{"id":165,"date":"2026-10-10T11:42:41","date_gmt":"2026-10-10T04:42:41","guid":{"rendered":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/10\/ton-thuong-slap-dau-hieu-phan-loai-va-phuc-hoi-sau-sua-chua\/"},"modified":"2026-10-10T11:42:41","modified_gmt":"2026-10-10T04:42:41","slug":"ton-thuong-slap-dau-hieu-phan-loai-va-phuc-hoi-sau-sua-chua","status":"publish","type":"post","link":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/10\/ton-thuong-slap-dau-hieu-phan-loai-va-phuc-hoi-sau-sua-chua\/","title":{"rendered":"T\u1ed5n th\u01b0\u01a1ng SLAP: d\u1ea5u hi\u1ec7u, ph\u00e2n lo\u1ea1i v\u00e0 ph\u1ee5c h\u1ed3i sau s\u1eeda ch\u1eefa"},"content":{"rendered":"

T\u1ed5n th\u01b0\u01a1ng SLAP<\/strong> l\u00e0 v\u1ea5n \u0111\u1ec1 li\u00ean quan \u0111\u1ebfn v\u00f9ng s\u1ee5n vi\u1ec1n ph\u00eda tr\u00ean c\u1ee7a \u1ed5 ch\u1ea3o v\u00e0 ph\u1ee9c h\u1ee3p g\u00e2n nh\u1ecb \u0111\u1ea7u\u2013s\u1ee5n vi\u1ec1n. T\u00ean g\u1ecdi SLAP l\u00e0 vi\u1ebft t\u1eaft c\u1ee7a \u201csuperior labral anterior\u2013posterior\u201d, m\u00f4 t\u1ea3 t\u1ed5n th\u01b0\u01a1ng s\u1ee5n vi\u1ec1n tr\u00ean theo h\u01b0\u1edbng t\u1eeb tr\u01b0\u1edbc ra sau [1]. T\u00e0i li\u1ec7u \u0111\u01b0\u1ee3c cung c\u1ea5p t\u1eadp trung v\u00e0o th\u0103m kh\u00e1m n\u1ed9i soi, s\u1eeda ch\u1eefa v\u00e0 ph\u1ee5c h\u1ed3i sau ph\u1eabu thu\u1eadt; v\u00ec v\u1eady, b\u00e0i vi\u1ebft n\u00e0y kh\u00f4ng thay th\u1ebf \u0111\u00e1nh gi\u00e1 tr\u1ef1c ti\u1ebfp c\u1ee7a b\u00e1c s\u0129.<\/p>\n

T\u1ed5n th\u01b0\u01a1ng SLAP l\u00e0 g\u00ec?<\/h2>\n

Trong n\u1ed9i soi kh\u1edbp vai, t\u1ed5n th\u01b0\u01a1ng SLAP c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn ph\u1ea7n b\u00e1m ph\u00eda tr\u00ean c\u1ee7a s\u1ee5n vi\u1ec1n. M\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p c\u00f3 s\u1ef1 gi\u00e1n \u0111o\u1ea1n \u1edf v\u00f9ng b\u00e1m n\u1eb1m ph\u00eda trong; khi \u0111\u00f3, b\u00e1c s\u0129 c\u00f3 th\u1ec3 c\u1ea7n ho\u00e0n t\u1ea5t vi\u1ec7c x\u00e1c \u0111\u1ecbnh t\u1ed5n th\u01b0\u01a1ng, chu\u1ea9n b\u1ecb n\u1ec1n x\u01b0\u01a1ng v\u00e0 s\u1eeda ch\u1eefa trong nh\u1eefng b\u1ec7nh c\u1ea3nh \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn [5].<\/p>\n

