{"id":275,"date":"2026-10-10T20:51:32","date_gmt":"2026-10-10T13:51:32","guid":{"rendered":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/10\/gay-co-xuong-sen-nguyen-tac-cap-cuu-va-danh-gia-chan-thuong-cot-song\/"},"modified":"2026-10-10T20:51:32","modified_gmt":"2026-10-10T13:51:32","slug":"gay-co-xuong-sen-nguyen-tac-cap-cuu-va-danh-gia-chan-thuong-cot-song","status":"publish","type":"post","link":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/10\/gay-co-xuong-sen-nguyen-tac-cap-cuu-va-danh-gia-chan-thuong-cot-song\/","title":{"rendered":"G\u00e3y c\u1ed5 x\u01b0\u01a1ng s\u00ean: Nguy\u00ean t\u1eafc c\u1ea5p c\u1ee9u v\u00e0 \u0111\u00e1nh gi\u00e1 ch\u1ea5n th\u01b0\u01a1ng c\u1ed9t s\u1ed1ng"},"content":{"rendered":"<h2>Nguy\u00ean t\u1eafc c\u1ed1t l\u00f5i trong c\u1ea5p c\u1ee9u ch\u1ea5n th\u01b0\u01a1ng c\u1ed9t s\u1ed1ng<\/h2>\n<p>V\u1ea5n \u0111\u1ec1 \u0111i\u1ec1u tr\u1ecb ch\u1ea5n th\u01b0\u01a1ng c\u1ed9t s\u1ed1ng \u0111\u00f2i h\u1ecfi s\u1ef1 can thi\u1ec7p nhanh ch\u00f3ng \u0111\u1ec3 gi\u1ea3m thi\u1ec3u t\u1ed5n th\u01b0\u01a1ng d\u00e2y th\u1ea7n kinh. Th\u1eddi gian l\u00e0 y\u1ebfu t\u1ed1 then ch\u1ed1t; vi\u1ec7c ho\u00e0n t\u1ea5t c\u00e1c h\u00ecnh \u1ea3nh ch\u1ea9n \u0111o\u00e1n c\u1ee7a c\u1ed9t s\u1ed1ng c\u1ea7n di\u1ec5n ra c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t sau khi x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c ch\u1ea5n th\u01b0\u01a1ng [1]. Tuy nhi\u00ean, qu\u1ea3n l\u00fd y t\u1ebf cho t\u1ed5n th\u01b0\u01a1ng t\u1ee7y s\u1ed1ng b\u1eaft \u0111\u1ea7u ngay l\u1eadp t\u1ee9c khi ch\u1ea5n th\u01b0\u01a1ng \u0111\u01b0\u1ee3c nh\u1eadn di\u1ec7n. N\u1ebfu b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 d\u1ea5u hi\u1ec7u t\u1ed5n th\u01b0\u01a1ng t\u1ee7y d\u1ef1a tr\u00ean kh\u00e1m l\u00e2m s\u00e0ng, c\u1ea7n x\u00e1c \u0111\u1ecbnh xem h\u1ecd c\u00f3 \u0111\u00e1p \u1ee9ng c\u00e1c ti\u00eau ch\u00ed \u0111\u1ec3 \u0111\u01b0\u1ee3c coi l\u00e0 kh\u00f4ng tri\u1ec7u ch\u1ee9ng hay kh\u00f4ng [1].<\/p>\n<h3>H\u1ea1n ch\u1ebf thao t\u00e1c c\u1ed9t c\u1ed5 trong giai \u0111o\u1ea1n s\u01a1 c\u1ee9u<\/h3>\n<p>B\u1ea5t k\u1ef3 thao t\u00e1c n\u00e0o l\u00ean c\u1ed9t s\u1ed1ng c\u1ed5 \u0111\u1ec1u ph\u1ea3i th\u1ef1c hi\u1ec7n v\u1edbi s\u1ef1 th\u1eadn tr\u1ecdng v\u00e0 gi\u1ea3 \u0111\u1ecbnh r\u1eb1ng b\u1ec7nh nh\u00e2n b\u1ecb ch\u1ea5n th\u01b0\u01a1ng c\u1ed9t c\u1ed5 kh\u00f4ng \u1ed5n \u0111\u1ecbnh cho \u0111\u1ebfn khi c\u00f3 b\u1eb1ng ch\u1ee9ng ng\u01b0\u1ee3c l\u1ea1i [2]. M\u1ed9t nghi\u00ean