ec3 ch\u1eefa l\u00e0nh gi\u1eefa c\u00e1c l\u1ea7n xu\u1ea5t hi\u1ec7n. Vi\u00eam g\u00e2n v\u00e0 vi\u00eam bao ho\u1ea1t d\u1ecbch l\u00e0 nh\u1eefng ch\u1ea5n th\u01b0\u01a1ng do l\u1ea1m d\u1ee5ng qu\u00e1 m\u1ee9c m\u00f4 m\u1ec1m.<\/li>\n<\/ul>\n<h2><strong>3. PH\u00c2N LO\u1ea0I<\/strong><\/h2>\n<h3>3.1. T\u1ed5n th\u01b0\u01a1ng m\u00f4 m\u1ec1m c\u1ea5p t\u00ednh<\/h3>\n<h4><strong>3.1.1. Bong g\u00e2n<\/strong><\/h4>\n<p>L\u00e0 hi\u1ec7n t\u01b0\u1ee3ng c\u0103ng v\u00e0\/ho\u1eb7c r\u00e1ch d\u00e2y ch\u1eb1ng, m\u1ed9t d\u1ea3i m\u00f4 li\u00ean k\u1ebft b\u1ec1n ch\u1eafc n\u1ed1i ph\u1ea7n cu\u1ed1i c\u1ee7a x\u01b0\u01a1ng n\u00e0y v\u1edbi x\u01b0\u01a1ng kh\u00e1c.<\/p>\n<p>Nh\u1eefng v\u00f9ng c\u01a1 th\u1ec3 d\u1ec5 b\u1ecb bong g\u00e2n nh\u1ea5t l\u00e0 m\u1eaft c\u00e1 ch\u00e2n, \u0111\u1ea7u g\u1ed1i v\u00e0 c\u1ed5 tay. Bong g\u00e2n m\u1eaft c\u00e1 ch\u00e2n c\u00f3 th\u1ec3 x\u1ea3y ra khi b\u00e0n ch\u00e2n c\u1ee7a l\u1eadt v\u00e0o trong ho\u1eb7c ra ngo\u00e0i, g\u00e2y c\u0103ng th\u1eb3ng c\u1ef1c \u0111\u1ed9 l\u00ean<\/p>\n<p>c\u00e1c d\u00e2y ch\u1eb1ng v\u00f9ng c\u1ed5 ch\u00e2n. \u0110\u1ea7u g\u1ed1i b\u1ecb bong g\u00e2n c\u00f3 th\u1ec3 do xoay ng\u01b0\u1eddi \u0111\u1ed9t ng\u1ed9t v\u00e0 bong g\u00e2n c\u1ed5 tay c\u00f3 th\u1ec3 x\u1ea3y ra n\u1ebfu ng\u00e3 v\u1edbi b\u00e0n tay dang r\u1ed9ng.<\/p>\n<p>Bong g\u00e2n \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i theo ba m\u1ee9c \u0111\u1ed9:<\/p>\n<ul>\n<li>Bong g\u00e2n \u0111\u1ed9 1 (nh\u1eb9): gi\u00e3n nh\u1eb9 v\u00e0 t\u1ed5n th\u01b0\u01a1ng m\u1ed9t s\u1ed1 s\u1ee3i c\u1ee7a d\u00e2y ch\u1eb1ng<\/li>\n<li>Bong g\u00e2n \u0111\u1ed9 2 (trung b\u00ecnh): \u0111\u1ee9t m\u1ed9t ph\u1ea7n d\u00e2y ch\u1eb1ng &#8211; Bong g\u00e2n \u0111\u1ed9 3 (n\u1eb7ng): \u0111\u1ee9t d\u00e2y ch\u1eb1ng ho\u00e0n to\u00e0n.<\/li>\n<\/ul>\n<p><strong>\u0110\u1ee9t g\u00e2n<\/strong> c\u00f3 th\u1ec3 b\u00e1n ph\u1ea7n ho\u1eb7c ho\u00e0n to\u00e0n.<\/p>\n<p>V\u1edbi t\u1ed5n th\u01b0\u01a1ng ho\u00e0n to\u00e0n, th\u01b0\u1eddng m\u1ea5t v\u1eadn \u0111\u1ed9ng do c\u01a1 chi ph\u1ed1i.<\/p>\n<p>T\u1ed5n th\u01b0\u01a1ng b\u00e1n ph\u1ea7n c\u00f3 th\u1ec3 l\u00e0 do m\u1ed9t ch\u1ea5n th\u01b0\u01a1ng ri\u00eang l\u1ebb (v\u00ed d\u1ee5 ch\u1ea5n th\u01b0\u01a1ng xuy\u00ean th\u1ea5u) ho\u1eb7c ho\u1ea1t \u0111\u1ed9ng l\u1eb7p \u0111i l\u1eb7p l\u1ea1i (m\u1ea1n t\u00ednh, g\u00e2y ra b\u1ec7nh v\u1ec1 g\u00e2n). V\u1eadn \u0111\u1ed9ng th\u01b0\u1eddng kh\u00f4ng thay \u0111\u1ed5i, nh\u01b0ng t\u1ed5n th\u01b0\u01a1ng b\u00e1n ph\u1ea7n c\u00f3 th\u1ec3 ti\u1ebfn tri\u1ec3n th\u00e0nh t\u1ed5n th\u01b0\u01a1ng ho\u00e0n to\u00e0n, \u0111\u1eb7c bi\u1ec7t khi c\u00f3 l\u1ef1c t\u00e1c \u0111\u1ed9ng \u0111\u00e1ng k\u1ec3 ho\u1eb7c l\u1eb7p \u0111i l\u1eb7p l\u1ea1i.<\/p>\n<p><strong>Ti\u1ebfn tri\u1ec3n<\/strong><\/p>\n<ul>\n<li>Nhi\u1ec1u t\u1ed5n th\u01b0\u01a1ng b\u00e1n ph\u1ea7n d\u00e2y ch\u1eb1ng, g\u00e2n ho\u1eb7c c\u01a1 h\u1ed3i ph\u1ee5c t\u1ef1 nhi\u00ean<\/li>\n<li>T\u1ed5n th\u01b0\u01a1ng ho\u00e0n to\u00e0n th\u01b0\u1eddng y\u00eau c\u1ea7u ph\u1eabu thu\u1eadt \u0111\u1ec3 h\u1ed3i ph\u1ee5c v\u1ec1 gi\u1ea3i ph\u1eabu v\u00e0 ch\u1ee9c n\u0103ng<\/li>\n<li>Ti\u00ean l\u01b0\u1ee3ng v\u00e0 \u0111i\u1ec1u tr\u1ecb thay \u0111\u1ed5i r\u1ea5t nhi\u1ec1u t\u00f9y theo v\u1ecb tr\u00ed v\u00e0 m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng c\u1ee7a t\u1ed5n th\u01b0\u01a1ng.<\/li>\n<\/ul>\n<p><strong>Symptoms<\/strong><\/p>\n<p>Bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng do ch\u1ea5n th\u01b0\u01a1ng g\u00e2n, d\u00e2y ch\u1eb1ng kh\u00f4ng th\u01b0\u1eddng g\u1eb7p, tuy nhi\u00ean, l\u1ea1i c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn m\u1ea5t ch\u1ee9c n\u0103ng chi th\u1ec3 v\u0129nh vi\u1ec5n.