{"id":189,"date":"2026-10-10T16:25:15","date_gmt":"2026-10-10T09:25:15","guid":{"rendered":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/10\/ton-thuong-dam-roi-than-kinh-canh-tay-o-tre-so-sinh-dau-hieu-va-cach-nhan-biet\/"},"modified":"2026-10-10T16:25:15","modified_gmt":"2026-10-10T09:25:15","slug":"ton-thuong-dam-roi-than-kinh-canh-tay-o-tre-so-sinh-dau-hieu-va-cach-nhan-biet","status":"publish","type":"post","link":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/10\/ton-thuong-dam-roi-than-kinh-canh-tay-o-tre-so-sinh-dau-hieu-va-cach-nhan-biet\/","title":{"rendered":"T\u1ed5n th\u01b0\u01a1ng \u0111\u00e1m r\u1ed1i th\u1ea7n kinh c\u00e1nh tay \u1edf tr\u1ebb s\u01a1 sinh: d\u1ea5u hi\u1ec7u v\u00e0 c\u00e1ch nh\u1eadn bi\u1ebft"},"content":{"rendered":"

T\u1ed5n th\u01b0\u01a1ng \u0111\u00e1m r\u1ed1i th\u1ea7n kinh c\u00e1nh tay \u1edf tr\u1ebb s\u01a1 sinh<\/strong> c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n sau qu\u00e1 tr\u00ecnh sinh do l\u1ef1c k\u00e9o c\u01a1 h\u1ecdc l\u00ean c\u00e1c r\u1ec5 th\u1ea7n kinh. T\u00ecnh tr\u1ea1ng n\u00e0y th\u01b0\u1eddng bi\u1ec3u hi\u1ec7n b\u1eb1ng vi\u1ec7c tr\u1ebb \u00edt ho\u1eb7c kh\u00f4ng c\u1eed \u0111\u1ed9ng m\u1ed9t tay, nh\u01b0ng d\u1ea5u hi\u1ec7u t\u01b0\u01a1ng t\u1ef1 c\u0169ng c\u00f3 th\u1ec3 g\u1eb7p khi tr\u1ebb b\u1ecb g\u00e3y x\u01b0\u01a1ng \u0111\u00f2n ho\u1eb7c \u0111\u1ea7u tr\u00ean x\u01b0\u01a1ng c\u00e1nh tay. V\u00ec v\u1eady, \u0111\u00e1nh gi\u00e1 n\u1ed1i ti\u1ebfp v\u00e0 ph\u00e2n bi\u1ec7t nguy\u00ean nh\u00e2n l\u00e0 r\u1ea5t quan tr\u1ecdng [4][6][8].<\/p>\n

T\u1ed5n th\u01b0\u01a1ng \u0111\u00e1m r\u1ed1i th\u1ea7n kinh c\u00e1nh tay \u1edf tr\u1ebb s\u01a1 sinh l\u00e0 g\u00ec?<\/h2>\n

\u0110\u00e1m r\u1ed1i th\u1ea7n kinh c\u00e1nh tay l\u00e0 m\u1ea1ng l\u01b0\u1edbi th\u1ea7n kinh chi ph\u1ed1i v\u1eadn \u0111\u1ed9ng v\u00e0 c\u1ea3m gi\u00e1c cho vai, c\u00e1nh tay, c\u1eb3ng tay v\u00e0 b\u00e0n tay. Li\u1ec7t \u0111\u00e1m r\u1ed1i th\u1ea7n kinh c\u00e1nh tay do sinh \u0111\u01b0\u1ee3c cho l\u00e0 li\u00ean quan \u0111\u1ebfn t\u1ed5n th\u01b0\u01a1ng k\u00e9o gi\u00e3n c\u01a1 h\u1ecdc trong qu\u00e1 tr\u00ecnh sinh. Sinh m\u1ed5 kh\u00f4ng lo\u1ea1i tr\u1eeb ho\u00e0n to\u00e0n nguy c\u01a1 n\u00e0y, d\u00f9 t\u00e0i li\u1ec7u cho bi\u1ebft nguy c\u01a1 th\u1ea5p h\u01a1n so v\u1edbi sinh \u0111\u01b0\u1eddng \u00e2m \u0111\u1ea1o [4][6].<\/p>\n