M\u1ee9c \u0111\u1ed9 \u1ed5n \u0111\u1ecbnh c\u1ee7a g\u00e2n nh\u1ecb \u0111\u1ea7u l\u00e0 y\u1ebfu t\u1ed1 quan tr\u1ecdng khi c\u00e2n nh\u1eafc x\u1eed tr\u00ed. Theo ph\u00e1c \u0111\u1ed3 \u0111\u01b0\u1ee3c tr\u00edch d\u1eabn, t\u1ed5n th\u01b0\u01a1ng lo\u1ea1i I v\u00e0 III th\u01b0\u1eddng \u0111\u01b0\u1ee3c x\u1eed l\u00fd b\u1eb1ng c\u1eaft l\u1ecdc, trong khi lo\u1ea1i II v\u00e0 IV li\u00ean quan \u0111\u1ebfn g\u00e2n nh\u1ecb \u0111\u1ea7u kh\u00f4ng v\u1eefng v\u00e0 c\u00f3 th\u1ec3 c\u1ea7n s\u1eeda ch\u1eefa [4]. C\u00e1ch \u0111i\u1ec1u tr\u1ecb c\u1ee5 th\u1ec3 c\u00f2n ph\u1ee5 thu\u1ed9c lo\u1ea1i t\u1ed5n th\u01b0\u01a1ng v\u00e0 bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng c\u1ee7a t\u1eebng ng\u01b0\u1eddi.<\/p>\n

D\u1ea5u hi\u1ec7u v\u00e0 nghi\u1ec7m ph\u00e1p g\u1ee3i \u00fd t\u1ed5n th\u01b0\u01a1ng SLAP<\/h2>\n

C\u00e1c tri\u1ec7u ch\u1ee9ng v\u00f9ng vai kh\u00f4ng t\u1ef1 x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c nguy\u00ean nh\u00e2n. Trong kh\u00e1m l\u00e2m s\u00e0ng, \u0111au ho\u1eb7c ti\u1ebfng l\u1ee5c c\u1ee5c n\u1eb1m s\u00e2u trong kh\u1edbp vai c\u00f3 th\u1ec3 g\u1ee3i \u00fd b\u1ea5t th\u01b0\u1eddng s\u1ee5n vi\u1ec1n, kh\u00e1c v\u1edbi \u0111au khu tr\u00fa tr\u00ean \u0111\u1ec9nh vai th\u01b0\u1eddng h\u01b0\u1edbng \u0111\u1ebfn v\u00f9ng kh\u1edbp c\u00f9ng\u2013\u0111\u00f2n [3]. \u0110\u00e2y ch\u1ec9 l\u00e0 \u0111\u1ecbnh h\u01b0\u1edbng khi kh\u00e1m, kh\u00f4ng ph\u1ea3i k\u1ebft lu\u1eadn ch\u1ea9n \u0111o\u00e1n \u0111\u1ed9c l\u1eadp.<\/p>\n

Nghi\u1ec7m ph\u00e1p \u00e9p ch\u1ee7 \u0111\u1ed9ng<\/h3>\n

Nghi\u1ec7m ph\u00e1p \u00e9p ch\u1ee7 \u0111\u1ed9ng \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 \u0111au li\u00ean quan \u0111\u1ebfn vai. Tuy nhi\u00ean, ngu\u1ed3n tr\u00edch d\u1eabn l\u01b0u \u00fd r\u1eb1ng gi\u00e1 tr\u1ecb ch\u1ea9n \u0111o\u00e1n c\u1ee7a nghi\u1ec7m ph\u00e1p n\u00e0y \u0111\u1ed1i v\u1edbi r\u00e1ch SLAP c\u00f3 th\u1ec3 kh\u00f4ng cao b\u1eb1ng \u0111\u1ed1i v\u1edbi m\u1ed9t s\u1ed1 d\u1ea1ng r\u00e1ch s\u1ee5n vi\u1ec1n kh\u00e1c [3]. V\u00ec v\u1eady, k\u1ebft qu\u1ea3 c\u1ea7n \u0111\u01b0\u1ee3c b\u00e1c s\u0129 di\u1ec5n gi\u1ea3i c\u00f9ng b\u1ec7nh s\u1eed, kh\u00e1m th\u1ef1c th\u1ec3 v\u00e0 c\u00e1c ph\u01b0\u01a1ng ti\u1ec7n \u0111\u00e1nh gi\u00e1 ph\u00f9 h\u1ee3p.<\/p>\n