<\/p>\n<p>Bi\u1ebfn ch\u1ee9ng c\u1ea5p t\u00ednh (t\u1ed5n th\u01b0\u01a1ng li\u00ean quan) bao g\u1ed3m:<\/p>\n<ul>\n<li><em>Ch\u1ea3y m\u00e1u:<\/em> ch\u1ea3y m\u00e1u (v\u00ed d\u1ee5, b\u1ea7m t\u00edm, t\u1ee5 m\u00e1u) k\u00e8m theo t\u1ea5t c\u1ea3 c\u00e1c t\u1ed5n th\u01b0\u01a1ng ph\u1ea7n m\u1ec1m nhi\u1ec1u<\/li>\n<li><em>T\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u:<\/em> \u00edt khi t\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng g\u00e2y ra t\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u tuy nhi\u00ean trong m\u1ed9t s\u1ed1 t\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng n\u1eb7ng v\u00ed d\u1ee5 tr\u1eadt <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/khai-thac-benh-su-va-tien-can-benh-ly-ngoai-chan-thuong\/\">knee joint<\/a> g\u00e2y t\u1ed5n th\u01b0\u01a1ng \u0111\u1ed9ng m\u1ea1ch c\u00f3 nguy c\u01a1 <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/dai-cuong-phau-thuat-cat-cut-chi-the\/\">amputation<\/a> cao<\/li>\n<\/ul>\n<p><em>Nerve damage:<\/em> th\u1ea7n kinh b\u1ecb t\u1ed5n th\u01b0\u01a1ng khi b\u1ecb c\u0103ng gi\u00e3n ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng do c\u00e1c ch\u1ea5n th\u01b0\u01a1ng \u0111i k\u00e8m nh\u01b0 <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-xuong-kin\/\">fracture<\/a> ho\u1eb7c tr\u1eadt kh\u1edbp ho\u1eb7c do t\u1ed5n th\u01b0\u01a1ng \u0111\u1ee5ng gi\u1eadp ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng gi\u1eadp n\u00e1t. Khi c\u00e1c d\u00e2y th\u1ea7n kinh b\u1ecb \u0111\u1ee5ng d\u1eadp (g\u1ecdi l\u00e0 neurapraxia), l\u00e0m gi\u1ea3m d\u1eabn truy\u1ec1n th\u1ea7n kinh, nh\u01b0ng d\u00e2y th\u1ea7n kinh kh\u00f4ng b\u1ecb \u0111\u1ee9t. M\u1ea5t ch\u1ee9c n\u0103ng th\u1ea7n kinh t\u1ea1m th\u1eddi g\u00e2y ra m\u1ea5t v\u1eadn \u0111\u1ed9ng v\u00e0\/ho\u1eb7c c\u1ea3m gi\u00e1c t\u1ea1m th\u1eddi; ch\u1ee9c n\u0103ng th\u1ea7n kinh h\u1ed3i ph\u1ee5c ho\u00e0n to\u00e0n trong kho\u1ea3ng 6 \u2013 8 tu\u1ea7n. Khi d\u00e2y th\u1ea7n kinh b\u1ecb gi\u1eadp n\u00e1t (g\u1ecdi l\u00e0 \u0111\u1ee9t s\u1ee3i tr\u1ee5c th\u1ea7n kinh), s\u1ee3i tr\u1ee5c b\u1ecb th\u01b0\u01a1ng, nh\u01b0ng bao myelin th\u00ec kh\u00f4ng, t\u1ed5n th\u01b0\u01a1ng n\u00e0y nghi\u00eam tr\u1ecdng h\u01a1n so v\u1edbi tri\u1ec7u ch\u1ee9ng ch\u00e8n \u00e9p ph\u00f9 n\u1ec1. T\u00f9y thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng, d\u00e2y th\u1ea7n kinh c\u00f3 th\u1ec3 t\u00e1i t\u1ea1o trong nhi\u1ec1u tu\u1ea7n \u0111\u1ebfn nhi\u1ec1u n\u0103m. Th\u00f4ng th\u01b0\u1eddng, c\u00e1c d\u00e2y th\u1ea7n kinh b\u1ecb \u0111\u1ee9t r\u1eddi (g\u1ecdi l\u00e0 \u0111\u1ee9t th\u1ea7n kinh) trong c\u00e1c v\u1ebft th\u01b0\u01a1ng h\u1edf. C\u00e1c d\u00e2y th\u1ea7n kinh b\u1ecb \u0111\u1ee9t kh\u00f4ng t\u1ef1 l\u00e0nh v\u00e0 c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c ph\u1eabu thu\u1eadt.<\/p>\n<ul>\n<li><em>Syndrome <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/hoi-chung-chen-ep-khoang\/\">cavity compression<\/a>:<\/em> hi\u1ebfm g\u1eb7p, vi\u1ec7c s\u01b0ng n\u1ec1 \u0111\u1ee7 \u0111\u1ec3 d\u1eabn \u0111\u1ebfn h\u1ed9i ch\u1ee9ng ch\u00e8n \u00e9p khoang. \u00c1p su\u1ea5t m\u00f4 t\u0103ng l\u00ean trong kh\u00f4ng gian kh\u00e9p k\u00edn, l\u00e0m gi\u00e1n \u0111o\u1ea1n c\u1ea5p m\u00e1u v\u00e0 gi\u1ea3m t\u01b0\u1edbi m\u00e1u m\u00f4. H\u1ed9i ch\u1ee9ng ch\u00e8n \u00e9p khoang kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb c\u00f3 th\u1ec3 d\u1eabn t\u1edbi ti\u00eau c\u01a1 v\u00e2n, t\u0103ng kali m\u00e1u v\u00e0 nhi\u1ec5m tr\u00f9ng. N\u00f3 c\u0169ng c\u00f3 th\u1ec3 g\u00e2y ra <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>, gi\u1ea3m c\u1ea3m gi\u00e1c, li\u1ec7t. H\u1ed9i ch\u1ee9ng ch\u00e8n \u00e9p khoang c\u00f3 th\u1ec3 g\u00e2y ra m\u1ea5t chi (nguy c\u01a1 c\u1eaft c\u1ee5t) v\u00e0 c\u1ea3 \u0111e d\u1ecda m\u1ea1ng s\u1ed1ng.<\/li>\n<\/ul>\n<p>C\u00e1c bi\u1ebfn ch\u1ee9ng mu\u1ed9n bao g\u1ed3m:<\/p>\n<ul>\n<li><em>S\u1ef1 m\u1ea5t v\u1eefng kh\u1edbp:<\/em> c\u00e1c t\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng kh\u00e1c nhau, \u0111\u1eb7c bi\u1ec7t l\u00e0 bong g\u00e2n \u0111\u1ed9 3, c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn m\u1ea5t v\u1eefng kh\u1edbp. M\u1ea5t v\u1eefng kh\u1edbp c\u00f3 th\u1ec3 l\u00e0m m\u1ea5t ch\u1ee9c n\u0103ng v\u00e0 l\u00e0m t\u0103ng nguy c\u01a1 <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/thoai-hoa-khop\/\">osteoarthritis<\/a><\/li>\n<li><em>C\u1ee9ng kh\u1edbp v\u00e0 gi\u1ea3m t\u1ea7m v\u1eadn \u0111\u1ed9ng: <\/em>c\u1ee9ng kh\u1edbp d\u1ec5 x\u1ea3y ra n\u1ebfu <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/so-cuu-bat-dong-gay-xuong\/\">motionless<\/a> kh\u1edbp k\u00e9o d\u00e0i. \u0110\u1ea7u g\u1ed1i, khu\u1ef7u tay v\u00e0 vai \u0111\u1eb7c bi\u1ec7t d\u1ec5 b\u1ecb c\u1ee9ng kh\u1edbp sau ch\u1ea5n th\u01b0\u01a1ng, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf ng\u01b0\u1eddi cao tu\u1ed5i<\/li>\n<li><em>Tho\u00e1i h\u00f3a kh\u1edbp: <\/em>c\u00e1c ch\u1ea5n th\u01b0\u01a1ng l\u00e0m m\u1ea5t v\u1eefng kh\u1edbp th\u01b0\u1eddng d\u1eabn \u0111\u1ebfn t\u0103ng l\u1ef1c t\u00e1c \u0111\u1ed9ng l\u00ean kh\u1edbp, h\u1ecfng s\u1ee5n kh\u1edbp v\u00e0 d\u1eabn \u0111\u1ebfn tho\u00e1i h\u00f3a kh\u1edbp.