M\u1ee9c \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng ph\u1ee5 thu\u1ed9c v\u00e0o v\u1ecb tr\u00ed v\u00e0 t\u00ednh ch\u1ea5t t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh. Th\u1ec3 th\u01b0\u1eddng g\u1eb7p nh\u1ea5t li\u00ean quan \u0111\u1ebfn r\u1ec5 C5\u2013C6, c\u00f2n g\u1ecdi l\u00e0 li\u1ec7t Erb, g\u00e2y h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng vai v\u00e0 m\u1ed9t s\u1ed1 \u0111\u1ed9ng t\u00e1c \u1edf khu\u1ef7u, c\u1eb3ng tay. T\u1ed5n th\u01b0\u01a1ng r\u1ed9ng h\u01a1n c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng th\u00eam C7, ho\u1eb7c to\u00e0n b\u1ed9 \u0111\u00e1m r\u1ed1i, khi\u1ebfn chi tr\u00ean m\u1ec1m v\u00e0 gi\u1ea3m v\u1eadn \u0111\u1ed9ng nhi\u1ec1u h\u01a1n [3][7].<\/p>\n

D\u1ea5u hi\u1ec7u g\u1ee3i \u00fd t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh<\/h2>\n

Tr\u1ebb b\u1ecb li\u1ec7t \u0111\u00e1m r\u1ed1i th\u1ea7n kinh c\u00e1nh tay c\u00f3 th\u1ec3 gi\u1eef tay \u1edf t\u01b0 th\u1ebf xoay v\u00e0o trong, h\u1ea1n ch\u1ebf d\u1ea1ng vai; khu\u1ef7u c\u00f3 th\u1ec3 h\u01a1i g\u1ea5p ho\u1eb7c du\u1ed7i ho\u00e0n to\u00e0n. Trong tr\u01b0\u1eddng h\u1ee3p li\u1ec7t ho\u00e0n to\u00e0n, to\u00e0n b\u1ed9 c\u00e1nh tay v\u00e0 b\u00e0n tay c\u00f3 th\u1ec3 m\u1ec1m, g\u1ea7n nh\u01b0 kh\u00f4ng c\u1eed \u0111\u1ed9ng. Ph\u1ea3n x\u1ea1 Moro kh\u00f4ng \u0111\u1ed1i x\u1ee9ng c\u0169ng l\u00e0 d\u1ea5u hi\u1ec7u c\u1ea7n ch\u00fa \u00fd [8].<\/p>\n

M\u1ed9t s\u1ed1 d\u1ea5u hi\u1ec7u cho th\u1ea5y t\u1ed5n th\u01b0\u01a1ng n\u1eb7ng h\u01a1n g\u1ed3m:<\/p>\n

    \n
  • H\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng c\u00e1c ng\u00f3n tay ho\u1eb7c b\u00e0n tay.<\/li>\n
  • Chi b\u1ecb \u1ea3nh h\u01b0\u1edfng nh\u1ee3t m\u00e0u h\u01a1n b\u00ean \u0111\u1ed1i di\u1ec7n, g\u1ee3i \u00fd r\u1ed1i lo\u1ea1n v\u1eadn m\u1ea1ch.<\/li>\n
  • S\u1ee5p mi v\u00e0 \u0111\u1ed3ng t\u1eed nh\u1ecf c\u00f9ng b\u00ean, ph\u00f9 h\u1ee3p v\u1edbi h\u1ed9i ch\u1ee9ng Horner do li\u00ean quan chu\u1ed7i giao c\u1ea3m c\u1ed5 [8].<\/li>\n
  • Kh\u00f4ng xu\u1ea5t hi\u1ec7n ho\u1eb7c kh\u00f4ng c\u1ea3i thi\u1ec7n v\u1eadn \u0111\u1ed9ng theo th\u1eddi gian theo d\u00f5i.<\/li>\n<\/ul>\n