Nghi\u1ec7m ph\u00e1p dynamic labral shear<\/h3>\n

Nghi\u1ec7m ph\u00e1p dynamic labral shear \u0111\u01b0\u1ee3c x\u00e2y d\u1ef1ng nh\u1eb1m t\u00e1i t\u1ea1o c\u01a1 ch\u1ebf l\u1ef1c c\u1eaft c\u00f3 th\u1ec3 g\u00e2y t\u1ed5n th\u01b0\u01a1ng SLAP. Nghi\u1ec7m ph\u00e1p \u0111\u01b0\u1ee3c xem l\u00e0 d\u01b0\u01a1ng t\u00ednh khi t\u00e1i hi\u1ec7n \u0111\u01b0\u1ee3c \u0111au s\u00e2u \u1edf ph\u00eda sau kh\u1edbp vai trong m\u1ed9t cung v\u1eadn \u0111\u1ed9ng nh\u1ea5t \u0111\u1ecbnh [3]. Vi\u1ec7c xu\u1ea5t hi\u1ec7n \u0111au khi l\u00e0m nghi\u1ec7m ph\u00e1p kh\u00f4ng \u0111\u1ed3ng ngh\u0129a ch\u1eafc ch\u1eafn v\u1edbi vi\u1ec7c \u0111\u00e3 c\u00f3 t\u1ed5n th\u01b0\u01a1ng SLAP.<\/p>\n

D\u1ea5u hi\u1ec7u peel-back trong n\u1ed9i soi<\/h3>\n

Trong n\u1ed9i soi, d\u1ea5u hi\u1ec7u peel-back d\u01b0\u01a1ng t\u00ednh \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 l\u00e0 c\u00f3 gi\u00e1 tr\u1ecb ch\u1ea9n \u0111o\u00e1n \u0111\u1ed1i v\u1edbi t\u1ed5n th\u01b0\u01a1ng SLAP ph\u00eda sau. Khi \u0111\u01b0a vai \u0111\u1ebfn kho\u1ea3ng 90 \u0111\u1ed9 d\u1ea1ng v\u00e0 90 \u0111\u1ed9 xoay ngo\u00e0i, ph\u1ee9c h\u1ee3p g\u00e2n nh\u1ecb \u0111\u1ea7u\u2013s\u1ee5n vi\u1ec1n tr\u00ean c\u00f3 th\u1ec3 di chuy\u1ec3n v\u00e0o ph\u00eda trong qua b\u1edd \u1ed5 ch\u1ea3o n\u1ebfu c\u00f3 t\u1ed5n th\u01b0\u01a1ng d\u1ea1ng n\u00e0y [1]. Ng\u01b0\u1ee3c l\u1ea1i, t\u1ed5n th\u01b0\u01a1ng SLAP ph\u00eda tr\u01b0\u1edbc \u0111\u01a1n \u0111\u1ed9c c\u00f3 th\u1ec3 cho k\u1ebft qu\u1ea3 peel-back \u00e2m t\u00ednh, d\u00f9 c\u00e1c d\u1ea5u hi\u1ec7u n\u1ed9i soi kh\u00e1c v\u1eabn c\u00f3 th\u1ec3 b\u1ea5t th\u01b0\u1eddng [1].<\/p>\n