<\/li>\n<\/ul>\n<h4>3.1.2. C\u0103ng c\u01a1<\/h4>\n<p>C\u0103ng c\u01a1 l\u00e0 t\u00ecnh tr\u1ea1ng c\u00e1c c\u01a1 b\u1eafp b\u1ecb k\u00e9o gi\u00e3n qu\u00e1 m\u1ee9c, v\u01b0\u1ee3t qu\u00e1 ng\u01b0\u1ee1ng ch\u1ecbu \u0111\u1ef1ng. M\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p n\u1eb7ng c\u00f3 th\u1ec3 d\u1eabn t\u1edbi r\u00e1ch c\u01a1. T\u00ecnh tr\u1ea1ng n\u00e0y khi\u1ebfn c\u00e1c c\u01a1 li\u00ean quan c\u0103ng c\u1ee9ng, kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng th\u01b0 gi\u00e3n. Ng\u01b0\u1eddi b\u1ec7nh s\u1ebd b\u1ecb \u0111au bu\u1ed1t, c\u1eed \u0111\u1ed9ng kh\u00f3 kh\u0103n. B\u1ea5t k\u1ef3 b\u1ed9 ph\u1eadn n\u00e0o trong c\u01a1 th\u1ec3 c\u0169ng c\u00f3 th\u1ec3 b\u1ecb c\u0103ng c\u01a1, ph\u1ed5 bi\u1ebfn l\u00e0 \u1edf c\u01a1 ch\u00e2n ho\u1eb7c tay, th\u1eaft l\u01b0ng, c\u1ed5 v\u00e0 vai<\/p>\n<p>C\u00e1c <a href=\"https:\/\/bsvothanhtoan.com\/en\/\">tri\u1ec7u ch\u1ee9ng<\/a> c\u1ee7a c\u0103ng c\u01a1 c\u00f3 th\u1ec3 bao g\u1ed3m \u0111au, co th\u1eaft c\u01a1, y\u1ebfu c\u01a1, s\u01b0ng, vi\u00eam v\u00e0 chu\u1ed9t r\u00fat.<\/p>\n<h4>3.1.3. B\u1ea7m t\u00edm<\/h4>\n<p>B\u1ea7m t\u00edm x\u1ea3y ra khi b\u1ecb v\u1eadt c\u00f9n t\u00e1c \u0111\u1ed9ng tr\u1ef1c ti\u1ebfp (ho\u1eb7c nhi\u1ec1u l\u1ea7n) v\u00e0o m\u1ed9t ph\u1ea7n c\u1ee7a c\u01a1 th\u1ec3, l\u00e0m n\u00e1t c\u00e1c s\u1ee3i c\u01a1 v\u00e0 m\u00f4 li\u00ean k\u1ebft b\u00ean d\u01b0\u1edbi da m\u00e0 kh\u00f4ng l\u00e0m \u0111\u1ee9t da. C\u00f3 th\u1ec3 x\u1ea3y ra va ch\u1ea1m do ng\u00e3 ho\u1eb7c k\u1eb9t c\u01a1 th\u1ec3 tr\u00ean b\u1ec1 m\u1eb7t c\u1ee9ng. Da \u0111\u1ed5i m\u00e0u l\u00e0 do m\u00e1u t\u1ee5 xung quanh v\u1ebft th\u01b0\u01a1ng.<\/p>\n<h3><strong>3.2. Ch\u1ea5n th\u01b0\u01a1ng m\u00f4 m\u1ec1m do v\u1eadn \u0111\u1ed9ng qu\u00e1 m\u1ee9c<\/strong><\/h3>\n<h4>3.2.1. Vi\u00eam g\u00e2n<\/h4>\n<p>Vi\u00eam g\u00e2n l\u00e0 t\u00ecnh tr\u1ea1ng t\u1ed5n th\u01b0\u01a1ng g\u00e2n v\u00e0\/ho\u1eb7c <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/benh-ly-viem-bao-gan\/\">tendon bag<\/a> d\u1eabn \u0111\u1ebfn \u0111au, s\u01b0ng v\u00e0 \u1ea3nh h\u01b0\u1edfng nhi\u1ec1u \u0111\u1ebfn c\u1eed \u0111\u1ed9ng c\u1ee7a kh\u1edbp xung quanh.<\/p>\n<p>Vi\u00eam g\u00e2n v\u00e0 <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/benh-ly-viem-bao-gan\/\">vi\u00eam bao g\u00e2n<\/a> th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n \u1edf nh\u1eefng v\u1ecb tr\u00ed x\u01b0\u01a1ng kh\u1edbp ho\u1ea1t \u0111\u1ed9ng nhi\u1ec1u v\u00e0 ch\u1ecbu nhi\u1ec1u l\u1ef1c t\u00e1c \u0111\u1ed9ng nh\u01b0 vi\u00eam c\u00e1c g\u00e2n \u1edf <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/trat-khop-vai-khuyu-hang\/\">shoulder<\/a> (vi\u00eam g\u00e2n m\u0169 c\u01a1 quay), g\u00e2n \u1edf \u0111\u1ea7u d\u00e0i c\u01a1 nh\u1ecb \u0111\u1ea7u, vi\u00eam g\u00e2n g\u1ea5p c\u1ed5 tay tr\u1ee5 v\u00e0 c\u1ed5 tay quay, vi\u00eam g\u00e2n g\u1ea5p c\u00e1c <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-xuong-ban-ngon-tay-gay-xuong-ban-tay\/\">ng\u00f3n tay<\/a>, vi\u00eam g\u00e2n v\u00f9ng khoeo ch\u00e2n, vi\u00eam g\u00e2n g\u00f3t v\u00e0 g\u00e2n du\u1ed7i ng\u1eafn ho\u1eb7c g\u00e2n d\u1ea1ng d\u00e0i ng\u00f3n (h\u1ed9i ch\u1ee9ng De Quervain).<\/p>\n<p>C\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb vi\u00eam g\u00e2n b\u1eb1ng c\u00e1ch ngh\u1ec9 ng\u01a1i \u0111\u1ec3 lo\u1ea1i b\u1ecf c\u0103ng th\u1eb3ng, d\u00f9ng thu\u1ed1c ch\u1ed1ng vi\u00eam, ti\u00eam steroid, n\u1eb9p b\u1ea5t \u0111\u1ed9ng v\u00e0 c\u00e1c b\u00e0i t\u1eadp \u0111\u1ec3 \u0111i\u1ec1u ch\u1ec9nh s\u1ef1 m\u1ea5t c\u00e2n b\u1eb1ng c\u1ee7a c\u01a1 v\u00e0 c\u1ea3i thi\u1ec7n t\u00ednh linh ho\u1ea1t. T\u00ecnh tr\u1ea1ng vi\u00eam dai d\u1eb3ng c\u00f3 th\u1ec3 g\u00e2y t\u1ed5n th\u01b0\u01a1ng g\u00e2n \u0111\u00e1ng k\u1ec3, c\u00f3 th\u1ec3 ph\u1ea3i ph\u1eabu thu\u1eadt.