    Ph\u00e2n bi\u1ec7t v\u1edbi g\u00e3y x\u01b0\u01a1ng \u0111\u00f2n v\u00e0 li\u1ec7t gi\u1ea3<\/h2>\n

    Tr\u1ebb s\u01a1 sinh b\u1ecb g\u00e3y x\u01b0\u01a1ng \u0111\u00f2n c\u00f3 th\u1ec3 gi\u1ea3m c\u1eed \u0111\u1ed9ng vai v\u00ec \u0111au, t\u1ea1o n\u00ean t\u00ecnh tr\u1ea1ng gi\u1ed1ng li\u1ec7t, c\u00f2n g\u1ecdi l\u00e0 li\u1ec7t gi\u1ea3. C\u00e1c bi\u1ec3u hi\u1ec7n c\u00f3 th\u1ec3 g\u1ed3m kh\u00f3c khi v\u1eadn \u0111\u1ed9ng th\u1ee5 \u0111\u1ed9ng vai ho\u1eb7c c\u1ea3 chi tr\u00ean, s\u01b0ng, l\u1ea1o x\u1ea1o v\u00e0 bi\u1ebfn d\u1ea1ng x\u01b0\u01a1ng kh\u00f4ng \u0111\u1ed1i x\u1ee9ng. G\u00e3y x\u01b0\u01a1ng \u0111\u00f2n c\u0169ng c\u00f3 th\u1ec3 \u0111i k\u00e8m li\u1ec7t \u0111\u00e1m r\u1ed1i th\u1ea7n kinh c\u00e1nh tay [1][10].<\/p>\n

    \u0110i\u1ec3m quan tr\u1ecdng l\u00e0 t\u00ecnh tr\u1ea1ng gi\u1ea3m v\u1eadn \u0111\u1ed9ng do \u0111au th\u01b0\u1eddng c\u1ea3i thi\u1ec7n khi \u1ed5 g\u00e3y l\u00e0nh. T\u00e0i li\u1ec7u ghi nh\u1eadn g\u00e3y x\u01b0\u01a1ng \u1edf tr\u1ebb s\u01a1 sinh th\u01b0\u1eddng l\u00e0nh trong kho\u1ea3ng 1\u20133 tu\u1ea7n; m\u1ed9t ngu\u1ed3n kh\u00e1c cho bi\u1ebft li\u1ec7t gi\u1ea3 do g\u00e3y x\u01b0\u01a1ng \u0111\u00f2n ho\u1eb7c \u0111\u1ea7u tr\u00ean x\u01b0\u01a1ng c\u00e1nh tay th\u01b0\u1eddng h\u1ebft trong 10\u201321 ng\u00e0y [1][8]. N\u1ebfu h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng v\u1eabn t\u1ed3n t\u1ea1i sau kho\u1ea3ng 3\u20134 tu\u1ea7n ho\u1eb7c sau th\u00e1ng \u0111\u1ea7u, c\u1ea7n ngh\u0129 nhi\u1ec1u h\u01a1n \u0111\u1ebfn t\u1ed5n th\u01b0\u01a1ng \u0111\u00e1m r\u1ed1i th\u1ea7n kinh th\u1ef1c s\u1ef1 v\u00e0 \u0111\u00e1nh gi\u00e1 chuy\u00ean khoa [3][8].<\/p>\n

    Ngo\u00e0i g\u00e3y x\u01b0\u01a1ng, nhi\u1ec5m tr\u00f9ng kh\u1edbp vai c\u0169ng c\u00f3 th\u1ec3 g\u00e2y li\u1ec7t gi\u1ea3. T\u00ecnh tr\u1ea1ng n\u00e0y th\u01b0\u1eddng \u0111\u01b0\u1ee3c xem x\u00e9t khi tr\u1ebb c\u00f3 bi\u1ec3u hi\u1ec7n b\u1ec7nh to\u00e0n th\u00e2n v\u00e0 v\u1eadn \u0111\u1ed9ng c\u1ea3i thi\u1ec7n sau khi nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb [2].<\/p>\n