c\u1ee9u ch\u1ec9 ra r\u1eb1ng vi\u1ec7c k\u00e9o tr\u1ee5c tr\u00ean c\u00e1c b\u1ec7nh nh\u00e2n b\u1ecb ch\u1ea5n th\u01b0\u01a1ng c\u1ed9t c\u1ed5 kh\u00f4ng \u1ed5n \u0111\u1ecbnh \u0111\u00e3 c\u1ed1 g\u1eafng h\u1ed3i s\u1ee9c t\u1ea1i ph\u00f2ng c\u1ea5p c\u1ee9u th\u1ef1c t\u1ebf l\u00e0m t\u0103ng bi\u1ebfn d\u1ea1ng c\u1ee7a c\u1ed9t s\u1ed1ng [2]. Do \u0111\u00f3, n\u1eb9p c\u1ed5 v\u00e0 \u1ed5n \u0111\u1ecbnh theo \u0111\u01b0\u1eddng th\u1eb3ng trong tay l\u00e0 bi\u1ec7n ph\u00e1p b\u1eaft bu\u1ed9c khi di chuy\u1ec3n b\u1ec7nh nh\u00e2n.<\/p>\n<h2>\u0110\u00e1nh gi\u00e1 l\u00e2m s\u00e0ng v\u00e0 ti\u00eau ch\u00ed lo\u1ea1i tr\u1eeb ch\u1ea5n th\u01b0\u01a1ng c\u1ed5<\/h2>\n<p>B\u01b0\u1edbc \u0111\u1ea7u ti\u00ean trong c\u00f4ng t\u00e1c \u0111\u00e1nh gi\u00e1 ch\u1ea5n th\u01b0\u01a1ng c\u1ed9t s\u1ed1ng l\u00e0 x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 t\u1ec9nh t\u00e1o c\u1ee7a b\u1ec7nh nh\u00e2n [1]. \u0110\u1ec3 gi\u1ea3m s\u1ed1 l\u01b0\u1ee3ng ch\u1ee5p X-quang cho b\u1ec7nh nh\u00e2n ch\u1ea5n th\u01b0\u01a1ng, c\u00e1c ti\u00eau ch\u00ed NEXUS \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ph\u00e2n lo\u1ea1i b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng. C\u00f3 n\u0103m ti\u00eau ch\u00ed c\u1ee5 th\u1ec3 ph\u1ea3i \u0111\u01b0\u1ee3c \u0111\u00e1p \u1ee9ng: kh\u00f4ng \u0111au d\u1ecdc theo \u0111\u01b0\u1eddng gi\u1eefa c\u1ed9t s\u1ed1ng c\u1ed5 sau, kh\u00f4ng d\u1ea5u hi\u1ec7u say r\u01b0\u1ee3u, kh\u00f4ng v\u1ebft t\u00edch ch\u1ea5n th\u01b0\u01a1ng \u0111\u1ea7u, kh\u00f4ng thay \u0111\u1ed5i \u00fd th\u1ee9c v\u00e0 kh\u00f4ng b\u1ea5t th\u01b0\u1eddng tr\u00ean kh\u00e1m th\u1ea7n kinh [7]. N\u1ebfu b\u1ec7nh nh\u00e2n \u0111\u00e1p \u1ee9ng t\u1ea5t c\u1ea3 c\u00e1c ti\u00eau ch\u00ed n\u00e0y, c\u1ed9t c\u1ed5 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c lo\u1ea1i tr\u1eeb ch\u1ea5n th\u01b0\u01a1ng m\u00e0 kh\u00f4ng c\u1ea7n ch\u1ee5p X-quang [7].<\/p>\n<h3>Ch\u1ea9n \u0111o\u00e1n b\u1eb1ng h\u00ecnh \u1ea3nh v\u00e0 gi\u1edbi h\u1ea1n c\u1ee7a X-quang<\/h3>\n<p>M\u1eb7c d\u00f9 ch\u1ee5p phim X-quang t\u1eebng l\u00e0 ph\u01b0\u01a1ng ti\u1ec7n s\u00e0ng l\u1ecdc ch\u00ednh, nh\u01b0ng t\u1ef7 l\u1ec7 \u00e2m gi\u1ea3 kh\u00e1 cao: kho\u1ea3ng 30% \u0111\u1ed1i v\u1edbi ch\u1ea5n th\u01b0\u01a1ng c\u1ed9t c\u1ed5, 52% \u0111\u1ed1i v\u1edbi c\u1ed9t ng\u1ef1c v\u00e0 14% \u0111\u1ed1i v\u1edbi c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng [4]. Do \u0111\u00f3, quy\u1ebft \u0111\u1ecbnh ti\u1ebfn h\u00e0nh