<\/p>\n<h4>3.2.2. Vi\u00eam bao ho\u1ea1t d\u1ecbch<\/h4>\n<p>Vi\u00eam bao ho\u1ea1t d\u1ecbch kh\u1edbp l\u00e0 t\u00ecnh tr\u1ea1ng vi\u00eam, s\u01b0ng, \u0111\u1ecf c\u1ee7a m\u1ed9t t\u00fai ch\u1ee9a d\u1ecbch l\u1ecfng \u1edf c\u00e1c kh\u1edbp. Bao ho\u1ea1t d\u1ecbch th\u01b0\u1eddng n\u1eb1m \u1edf v\u1ecb tr\u00ed xung quanh vai, h\u00f4ng, khu\u1ef7u tay ho\u1eb7c \u0111\u1ea7u g\u1ed1i, b\u00e0n ch\u00e2n v\u00e0 c\u00f3 vai tr\u00f2 nh\u01b0 m\u1ed9t l\u1edbp \u0111\u1ec7m gi\u1eefa x\u01b0\u01a1ng v\u00e0 c\u00e1c b\u1ed9 ph\u1eadn xung quanh nh\u01b0 c\u01a1 b\u1eafp v\u00e0 g\u00e2n, da \u0111\u1ec3 gi\u00fap cho c\u00e1c ho\u1ea1t \u0111\u1ed9ng \u0111\u01b0\u1ee3c d\u1ec5 d\u00e0ng h\u01a1n.<\/p>\n<p>B\u1ec7nh vi\u00eam bao ho\u1ea1t d\u1ecbch th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n \u1edf nh\u1eefng kh\u1edbp x\u01b0\u01a1ng ph\u1ea3i ho\u1ea1t \u0111\u1ed9ng th\u01b0\u1eddng xuy\u00ean nh\u01b0 vi\u00eam bao kh\u1edbp g\u1ed1i, vi\u00eam bao kh\u1edbp c\u1ed5 tay,&#8230; Nhi\u1ec1u ng\u01b0\u1eddi b\u1ecb vi\u00eam bao ho\u1ea1t d\u1ecbch li\u00ean quan \u0111\u1ebfn vi\u00eam g\u00e2n.<\/p>\n<p>Vi\u00eam bao ho\u1ea1t d\u1ecbch th\u01b0\u1eddng c\u00f3 th\u1ec3 thuy\u00ean gi\u1ea3m khi thay \u0111\u1ed5i ho\u1ea1t \u0111\u1ed9ng v\u00e0 d\u00f9ng thu\u1ed1c ch\u1ed1ng vi\u00eam non steroid. Ti\u00eam <a href=\"https:\/\/en.wikipedia.org\/wiki\/Corticosteroid\" target=\"_blank\" rel=\"noopener\">corticosteroids<\/a> th\u01b0\u1eddng gi\u00fap gi\u1ea3m \u0111au v\u00e0 s\u01b0ng t\u1ea5y. Can thi\u1ec7p ngo\u1ea1i khoa n\u1ebfu \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa kh\u00f4ng \u0111\u1ee1 nh\u01b0 ch\u1ecdc h\u00fat d\u1ecbch trong bao, c\u1eaft b\u1ecf bao,\u2026<\/p>\n<h2><strong>4. CH\u1ea8N \u0110O\u00c1N<\/strong><\/h2>\n<h3><strong>Medical history<\/strong><\/h3>\n<p>Khi <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/khai-thac-benh-su-va-tien-can-benh-ly-ngoai-chan-thuong\/\">khai th\u00e1c b\u1ec7nh s\u1eed<\/a> t\u1eadp trung v\u00e0o:<\/p>\n<ul>\n<li>Mechanism of injury<\/li>\n<li>Ch\u1ea5n th\u01b0\u01a1ng \u0111\u00e3 t\u1eebng b\u1ecb<\/li>\n<li>Th\u1eddi \u0111i\u1ec3m b\u1eaft \u0111\u1ea7u \u0111au<\/li>\n<li>M\u1ee9c \u0111\u1ed9 v\u00e0 th\u1eddi gian \u0111au tr\u01b0\u1edbc, trong v\u00e0 sau khi ho\u1ea1t \u0111\u1ed9ng.<\/li>\n<\/ul>\n<p>C\u00e1c b\u00e1c s\u0129 c\u0169ng n\u00ean h\u1ecfi v\u1ec1 vi\u1ec7c s\u1eed d\u1ee5ng m\u1ed9t s\u1ed1 thu\u1ed1c (nh\u01b0: fluoroquinolon, corticosteroid) l\u00e0m t\u0103ng nguy c\u01a1 b\u1ecb t\u1ed5n th\u01b0\u01a1ng g\u00e2n.<\/p>\n<p>C\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng (nh\u01b0 h\u01b0\u1edbng v\u00e0 c\u01b0\u1eddng \u0111\u1ed9 c\u1ee7a l\u1ef1c) c\u00f3 th\u1ec3 g\u1ee3i \u00fd ki\u1ec3u ch\u1ea5n th\u01b0\u01a1ng. Tuy nhi\u00ean, nhi\u1ec1u b\u1ec7nh nh\u00e2n kh\u00f4ng nh\u1edb ho\u1eb7c kh\u00f4ng th\u1ec3 m\u00f4 t\u1ea3 ch\u00ednh x\u00e1c c\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng.<\/p>\n<p>Ti\u1ebfng k\u00eau \u1edf kh\u1edbp t\u1ea1i th\u1eddi \u0111i\u1ec3m b\u1ecb th\u01b0\u01a1ng c\u00f3 th\u1ec3 l\u00e0 d\u1ea5u hi\u1ec7u c\u1ee7a t\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng ho\u1eb7c g\u00e2n (ho\u1eb7c g\u00e3y x\u01b0\u01a1ng). T\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng n\u1eb7ng th\u01b0\u1eddng g\u00e2y \u0111au ngay l\u1eadp t\u1ee9c; \u0111au xu\u1ea5t hi\u1ec7n sau v\u00e0i gi\u1edd cho \u0111\u1ebfn v\u00e0i ng\u00e0y sau ch\u1ea5n th\u01b0\u01a1ng g\u1ee3i \u00fd t\u1ed5n th\u01b0\u01a1ng nh\u1eb9.<\/p>\n<h3><strong>Kh\u00e1m th\u1ef1c th\u1ec3<\/strong><\/h3>\n<p>Th\u0103m kh\u00e1m bao g\u1ed3m:<\/p>\n<ul>\n<li>\u0110\u00e1nh gi\u00e1 m\u1ea1ch v\u00e0 th\u1ea7n kinh<\/li>\n<li>Nh\u00ecn xem c\u00f3 bi\u1ebfn d\u1ea1ng, s\u01b0ng t\u1ea5y, b\u1ea7m t\u00edm, v\u1ebft th\u01b0\u01a1ng h\u1edf v\u00e0 gi\u1ea3m v\u1eadn \u0111\u1ed9ng ho\u1eb7c c\u1eed \u0111\u1ed9ng b\u1ea5t th\u01b0\u1eddng kh\u00f4ng?<\/li>\n<li>S\u1edd xem c\u00f3 \u0111i\u1ec3m \u0111au, ti\u1ebfng l\u00e9p b\u00e9p v\u00e0 t\u1ed5n th\u01b0\u01a1ng x\u01b0\u01a1ng ho\u1eb7c g\u00e2n kh\u00f4ng?<\/li>\n<li>Ki\u1ec3m tra c\u00e1c kh\u1edbp \u1edf tr\u00ean v\u00e0 d\u01b0\u1edbi v\u00f9ng b\u1ecb th\u01b0\u01a1ng t\u1ed5n.<\/li>\n<\/ul>\n<p>Sau khi g\u00e3y x\u01b0\u01a1ng v\u00e0 tr\u1eadt kh\u1edbp \u0111\u01b0\u1ee3c lo\u1ea1i tr\u1eeb (b\u1eb1ng th\u0103m kh\u00e1m l\u00e2m s\u00e0ng ho\u1eb7c b\u1eb1ng ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh), ki\u1ec3m tra c\u00e1c kh\u1edbp b\u1ecb \u1ea3nh h\u01b0\u1edfng c\u00f3 \u0111au v\u00e0 m\u1ea5t v\u1eefng kh\u00f4ng?