    Theo d\u00f5i v\u00e0 \u0111\u00e1nh gi\u00e1 v\u1eadn \u0111\u1ed9ng<\/h2>\n

    Tr\u1ebb c\u1ea7n \u0111\u01b0\u1ee3c kh\u00e1m l\u1eb7p l\u1ea1i \u0111\u1ec3 theo d\u00f5i s\u1ef1 tr\u1edf l\u1ea1i c\u1ee7a ch\u1ee9c n\u0103ng v\u1eadn \u0111\u1ed9ng v\u00e0 ph\u00e1t hi\u1ec7n s\u1edbm co r\u00fat kh\u1edbp. \u1ede tr\u1ebb nh\u1ecf, b\u00e1c s\u0129 th\u01b0\u1eddng \u0111\u00e1nh gi\u00e1 th\u00f4ng qua c\u00e1c v\u1eadn \u0111\u1ed9ng t\u1ef1 ph\u00e1t, ch\u1eb3ng h\u1ea1n quan s\u00e1t tr\u1ebb c\u00f3 n\u1eafm ho\u1eb7c v\u1edbi \u0111\u1ed3 v\u1eadt b\u1eb1ng b\u00ean chi b\u1ecb \u1ea3nh h\u01b0\u1edfng hay kh\u00f4ng. Bi\u00ean \u0111\u1ed9 xoay trong v\u00e0 xoay ngo\u00e0i c\u1ee7a vai c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111o \u1edf c\u00e1c t\u01b0 th\u1ebf kh\u00e1c nhau, \u0111\u1ed3ng th\u1eddi c\u1ea7n c\u1ed1 \u0111\u1ecbnh x\u01b0\u01a1ng b\u1ea3 vai \u0111\u1ec3 k\u1ebft qu\u1ea3 \u0111\u00e1ng tin c\u1eady h\u01a1n [2].<\/p>\n

    M\u1ed9t s\u1ed1 thang \u0111i\u1ec3m \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111\u00e1nh gi\u00e1 g\u1ed3m Toronto Test Score, Hospital for Sick Children Active Movement Scale v\u00e0 Mallet. Trong \u0111\u00f3, Active Movement Scale xem x\u00e9t nhi\u1ec1u \u0111\u1ed9ng t\u00e1c c\u1ee7a chi tr\u00ean, c\u00f2n Modified Mallet th\u01b0\u1eddng \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng vai \u1edf tr\u1ebb b\u1ecb li\u1ec7t \u0111\u00e1m r\u1ed1i th\u1ea7n kinh c\u00e1nh tay do sinh [2][9].<\/p>\n

    Khi n\u00e0o c\u1ea7n \u0111\u01b0a tr\u1ebb \u0111i kh\u00e1m?<\/h2>\n

    Cha m\u1eb9 n\u00ean \u0111\u01b0a tr\u1ebb \u0111\u1ebfn c\u01a1 s\u1edf y t\u1ebf khi tr\u1ebb \u0111\u1ed9t ng\u1ed9t \u00edt c\u1eed \u0111\u1ed9ng m\u1ed9t tay, kh\u00f3c nhi\u1ec1u khi n\u00e2ng ho\u1eb7c thay \u0111\u1ed5i t\u01b0 th\u1ebf chi, c\u00f3 s\u01b0ng ho\u1eb7c bi\u1ebfn d\u1ea1ng v\u00f9ng vai, b\u00e0n tay \u00edt c\u1eed \u0111\u1ed9ng, ho\u1eb7c xu\u1ea5t hi\u1ec7n s\u1ee5p mi v\u00e0 \u0111\u1ed3ng t\u1eed nh\u1ecf m\u1ed9t b\u00ean. Vi\u1ec7c th\u0103m kh\u00e1m s\u1edbm gi\u00fap ph\u00e2n bi\u1ec7t \u0111au do g\u00e3y x\u01b0\u01a1ng v\u1edbi t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh, \u0111\u1ed3ng th\u1eddi t\u1ea1o c\u01a1 s\u1edf theo d\u00f5i v\u1eadn \u0111\u1ed9ng theo th\u1eddi gian.<\/p>\n