ch\u1ee5p phim ch\u1ec9 n\u00ean \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n sau khi \u0111\u00e3 c\u00f3 l\u1ecbch s\u1eed v\u00e0 \u0111\u00e1nh gi\u00e1 ch\u1ea5n th\u01b0\u01a1ng to\u00e0n di\u1ec7n. Ch\u1ee5p CT th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u01b0u ti\u00ean trong c\u00e1c trung t\u00e2m ch\u1ea5n th\u01b0\u01a1ng hi\u1ec7n \u0111\u1ea1i \u0111\u1ec3 lo\u1ea1i tr\u1eeb t\u1ed5n th\u01b0\u01a1ng nghi\u00eam tr\u1ecdng tr\u01b0\u1edbc khi di chuy\u1ec3n b\u1ec7nh nh\u00e2n (logroll) [6].<\/p>\n<h2>Ph\u00e2n lo\u1ea1i v\u00e0 x\u1eed tr\u00ed g\u00e3y c\u1ed5 x\u01b0\u01a1ng s\u00ean<\/h2>\n<p>G\u00e3y c\u1ed5 x\u01b0\u01a1ng s\u00ean (talus neck fractures) \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i theo h\u1ec7 th\u1ed1ng Hawkins. C\u00e1c g\u00e3y c\u1ed5 x\u01b0\u01a1ng s\u00ean d\u1ecbch v\u1ecb (Hawkins lo\u1ea1i II\u2013IV) n\u00ean \u0111\u01b0\u1ee3c xem x\u00e9t l\u00e0 g\u00e3y c\u1ea7n ph\u1eabu thu\u1eadt [5]. H\u1ec7 th\u1ed1ng m\u00e1u nu\u00f4i cung c\u1ea5p cho talus r\u1ea5t mong manh v\u00e0 th\u01b0\u1eddng b\u1ecb gi\u00e1n \u0111o\u1ea1n khi c\u00f3 d\u1ecbch v\u1ecb, do \u0111\u00f3 vi\u1ec7c gi\u1ea3m h\u00ecnh h\u1ecdc l\u1ea1i v\u1edbi c\u1ed1 \u0111\u1ecbnh \u1ed5n \u0111\u1ecbnh gi\u00fap ph\u1ee5c h\u1ed3i gi\u1ea3i ph\u1eabu v\u00e0 c\u00f3 th\u1ec3 cho ph\u00e9p t\u00e1i t\u01b0\u1edbi m\u00e1u c\u00f9ng l\u00e0nh v\u1ebft th\u01b0\u01a1ng c\u1ee7a c\u00e1c k\u00eanh m\u1ea1ch m\u00e1u [5].<\/p>\n<h3>M\u1ee5c ti\u00eau c\u1ee7a ph\u1eabu thu\u1eadt v\u00e0 h\u1eadu ph\u1eabu<\/h3>\n<p>\u0110\u1ed1i v\u1edbi nh\u1eefng t\u1ed5n th\u01b0\u01a1ng b\u1ea5t kh\u1ea3 quy v\u1ec1 b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p \u0111\u00f3ng, can thi\u1ec7p ph\u1eabu thu\u1eadt kh\u1ea9n c\u1ea5p n\u00ean \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n. C\u1ed1 \u0111\u1ecbnh \u1ed5n \u0111\u1ecbnh cho ph\u00e9p v\u1eadn \u0111\u1ed9ng s\u1edbm m\u00e0 kh\u00f4ng ch\u1ecbu tr\u1ecdng l\u01b0\u1ee3ng, \u0111i\u1ec1u n\u00e0y c\u00f3 l\u1ee3i trong vi\u1ec7c duy tr\u00ec to\u00e0n v\u1eb9n s\u1ee5n kh\u1edbp [5]. C\u00e1c g\u00e3y c\u1ed5 x\u01b0\u01a1ng s\u00ean d\u1ecbch v\u1ecb th\u01b0\u1eddng \u0111i k\u00e8m v\u1edbi c\u00e1c t\u1ed5n th\u01b0\u01a1ng kh\u00e1c c\u1ee7a ch\u00e2n v\u00e0 m\u1eaft c\u00e1 ch\u00e2n c\u00f9ng b\u00ean, \u0111\u00f2i h\u1ecfi k\u1ebf ho\u1ea1ch ph\u1eabu thu\u1eadt c\u1ea9n th\u1eadn \u0111\u1ec3 gi\u1ea3m v\u00e0 c\u1ed1 \u0111\u1ecbnh [3].