<\/p>\n<p>N\u1ebfu co c\u01a1 v\u00e0 \u0111au l\u00e0m h\u1ea1n ch\u1ebf th\u0103m kh\u00e1m th\u1ef1c th\u1ec3 (\u0111\u1eb7c bi\u1ec7t l\u00e0 c\u00e1c nghi\u1ec7m ph\u00e1p th\u0103m kh\u00e1m), th\u0103m kh\u00e1m s\u1ebd d\u1ec5 d\u00e0ng h\u01a1n sau khi b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c d\u00f9ng thu\u1ed1c gi\u1ea3m \u0111au to\u00e0n th\u00e2n ho\u1eb7c g\u00e2y t\u00ea t\u1ea1i ch\u1ed7 ho\u1eb7c v\u00f9ng t\u1ed5n th\u01b0\u01a1ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c b\u1ea5t \u0111\u1ed9ng cho \u0111\u1ebfn khi b\u1edbt co c\u01a1 v\u00e0 gi\u1ea3m \u0111au, th\u01b0\u1eddng l\u00e0 sau v\u00e0i ng\u00e0y v\u00e0 sau \u0111\u00f3, b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ki\u1ec3m tra l\u1ea1i.<\/p>\n<p>Bi\u1ebfn d\u1ea1ng g\u1ee3i \u00fd \u0111\u1ebfn tr\u1eadt kh\u1edbp, b\u00e1n tr\u1eadt (di l\u1ec7ch m\u1ed9t ph\u1ea7n trong s\u1ed1 c\u00e1c x\u01b0\u01a1ng t\u1ea1o l\u00ean kh\u1edbp) ho\u1eb7c g\u00e3y x\u01b0\u01a1ng.<\/p>\n<p>S\u01b0ng th\u01b0\u1eddng l\u00e0 d\u1ea5u hi\u1ec7u t\u1ed5n th\u01b0\u01a1ng <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/tiep-can-chan-doan-dau-he-van-dong\/\">h\u1ec7 v\u1eadn \u0111\u1ed9ng<\/a> nh\u01b0ng c\u00f3 th\u1ec3 c\u1ea7n v\u00e0i gi\u1edd \u0111\u1ec3 ti\u1ebfn tri\u1ec3n. N\u1ebfu s\u01b0ng kh\u00f4ng xu\u1ea5t hi\u1ec7n trong th\u1eddi gian n\u00e0y, kh\u00f4ng ngh\u0129 \u0111\u1ebfn c\u00f3 \u0111\u1ee9t d\u00e2y ch\u1eb1ng.<\/p>\n<p>\u1ea4n \u0111au \u0111i k\u00e8m v\u1edbi g\u1ea7n nh\u01b0 t\u1ea5t c\u1ea3 c\u00e1c t\u1ed5n th\u01b0\u01a1ng v\u1edbi nhi\u1ec1u b\u1ec7nh nh\u00e2n, ch\u1ea1m v\u00e0o b\u1ea5t c\u1ee9 n\u01a1i n\u00e0o xung quanh v\u00f9ng t\u1ed5n th\u01b0\u01a1ng \u0111\u1ec1u g\u00e2y kh\u00f3 ch\u1ecbu. Tuy nhi\u00ean, s\u1ef1 gia t\u0103ng \u0111\u00e1ng k\u1ec3 m\u1ee9c \u0111\u1ed9 \u1ea5n \u0111au \u1edf m\u1ed9t v\u00f9ng khu tr\u00fa (\u0111i\u1ec3m \u0111au ch\u00f3i c\u1ed1 \u0111\u1ecbnh) g\u1ee3i \u00fd \u0111\u1ebfn bong g\u00e2n (ho\u1eb7c g\u00e3y x\u01b0\u01a1ng). \u1ea4n \u0111au t\u1ea1i ch\u1ed7 b\u00e1m d\u00e2y ch\u1eb1ng v\u00e0 c\u1ea3m gi\u00e1c \u0111au khi kh\u1edbp b\u1ecb \u1ea3nh h\u01b0\u1edfng cho th\u1ea5y c\u00f3 t\u1ed5n th\u01b0\u01a1ng. V\u1edbi r\u00e1ch g\u00e2n ho\u1eb7c c\u01a1 ho\u00e0n to\u00e0n, c\u00f3 th\u1ec3 s\u1edd th\u1ea5y r\u00f5 m\u1ed9t v\u00f9ng khuy\u1ebft n\u01a1i c\u1ea5u tr\u00fac b\u1ecb \u1ea3nh h\u01b0\u1edfng.<\/p>\n<p>M\u1ea5t v\u1eefng kh\u1edbp nhi\u1ec1u g\u1ee3i \u00fd \u0111\u1ebfn \u0111\u1ee9t d\u00e2y ch\u1eb1ng r\u1ea5t n\u1eb7ng (ho\u1eb7c tr\u1eadt kh\u1edbp, c\u00e1i c\u00f3 th\u1ec3 t\u1ef1 thuy\u00ean gi\u1ea3m).<\/p>\n<p>Test \u00e1p l\u1ef1c (stress) \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 \u0111\u1ed9 v\u1eefng c\u1ee7a m\u1ed9t kh\u1edbp b\u1ecb t\u1ed5n th\u01b0\u01a1ng; tuy nhi\u00ean, n\u1ebfu nghi ng\u1edd c\u00f3 g\u00e3y x\u01b0\u01a1ng th\u00ec nghi\u1ec7m ph\u00e1p n\u00e0y kh\u00f4ng \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n cho \u0111\u1ebfn khi <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/x-quang-trong-chan-thuong-chinh-hinh\/\">X-ray<\/a> lo\u1ea1i tr\u1eeb \u0111\u01b0\u1ee3c g\u00e3y x\u01b0\u01a1ng. Test \u00e1p l\u1ef1c c\u1ea1nh gi\u01b0\u1eddng bao g\u1ed3m vi\u1ec7c v\u1eadn \u0111\u1ed9ng th\u1ee5 \u0111\u1ed9ng kh\u1edbp theo h\u01b0\u1edbng vu\u00f4ng g\u00f3c v\u1edbi v\u1eadn \u0111\u1ed9ng b\u00ecnh th\u01b0\u1eddng. B\u1edfi v\u00ec co c\u01a1 trong nh\u1eefng ch\u1ea5n th\u01b0\u01a1ng \u0111au c\u1ea5p t\u00ednh c\u00f3 th\u1ec3 lu m\u1edd s\u1ef1 m\u1ea5t v\u1eefng kh\u1edbp, c\u00e1c c\u01a1 xung quanh kh\u1edbp \u0111\u01b0\u1ee3c gi\u00e3n c\u00e0ng nhi\u1ec1u c\u00e0ng t\u1ed1t, m\u1ed7i l\u1ea7n kh\u00e1m ph\u1ea3i b\u1eaft \u0111\u1ea7u m\u1ed9t c\u00e1ch nh\u1eb9 nh\u00e0ng, l\u1eb7p \u0111i l\u1eb7p l\u1ea1i, m\u1ed7i l\u1ea7n gia t\u0103ng th\u00eam m\u1ed9t \u00edt l\u1ef1c. C\u00e1c k\u1ebft qu\u1ea3 \u0111\u01b0\u1ee3c so s\u00e1nh v\u1edbi b\u00ean \u0111\u1ed1i di\u1ec7n b\u00ecnh th\u01b0\u1eddng nh\u01b0ng c\u00f3 th\u1ec3 b\u1ecb gi\u1edbi h\u1ea1n b\u1edfi b\u1ea3n ch\u1ea5t ch\u1ee7 quan.