    Vai tr\u00f2 v\u00e0 th\u1eddi \u0111i\u1ec3m ph\u1eabu thu\u1eadt vi ph\u1eabu ph\u1ee5 thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng, kh\u1ea3 n\u0103ng h\u1ed3i ph\u1ee5c v\u1eadn \u0111\u1ed9ng v\u00e0 s\u1ef1 xu\u1ea5t hi\u1ec7n c\u1ee7a co r\u00fat kh\u1edbp. T\u00e0i li\u1ec7u cho bi\u1ebft ch\u1ec9 \u0111\u1ecbnh can thi\u1ec7p v\u1eabn c\u00f2n kh\u00e1c nhau, nh\u01b0ng vi\u1ec7c kh\u00f4ng tr\u1edf l\u1ea1i s\u1ee9c g\u1ea5p khu\u1ef7u ch\u1ed1ng tr\u1ecdng l\u1ef1c trong giai \u0111o\u1ea1n theo d\u00f5i l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 quan tr\u1ecdng khi c\u00e2n nh\u1eafc th\u0103m d\u00f2 v\u00e0 t\u00e1i t\u1ea1o th\u1ea7n kinh [5].<\/p>\n

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

    T\u1ed5n th\u01b0\u01a1ng \u0111\u00e1m r\u1ed1i th\u1ea7n kinh c\u00e1nh tay \u1edf tr\u1ebb s\u01a1 sinh kh\u00f4ng ph\u1ea3i l\u00fac n\u00e0o c\u0169ng d\u1ec5 nh\u1eadn bi\u1ebft v\u00ec c\u00f3 th\u1ec3 gi\u1ed1ng li\u1ec7t gi\u1ea3 do g\u00e3y x\u01b0\u01a1ng \u0111\u00f2n. Theo d\u00f5i v\u1eadn \u0111\u1ed9ng n\u1ed1i ti\u1ebfp, ch\u00fa \u00fd c\u00e1c d\u1ea5u hi\u1ec7u th\u1ea7n kinh v\u00e0 \u0111\u00e1nh gi\u00e1 chuy\u00ean khoa khi h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng k\u00e9o d\u00e0i l\u00e0 nh\u1eefng b\u01b0\u1edbc then ch\u1ed1t. C\u00e1c th\u00f4ng tin tr\u00ean t\u1eadp trung v\u00e0o nh\u1eadn bi\u1ebft v\u00e0 theo d\u00f5i ban \u0111\u1ea7u; t\u00e0i li\u1ec7u \u0111\u01b0\u1ee3c cung c\u1ea5p kh\u00f4ng \u0111\u1ee7 \u0111\u1ec3 tr\u00ecnh b\u00e0y \u0111\u1ea7y \u0111\u1ee7 m\u1ecdi ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ho\u1eb7c ti\u00ean l\u01b0\u1ee3ng cho t\u1eebng tr\u01b0\u1eddng h\u1ee3p.<\/p>\n

    T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n
      \n
    • [1] Rockwood and Green's Fractures in Children, 9th Edition, 2020, trang 1156<\/li>\n
    • [2] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 1693<\/li>\n
    • [3] Rockwood and Green's Fractures in Children, 9th Edition, 2020, trang 1157<\/li>\n
    • [4] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 1692<\/li>\n
    • [5] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 1695<\/li>\n
    • [6] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 1692<\/li>\n
    • [7] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 1692<\/li>\n
    • [8] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 1693<\/li>\n
    • [9] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 1693<\/li>\n
    • [10] Rockwood and Green's Fractures in Children, 9th Edition, 2020, trang 1157<\/li>\n<\/ul>\n

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

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