Ph\u1ee5c h\u1ed3i sau s\u1eeda ch\u1eefa t\u1ed5n th\u01b0\u01a1ng SLAP<\/h2>\n

Ph\u1ee5c h\u1ed3i sau ph\u1eabu thu\u1eadt c\u1ea7n \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh theo lo\u1ea1i t\u1ed5n th\u01b0\u01a1ng v\u00e0 h\u01b0\u1edbng d\u1eabn c\u1ee7a b\u00e1c s\u0129. V\u1edbi t\u1ed5n th\u01b0\u01a1ng lo\u1ea1i II v\u00e0 IV, ph\u00e1c \u0111\u1ed3 nh\u1ea5n m\u1ea1nh vi\u1ec7c h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng ch\u1ee7 \u0111\u1ed9ng c\u1ee7a c\u01a1 nh\u1ecb \u0111\u1ea7u trong giai \u0111o\u1ea1n \u0111\u1ea7u [4].<\/p>\n

    \n
  • Tu\u1ea7n 0\u20132:<\/strong> \u01b0u ti\u00ean v\u1eadn \u0111\u1ed9ng th\u1ee5 \u0111\u1ed9ng ho\u1eb7c c\u00f3 tr\u1ee3 gi\u00fap trong gi\u1edbi h\u1ea1n quy \u0111\u1ecbnh, b\u00e0i t\u1eadp con l\u1eafc, v\u1eadn \u0111\u1ed9ng x\u01b0\u01a1ng b\u1ea3 vai, v\u1eadn \u0111\u1ed9ng khu\u1ef7u th\u1ee5 \u0111\u1ed9ng v\u00e0 c\u00e1c b\u00e0i t\u1eadp b\u00e0n tay, c\u1ed5 tay. Ng\u01b0\u1eddi b\u1ec7nh c\u1ea7n tu\u00e2n th\u1ee7 vi\u1ec7c \u0111eo \u0111ai v\u00e0 tr\u00e1nh co c\u01a1 nh\u1ecb \u0111\u1ea7u ch\u1ee7 \u0111\u1ed9ng [7].<\/li>\n
  • Tu\u1ea7n 3\u20136:<\/strong> t\u1eebng b\u01b0\u1edbc t\u0103ng t\u1ea7m v\u1eadn \u0111\u1ed9ng th\u1ee5 \u0111\u1ed9ng, chuy\u1ec3n sang v\u1eadn \u0111\u1ed9ng ch\u1ee7 \u0111\u1ed9ng c\u00f3 tr\u1ee3 gi\u00fap r\u1ed3i ch\u1ee7 \u0111\u1ed9ng; c\u00f3 th\u1ec3 b\u1eaft \u0111\u1ea7u m\u1ed9t s\u1ed1 b\u00e0i t\u1eadp \u1ed5n \u0111\u1ecbnh x\u01b0\u01a1ng b\u1ea3 vai v\u00e0 xoay ngo\u00e0i\u2013xoay trong \u0111\u1eb3ng tr\u01b0\u1eddng theo h\u01b0\u1edbng d\u1eabn [7].<\/li>\n
  • T\u1eeb tu\u1ea7n 6 tr\u1edf \u0111i:<\/strong> ch\u01b0\u01a1ng tr\u00ecnh th\u01b0\u1eddng ti\u1ebfp t\u1ee5c v\u1edbi c\u00e1c b\u00e0i t\u1eadp t\u0103ng s\u1ee9c m\u1ea1nh cho ch\u00f3p xoay, c\u01a1 \u1ed5n \u0111\u1ecbnh x\u01b0\u01a1ng b\u1ea3 vai v\u00e0 c\u01a1 delta; t\u1eadp s\u1ee9c m\u1ea1nh c\u01a1 nh\u1ecb \u0111\u1ea7u \u0111\u01b0\u1ee3c b\u1eaft \u0111\u1ea7u mu\u1ed9n h\u01a1n, kho\u1ea3ng sau 8 tu\u1ea7n trong ph\u00e1c \u0111\u1ed3 \u0111\u01b0\u1ee3c tr\u00edch d\u1eabn [6].<\/li>\n<\/ul>\n