<\/p>\n<p>C\u00e1c k\u1ebft qu\u1ea3 c\u00f3 th\u1ec3 gi\u00fap ph\u00e2n bi\u1ec7t \u0111\u1ee9t d\u00e2y ch\u1eb1ng \u0111\u1ed9 2 v\u00e0 \u0111\u1ed9 3:<\/p>\n<ul>\n<li>\u0110\u1ee9t d\u00e2y ch\u1eb1ng \u0111\u1ed9 2: \u0111au khi ti\u1ebfn h\u00e0nh nghi\u1ec7m ph\u00e1p, v\u1eadn \u0111\u1ed9ng c\u1ee7a kh\u1edbp b\u1ecb gi\u1edbi h\u1ea1n<\/li>\n<li>\u0110\u1ee9t d\u00e2y ch\u1eb1ng \u0111\u1ed9 3: \u00edt \u0111au \u0111\u1edbn h\u01a1n khi ti\u1ebfn h\u00e0nh nghi\u1ec7m ph\u00e1p b\u1edfi v\u00ec d\u00e2y ch\u1eb1ng \u0111\u00e3 b\u1ecb r\u00e1ch ho\u00e0n to\u00e0n v\u00e0 kh\u00f4ng c\u00f2n \u0111\u01b0\u1ee3c k\u00e9o c\u0103ng, t\u1ea7m v\u1eadn \u0111\u1ed9ng kh\u1edbp t\u0103ng r\u00f5 r\u1ec7t.<\/li>\n<\/ul>\n<p>N\u1ebfu c\u01a1 c\u00f2n co nhi\u1ec1u d\u00f9 \u0111\u00e3 s\u1eed d\u1ee5ng thu\u1ed1c gi\u1ea3m \u0111au ho\u1eb7c thu\u1ed1c g\u00e2y t\u00ea, n\u00ean kh\u00e1m l\u1ea1i v\u00e0i ng\u00e0y sau \u0111\u00f3, khi b\u1edbt co c\u01a1.<\/p>\n<p>M\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p \u0111\u1ee9t g\u00e2n b\u00e1n ph\u1ea7n ban \u0111\u1ea7u kh\u00f3 ph\u00e1t hi\u1ec7n tr\u00ean l\u00e2m s\u00e0ng v\u00ec ch\u1ee9c n\u0103ng kh\u00f4ng thay \u0111\u1ed5i. B\u1ea5t k\u1ef3 d\u1ea5u hi\u1ec7u n\u00e0o sau \u0111\u00e2y \u0111\u1ec1u g\u1ee3i \u00fd \u0111\u1ebfn \u0111\u1ee9t g\u00e2n b\u00e1n ph\u1ea7n:<\/p>\n<ul>\n<li>\u1ea4n \u0111au t\u1ea1i g\u00e2n<\/li>\n<li>\u0110au khi v\u1eadn \u0111\u1ed9ng theo t\u1ea7m v\u1eadn \u0111\u1ed9ng c\u1ee7a kh\u1edbp<\/li>\n<li>R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng<\/li>\n<li>Y\u1ebfu<\/li>\n<li>S\u1edd th\u1ea5y v\u00f9ng t\u1ed5n th\u01b0\u01a1ng.<\/li>\n<\/ul>\n<p>\u0110\u1ee9t g\u00e2n b\u00e1n ph\u1ea7n c\u00f3 th\u1ec3 ti\u1ebfn tri\u1ec3n th\u00e0nh \u0111\u1ee9t g\u00e2n ho\u00e0n to\u00e0n n\u1ebfu b\u1ec7nh nh\u00e2n ti\u1ebfp t\u1ee5c v\u1eadn \u0111\u1ed9ng v\u00f9ng b\u1ecb th\u01b0\u01a1ng. N\u1ebfu c\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng ho\u1eb7c th\u0103m kh\u00e1m cho th\u1ea5y t\u1ed5n th\u01b0\u01a1ng g\u00e2n b\u00e1n ph\u1ea7n ho\u1eb7c n\u1ebfu th\u0103m kh\u00e1m kh\u00f4ng x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c th\u00ec c\u1ea7n d\u00f9ng n\u1eb9p \u0111\u1ec3 b\u1ea5t \u0111\u1ed9ng v\u00e0 kh\u00f4ng g\u00e2y t\u1ed5n th\u01b0\u01a1ng th\u00eam. B\u01b0\u1edbc \u0111\u00e1nh gi\u00e1 ti\u1ebfp, \u0111\u00f4i khi c\u1ea7n ch\u1ee5p MRI, \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 ph\u1ea1m vi, m\u1ee9c \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng.<\/p>\n<h3><strong>4.3. Ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh<\/strong><\/h3>\n<p>Kh\u00f4ng ph\u1ea3i t\u1ea5t c\u1ea3 c\u00e1c ch\u1ea5n th\u01b0\u01a1ng chi \u0111\u1ec1u c\u1ea7n ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh. Ch\u1ee5p X-quang th\u01b0\u1eddng quy, cho ch\u00fang ta th\u1ea5y \u0111\u01b0\u1ee3c ch\u1ee7 y\u1ebfu l\u00e0 x\u01b0\u01a1ng (v\u00e0 gi\u00e1n ti\u1ebfp th\u1ea5y tr\u00e0n d\u1ecbch kh\u1edbp do ch\u1ea3y m\u00e1u ho\u1eb7c c\u00f3 v\u1ee1 x\u01b0\u01a1ng nh\u01b0ng b\u1ecb khu\u1ea5t), do \u0111\u00f3, X-quang \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u1ec3 ki\u1ec3m tra tr\u1eadt kh\u1edbp v\u00e0 g\u00e3y x\u01b0\u01a1ng; ch\u1ee5p X-quang th\u01b0\u1eddng kh\u00f4ng th\u1ea5y \u0111\u01b0\u1ee3c c\u00e1c b\u1eb1ng ch\u1ee9ng tr\u1ef1c ti\u1ebfp c\u1ee7a \u0111\u1ee9t d\u00e2y ch\u1eb1ng nh\u01b0ng c\u00f3 th\u1ec3 th\u1ea5y c\u00e1c t\u01b0\u01a1ng quan gi\u1ea3i ph\u1eabu b\u1ea5t th\u01b0\u1eddng g\u1ee3i \u00fd \u0111\u1ebfn \u0111\u1ee9t d\u00e2y ch\u1eb1ng ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng ph\u1ea7n m\u1ec1m kh\u00e1c. Ch\u1ee5p X-quang n\u00ean g\u1ed3m \u00edt nh\u1ea5t hai h\u01b0\u1edbng \u0111\u01b0\u1ee3c ch\u1ee5p \u1edf hai m\u1eb7t ph\u1eb3ng kh\u00e1c nhau (th\u01b0\u1eddng l\u00e0 t\u01b0 th\u1ebf th\u1eb3ng v\u00e0 nghi\u00eang).<\/p>\n<p>MRI c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh t\u1ed5n th\u01b0\u01a1ng ph\u1ea7n m\u1ec1m, bao g\u1ed3m d\u00e2y ch\u1eb1ng, g\u00e2n, s\u1ee5n v\u00e0 c\u00e1c t\u1ed5n th\u01b0\u01a1ng c\u01a1.<\/p>\n<p>MRI ho\u1eb7c CT-scan c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u1ec3 ki\u1ec3m tra c\u00e1c \u0111\u01b0\u1eddng v\u1ee1 kh\u00f3 ph\u00e1t hi\u1ec7n.