<\/p>\n<h2>Ti\u00eau ch\u00ed NEXUS trong \u0111\u00e1nh gi\u00e1 b\u1ec7nh nh\u00e2n Vi\u1ec7t Nam<\/h2>\n<p>Vi\u1ec7c \u00e1p d\u1ee5ng ti\u00eau ch\u00ed NEXUS cho ph\u00e9p m\u1ed9t ph\u1ea7n ba c\u00e1c b\u1ec7nh nh\u00e2n ch\u1ea5n th\u01b0\u01a1ng \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 t\u1ea1i c\u00e1c ph\u00f2ng c\u1ea5p c\u1ee9u c\u1ed9ng \u0111\u1ed3ng ho\u1eb7c trung t\u00e2m ch\u1ea5n th\u01b0\u01a1ng m\u1ee9c 1 \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y l\u00e0 kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng [1]. Vi\u1ec7c x\u00e1c \u0111\u1ecbnh b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111au sau khi palpate \u0111\u01b0\u1eddng gi\u1eefa c\u1ed9t s\u1ed1ng c\u1ed5, kh\u00f4ng say, kh\u00f4ng ch\u1ea5n th\u01b0\u01a1ng \u0111\u1ea7u v\u00e0 kh\u00f4ng thay \u0111\u1ed5i \u00fd th\u1ee9c l\u00e0 n\u1ec1n t\u1ea3ng \u0111\u1ec3 tr\u00e1nh chi\u1ebfu x\u1ea1 kh\u00f4ng c\u1ea7n thi\u1ebft. C\u00e1c d\u1ea5u hi\u1ec7u nh\u01b0 v\u1ebft t\u00edch ch\u00e0 x\u00e1t t\u1eeb d\u00e2y an to\u00e0n tr\u00ean c\u1ed5 ho\u1eb7c c\u00e1c v\u1ebft x\u01b0\u1edbc m\u1ec1m m\u00f4 \u0111\u1ec1u l\u00e0 manh m\u1ed1i cho t\u1ed5n th\u01b0\u01a1ng c\u1ed9t c\u1ed5 ti\u1ec1m \u1ea9n [2].<\/p>\n<h2>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n<ul>\n<li>[1] Campbell&#x27;s Operative Orthopaedics, 15th Edition, 2026, trang 2457<\/li>\n<li>[2] Rockwood and Green&#x27;s Fractures in Children, 9th Edition, 2020, trang 1235<\/li>\n<li>[3] Rockwood and Green&#x27;s Fractures in Adults, 10th Edition, 2025, trang 3374<\/li>\n<li>[4] Rockwood and Green&#x27;s Fractures in Adults, 10th Edition, 2025, trang 2118<\/li>\n<li>[5] Rockwood and Green&#x27;s Fractures in Adults, 10th Edition, 2025, trang 3367<\/li>\n<li>[6] Rockwood and Green&#x27;s Fractures in Adults, 10th Edition, 2025, trang 2136<\/li>\n<li>[7] Campbell&#x27;s Operative Orthopaedics, 15th Edition, 2026, trang 2457<\/li>\n<\/ul>\n<p><!-- aiwriter:ea429359511043f38661bd0a --><\/p>\n","protected":false},"excerpt":{"rendered":"<p>H\u01b0\u1edbng d\u1eabn x\u1eed tr\u00ed g\u00e3y c\u1ed5 x\u01b0\u01a1ng s\u00ean t\u1eadp trung v\u00e0o \u1ed5n \u0111\u1ecbnh c\u1ed9t s\u1ed1ng, ch\u1ea9n \u0111o\u00e1n NEXUS v\u00e0 h\u1ea1n ch\u1ebf thao t\u00e1c nguy hi\u1ec3m trong giai \u0111o\u1ea1n s\u01a1 c\u1ee9u.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-275","post","type-post","status-publish","format-standard","hentry","category-gay-xuong"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - 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