    \u1ede v\u1eadn \u0111\u1ed9ng vi\u00ean n\u00e9m, vi\u1ec7c quay l\u1ea1i n\u00e9m c\u1ea7n ti\u1ebfn h\u00e0nh theo t\u1eebng giai \u0111o\u1ea1n. T\u00e0i li\u1ec7u m\u00f4 t\u1ea3 ch\u01b0\u01a1ng tr\u00ecnh n\u00e9m ng\u1eaft qu\u00e3ng t\u1eeb kho\u1ea3ng th\u00e1ng th\u1ee9 t\u01b0; v\u1eadn \u0111\u1ed9ng vi\u00ean n\u00e9m b\u00f3ng c\u00f3 th\u1ec3 b\u1eaft \u0111\u1ea7u n\u00e9m t\u1ed1c \u0111\u1ed9 t\u1ed1i \u0111a v\u00e0o kho\u1ea3ng th\u00e1ng th\u1ee9 s\u00e1u v\u00e0 n\u00e9m to\u00e0n l\u1ef1c t\u1eeb g\u00f2 n\u00e9m v\u00e0o kho\u1ea3ng th\u00e1ng th\u1ee9 b\u1ea3y, t\u00f9y \u0111\u00e1nh gi\u00e1 l\u00e2m s\u00e0ng [6]. C\u0103ng gi\u00e3n bao kh\u1edbp ph\u00eda sau\u2013ph\u00eda d\u01b0\u1edbi \u0111\u01b0\u1ee3c nh\u1ea5n m\u1ea1nh nh\u1eb1m gi\u1ea3m nguy c\u01a1 t\u00e1i ph\u00e1t t\u00ecnh tr\u1ea1ng co c\u1ee9ng \u1edf nh\u00f3m v\u1eadn \u0111\u1ed9ng vi\u00ean n\u00e0y [2].<\/p>\n

    K\u1ebft lu\u1eadn<\/h2>\n

    T\u1ed5n th\u01b0\u01a1ng SLAP c\u1ea7n \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 trong b\u1ed1i c\u1ea3nh tri\u1ec7u ch\u1ee9ng, kh\u00e1m vai v\u00e0 c\u00e1c d\u1ea5u hi\u1ec7u chuy\u00ean bi\u1ec7t; kh\u00f4ng n\u00ean d\u1ef1a v\u00e0o m\u1ed9t nghi\u1ec7m ph\u00e1p \u0111\u01a1n l\u1ebb. Ph\u00e2n lo\u1ea1i t\u1ed5n th\u01b0\u01a1ng v\u00e0 \u0111\u1ed9 v\u1eefng c\u1ee7a g\u00e2n nh\u1ecb \u0111\u1ea7u \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn l\u1ef1a ch\u1ecdn x\u1eed tr\u00ed c\u0169ng nh\u01b0 ti\u1ebfn tr\u00ecnh ph\u1ee5c h\u1ed3i. Sau s\u1eeda ch\u1eefa, tu\u00e2n th\u1ee7 gi\u1edbi h\u1ea1n v\u1eadn \u0111\u1ed9ng, tr\u00ec ho\u00e3n co c\u01a1 nh\u1ecb \u0111\u1ea7u v\u00e0 t\u0103ng t\u1ea3i t\u1eebng b\u01b0\u1edbc l\u00e0 nh\u1eefng \u0111i\u1ec3m c\u1ed1t l\u00f5i trong ph\u00e1c \u0111\u1ed3 \u0111\u01b0\u1ee3c cung c\u1ea5p [4][7].<\/p>\n

    T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n
      \n
    • [1] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 3162<\/li>\n
    • [2] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 3164<\/li>\n
    • [3] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 2813<\/li>\n
    • [4] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 3166<\/li>\n
    • [5] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 3161<\/li>\n
    • [6] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 3164<\/li>\n
    • [7] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 3165<\/li>\n<\/ul>\n

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