<\/p>\n<h2><strong>5. \u0110I\u1ec0U TR\u1eca<\/strong><\/h2>\n<h3><strong>5.1. \u0110i\u1ec1u tr\u1ecb ban \u0111\u1ea7u<\/strong><\/h3>\n<p>N\u1ebfu c\u00f3 c\u00e1c t\u1ed5n th\u01b0\u01a1ng nghi\u00eam tr\u1ecdng li\u00ean quan th\u00ec ph\u1ea3i \u0111\u01b0\u1ee3c x\u1eed l\u00fd tr\u01b0\u1edbc. Ch\u1eb3ng h\u1ea1n nh\u01b0: s\u1ed1c m\u1ea5t m\u00e1u \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb ngay l\u1eadp t\u1ee9c, c\u00e1c t\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u c\u1ea7n \u0111\u01b0\u1ee3c ph\u1eabu thu\u1eadt x\u1eed tr\u00ed (tr\u1eeb khi t\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u nh\u1ecf m\u00e0 tu\u1ea7n ho\u00e0n b\u00ean t\u1ed1t), c\u00e1c d\u00e2y th\u1ea7n kinh b\u1ecb \u0111\u1ee9t c\u1ea7n \u0111\u01b0\u1ee3c ph\u1eabu thu\u1eadt s\u1eeda ch\u1eefa; \u0111\u1ed1i v\u1edbi ch\u1ee9ng \u0111au th\u1ea7n kinh v\u00e0 b\u1ec7nh l\u00fd s\u1ee3i tr\u1ee5c, \u0111i\u1ec1u tr\u1ecb ban \u0111\u1ea7u th\u01b0\u1eddng l\u00e0 theo d\u00f5i, \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 v\u00e0 \u0111\u00f4i khi v\u1eadt l\u00fd tr\u1ecb li\u1ec7u.<\/p>\n<p>Nghi ng\u1edd b\u1ecb <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-xuong-ho\/\">open fracture<\/a> ho\u1eb7c tr\u1eadt kh\u1edbp h\u1edf c\u1ea7n:<\/p>\n<ul>\n<li>B\u0103ng v\u1ebft th\u01b0\u01a1ng b\u1eb1ng g\u1ea1c v\u00f4 tr\u00f9ng<\/li>\n<li>Ti\u00eam ph\u00f2ng u\u1ed1n v\u00e1n<\/li>\n<\/ul>\n<ul>\n<li>Thu\u1ed1c kh\u00e1ng sinh ph\u1ed5 r\u1ed9ng (v\u00ed d\u1ee5: cephalosporin th\u1ebf h\u1ec7 2 c\u1ed9ng v\u1edbi aminoglycosid), n\u00ean b\u1eaft \u0111\u1ea7u s\u1eed d\u1ee5ng trong v\u00f2ng m\u1ed9t gi\u1edd sau khi \u0111\u1ebfn khoa c\u1ea5p c\u1ee9u<\/li>\n<li>Ph\u1eabu thu\u1eadt l\u00e0m s\u1ea1ch v\u00e0 c\u1eaft l\u1ecdc m\u00f4 <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/hoai-tu-vo-mach-chom-xuong-dui\/\">caseation<\/a> (\u0111\u1ec3 ng\u0103n ng\u1eeba nhi\u1ec5m tr\u00f9ng).<\/li>\n<\/ul>\n<p>H\u1ea7u h\u1ebft c\u00e1c t\u1ed5n th\u01b0\u01a1ng m\u1ee9c trung b\u00ecnh v\u00e0 n\u1eb7ng, \u0111\u1eb7c bi\u1ec7t t\u1ed5n th\u01b0\u01a1ng m\u1ea5t v\u1eefng ho\u00e0n to\u00e0n, \u0111\u01b0\u1ee3c c\u1ed1 \u0111\u1ecbnh l\u1eadp t\u1ee9c b\u1eb1ng n\u1eb9p \u0111\u1ec3 gi\u1ea3m \u0111au v\u00e0 \u0111\u1ec3 tr\u00e1nh th\u01b0\u01a1ng t\u1ed5n th\u00eam m\u00f4 kh\u00e1c do t\u1ed5n th\u01b0\u01a1ng m\u1ea5t v\u1eefng.<\/p>\n<p>\u0110au \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t; \u0111\u00f4i khi ph\u1ea3i d\u00f9ng opioid.<\/p>\n<p>Sau khi \u0111i\u1ec1u tr\u1ecb ban \u0111\u1ea7u, c\u00e1c th\u01b0\u01a1ng t\u1ed5n ph\u1ea7n m\u1ec1m \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb theo tri\u1ec7u ch\u1ee9ng v\u00e0 v\u1eabn b\u1ea5t \u0111\u1ed9ng chi.<\/p>\n<p>C\u00e1c t\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng ho\u1eb7c \u0111\u1ee9t g\u00e2n \u0111\u1ec1u c\u1ea7n \u0111\u01b0\u1ee3c x\u1eed tr\u00ed.<\/p>\n<p>H\u1ea7u h\u1ebft c\u00e1c tr\u01b0\u1eddng h\u1ee3p b\u1ea7m t\u00edm \u0111\u1ec1u nh\u1eb9 v\u00e0 \u0111\u00e1p \u1ee9ng t\u1ed1t v\u1edbi ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb. T\u1ed5n th\u01b0\u01a1ng m\u00f4 m\u1ec1m c\u1ea5p t\u00ednh kh\u00e1c nhau v\u1ec1 lo\u1ea1i v\u00e0 m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng. Khi m\u1ed9t ch\u1ea5n th\u01b0\u01a1ng c\u1ea5p t\u00ednh x\u1ea3y ra, \u0111i\u1ec1u tr\u1ecb ban \u0111\u1ea7u b\u1eb1ng ph\u00e1c \u0111\u1ed3 RICE (Rest, Ice, Compression v\u00e0 Elevation) th\u01b0\u1eddng r\u1ea5t hi\u1ec7u qu\u1ea3.<\/p>\n<p><strong>Rest (ngh\u1ec9 ng\u01a1i)<\/strong>: t\u1ea1m d\u1eebng ho\u1ea1t \u0111\u1ed9ng g\u00e2y ra ch\u1ea5n th\u01b0\u01a1ng. N\u1ebfu ch\u1ea5n th\u01b0\u01a1ng \u1edf ch\u00e2n, b\u00e1c s\u0129 c\u0169ng c\u00f3 th\u1ec3 khuy\u1ebfn ngh\u1ecb b\u1ea1n s\u1eed d\u1ee5ng n\u1ea1ng \u0111\u1ec3 tr\u00e1nh ch\u1ecbu s\u1ee9c n\u1eb7ng.<\/p>\n<p><strong>Ice (ch\u01b0\u1eddm l\u1ea1nh)<\/strong>: m\u1ed7i l\u1ea7n ch\u01b0\u1eddm l\u1ea1nh trong 20 ph\u00fat, nhi\u1ec1u l\u1ea7n trong ng\u00e0y. Kh\u00f4ng ch\u01b0\u1eddm \u0111\u00e1 tr\u1ef1c ti\u1ebfp l\u00ean da.<\/p>\n<p><strong>Compression (b\u0103ng \u00e9p)<\/strong>: \u0111\u1ec3 ng\u0103n ng\u1eeba s\u01b0ng th\u00eam v\u00e0 m\u1ea5t m\u00e1u, n\u00ean \u0111eo b\u0103ng \u00e9p \u0111\u00e0n h\u1ed3i.<\/p>\n<p><strong>Elevation (k\u00ea cao)<\/strong>: \u0111\u1ec3 gi\u1ea3m s\u01b0ng, n\u00e2ng ch\u1ea5n th\u01b0\u01a1ng cao h\u01a1n tim trong khi ngh\u1ec9 ng\u01a1i.<\/p>\n<h3><strong>5.2 B\u1ea5t \u0111\u1ed9ng<\/strong><\/h3>\n<p>C\u1ed1 \u0111\u1ecbnh gi\u00fap gi\u1ea3m \u0111au v\u00e0 t\u1ea1o \u0111i\u1ec1u ki\u1ec7n ph\u1ee5c h\u1ed3i nhanh h\u01a1n do ng\u0103n ng\u1eeba \u0111\u01b0\u1ee3c th\u01b0\u01a1ng t\u1ed5n th\u00eam.<\/p>\n<p>\u0110\u1ee9t d\u00e2y ch\u1eb1ng \u0111\u1ed9 1 \u0111\u01b0\u1ee3c c\u1ed1 \u0111\u1ecbnh trong th\u1eddi gian ng\u1eafn. V\u1eadn \u0111\u1ed9ng s\u1edbm l\u00e0 t\u1ed1t nh\u1ea5t. \u0110\u1ed9 2 nh\u1eb9 th\u01b0\u1eddng \u0111\u01b0\u1ee3c c\u1ed1 \u0111\u1ecbnh b\u1eb1ng b\u0103ng treo ho\u1eb7c n\u1eb9p trong v\u00e0i ng\u00e0y. \u0110\u1ee9t d\u00e2y ch\u1eb1ng \u0111\u1ed9 2 v\u00e0 m\u1ed9t s\u1ed1 \u0111\u1ed9 3 ho\u1eb7c r\u00e1ch g\u00e2n \u0111\u01b0\u1ee3c c\u1ed1 \u0111\u1ecbnh trong v\u00e0i ng\u00e0y ho\u1eb7c v\u00e0i tu\u1ea7n, \u0111\u00f4i khi c\u1ea7n <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/bo-bot\/\">cast<\/a>. \u0110\u1ee9t d\u00e2y ch\u1eb1ng \u0111\u1ed9 3 \u0111\u00f2i h\u1ecfi ph\u1eabu thu\u1eadt; th\u01b0\u1eddng c\u1ed1 \u0111\u1ecbnh ch\u1ec9 l\u00e0 bi\u1ec7n ph\u00e1p b\u1ed5 tr\u1ee3.<\/p>\n<p>B\u00f3 b\u1ed9t th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng v\u1edbi c\u00e1c t\u1ed5n th\u01b0\u01a1ng c\u1ea7n c\u1ed1 \u0111\u1ecbnh v\u00e0i tu\u1ea7n. Hi\u1ebfm khi, s\u01b0ng n\u1ec1 do b\u00f3 b\u1ed9t d\u1eabn \u0111\u1ebfn h\u1ed9i ch\u1ee9ng ch\u00e8n \u00e9p khoang. N\u1ebfu b\u00e1c s\u0129 l\u00e2m s\u00e0ng nghi ng\u1edd s\u01b0ng n\u1ec1 n\u1eb7ng v\u00f9ng chi c\u00f3 b\u1ed9t, b\u1ed9t (v\u00e0 t\u1ea5t c\u1ea3 c\u00e1c \u0111\u1ec7m l\u00f3t) \u0111\u01b0\u1ee3c r\u1ea1ch d\u1ecdc b\u1ed9t. B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c b\u1ea5t \u0111\u1ed9ng b\u1eb1ng b\u1ed9t c\u1ea7n \u0111\u01b0\u1ee3c h\u01b0\u1edbng d\u1eabn theo d\u00f5i b\u1ed9t.<\/p>\n<p>N\u1eb9p c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 c\u1ed1 \u0111\u1ecbnh m\u1ed9t s\u1ed1 th\u01b0\u01a1ng t\u1ed5n v\u1eefng, m\u1ed9t s\u1ed1 k\u1ef9 thu\u1eadt th\u01b0\u1eddng d\u00f9ng bao g\u1ed3m m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p nghi ng\u1edd g\u00e3y x\u01b0\u01a1ng, gi\u00fap nhanh ch\u00f3ng l\u00e0m <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/cham-lanh-xuong-va-khong-lanh-xuong\/\">heal bones<\/a> g\u00e3y, bong g\u00e2n v\u00e0 c\u00e1c th\u01b0\u01a1ng t\u1ed5n kh\u00e1c m\u00e0 c\u1ea7n ph\u1ea3i c\u1ed1 \u0111\u1ecbnh trong nhi\u1ec1u ng\u00e0y ho\u1eb7c \u00edt h\u01a1n, n\u00f3 cho ph\u00e9p b\u1ec7nh nh\u00e2n ch\u01b0\u1eddm \u0111\u00e1 v\u00e0 v\u1eadn \u0111\u1ed9ng nhi\u1ec1u h\u01a1n khi ph\u1ea3i b\u00f3 b\u1ed9t. Ngo\u00e0i ra, n\u00f3 kh\u00f4ng g\u00e2y ch\u00e8n \u00e9p trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p chi b\u1ecb s\u01b0ng n\u1ec1, do v\u1eady kh\u00f4ng g\u00e2y ra h\u1ed9i ch\u1ee9ng khoang.<\/p>\n<p>M\u1ed9t s\u1ed1 t\u1ed5n th\u01b0\u01a1ng m\u00e0 cu\u1ed1i c\u00f9ng c\u1ea7n b\u00f3 b\u1ed9t \u0111\u01b0\u1ee3c c\u1ed1 \u0111\u1ecbnh ban \u0111\u1ea7u b\u1eb1ng n\u1eb9p cho \u0111\u1ebfn khi g\u1ea7n h\u1ebft s\u01b0ng n\u1ec1 chi.<\/p>\n<h3><strong>5.3 Ph\u1eabu thu\u1eadt<\/strong><\/h3>\n<p>Nhi\u1ec1u \u0111\u1ee9t d\u00e2y ch\u1eb1ng \u0111\u1ed9 ba ho\u1eb7c \u0111\u1ee9t g\u00e2n c\u1ea7n ph\u1eabu thu\u1eadt s\u1eeda ch\u1eefa.<\/p>\n<p>Ph\u1eabu thu\u1eadt n\u1ed9i soi \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng th\u01b0\u1eddng xuy\u00ean nh\u1ea5t \u0111\u1ec3 s\u1eeda ch\u1eefa d\u00e2y ch\u1eb1ng ho\u1eb7c <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/ton-thuong-day-chang-cheo\/\">meniscus<\/a> \u1edf kh\u1edbp g\u1ed1i.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>","protected":false},"featured_media":2260,"comment_status":"open","ping_status":"closed","template":"","tags":[45,217,166],"chuyen-muc":[58],"class_list":["post-1949","bai-giang","type-bai-giang","status-publish","has-post-thumbnail","hentry","tag-gay-xuong-kin","tag-mo-mem","tag-ton-thuong-kin-mo-mem","chuyen-muc-dieu-tri-co-ban-trong-chan-thuong-chinh-hinh"],"_links":{"self":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/1949","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=1949"}],"version-history":[{"count":0,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/1949\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media\/2260"}],"wp:attachment":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media?parent=1949"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/tags?post=1949"},{"taxonomy":"chuyen-muc","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-muc?post=1949"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}