{"id":411,"date":"2026-10-11T18:53:13","date_gmt":"2026-10-11T11:53:13","guid":{"rendered":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/11\/hoai-tu-xuong-ghe-ban-chan-benh-kohler-o-tre-em-dau-hieu-va-chan-doan\/"},"modified":"2026-10-11T18:53:13","modified_gmt":"2026-10-11T11:53:13","slug":"hoai-tu-xuong-ghe-ban-chan-benh-kohler-o-tre-em-dau-hieu-va-chan-doan","status":"publish","type":"post","link":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/11\/hoai-tu-xuong-ghe-ban-chan-benh-kohler-o-tre-em-dau-hieu-va-chan-doan\/","title":{"rendered":"Ho\u1ea1i t\u1eed x\u01b0\u01a1ng ghe b\u00e0n ch\u00e2n (B\u1ec7nh Kohler) \u1edf tr\u1ebb em: D\u1ea5u hi\u1ec7u v\u00e0 ch\u1ea9n \u0111o\u00e1n"},"content":{"rendered":"<p>B\u1ec7nh ho\u1ea1i t\u1eed x\u01b0\u01a1ng ghe b\u00e0n ch\u00e2n (B\u1ec7nh Kohler) \u1edf tr\u1ebb em<\/p>\n<p>B\u1ec7nh ho\u1ea1i t\u1eed x\u01b0\u01a1ng ghe b\u00e0n ch\u00e2n, c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 b\u1ec7nh Kohler, l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng y khoa \u0111\u1eb7c th\u00f9 x\u1ea3y ra ch\u1ee7 y\u1ebfu \u1edf tr\u1ebb em trong \u0111\u1ed9 tu\u1ed5i t\u1eeb 2 \u0111\u1ebfn 5 n\u0103m. \u0110\u00e2y kh\u00f4ng ph\u1ea3i l\u00e0 ch\u1ea5n th\u01b0\u01a1ng g\u00e3y x\u01b0\u01a1ng th\u00f4ng th\u01b0\u1eddng m\u00e0 l\u00e0 qu\u00e1 tr\u00ecnh m\u1ea5t m\u00e1u nu\u00f4i d\u01b0\u1ee1ng (avascular necrosis) khi\u1ebfn x\u01b0\u01a1ng ghe b\u1ecb ho\u1ea1i t\u1eed [1].<\/p>\n<p>Tr\u1ebb em m\u1eafc b\u1ec7nh n\u00e0y th\u01b0\u1eddng bi\u1ec3u hi\u1ec7n b\u1eb1ng \u0111au t\u1ea1i b\u00e0n ch\u00e2n, kh\u00f3 ch\u1ecbu khi \u0111i l\u1ea1i ho\u1eb7c thay \u0111\u1ed5i c\u00e1ch di chuy\u1ec3n nh\u01b0 \u0111i \u1ebfch sang b\u00ean. Tri\u1ec7u ch\u1ee9ng ban \u0111\u1ea7u c\u00f3 th\u1ec3 r\u1ea5t nh\u1eb9 v\u00e0 d\u1ec5 b\u1ecb nh\u1ea7m l\u1eabn v\u1edbi c\u00e1c v\u1ea5n \u0111\u1ec1 c\u01a1 b\u1ea3n kh\u00e1c n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c quan s\u00e1t k\u1ef9.<\/p>\n<h2>\u0110\u1eb7c \u0111i\u1ec3m b\u1ec7nh h\u1ecdc v\u00e0 tu\u1ed5i t\u00e1c<\/h2>\n<p>B\u1ec7nh Kohler li\u00ean quan \u0111\u1ebfn s\u1ef1 ph\u00e1t tri\u1ec3n t\u1ef1 nhi\u00ean c\u1ee7a x\u01b0\u01a1ng ghe, v\u1ed1n ch\u01b0a ho\u00e0n to\u00e0n li\u1ec1n m\u1ea1ch \u1edf tr\u1ebb nh\u1ecf. X\u01b0\u01a1ng ghe l\u00fac n\u00e0y g\u1ed3m hai ph\u1ea7n: m\u1ed9t ph\u1ea7n \u0111\u1ea7u (t\u01b0\u01a1ng \u1ee9ng v\u1edbi ph\u1ea7n gi\u00e0) v\u00e0 m\u1ed9t ph\u1ea7n th\u00e2n (ph\u1ea7n non). Ph\u1ea7n th\u00e2n n\u00e0y c\u00f3 m\u1ed9t l\u1ed7 h\u1ed5ng trung t\u00e2m \u0111\u1ec3 nu\u00f4i d\u01b0\u1ee1ng m\u1ea1ch m\u00e1u [2].<\/p>\n<p>Trong giai \u0111o\u1ea1n t\u1eeb 2 \u0111\u1ebfn 5 tu\u1ed5i, khi x\u01b0\u01a1ng ghe \u0111ang ph\u00e1t tri\u1ec3n, c\u00e1c m\u1ea1ch m\u00e1u nu\u00f4i d\u01b0\u1ee1ng ph\u1ea7n th\u00e2n x\u01b0\u01a1ng n\u00e0y c\u00f3 th\u1ec3 b\u1ecb teo l\u1ea1i ho\u1eb7c \u0111\u00f3ng t\u1eafc. Khi \u0111\u00f3, ph\u1ea7n th\u00e2n x\u01b0\u01a1ng m\u1ea5t ngu\u1ed3n dinh d\u01b0\u1ee1ng v\u00e0 b\u1eaft \u0111\u1ea7u ho\u1ea1i t\u1eed. Qu\u00e1 tr\u00ecnh n\u00e0y di\u1ec5n ra t\u1ef1 nhi\u00ean nh\u01b0ng g\u00e2y ra \u0111au \u0111\u1edbn cho tr\u1ebb do s\u1ef1 thay \u0111\u1ed5i c\u1ea5u tr\u00fac x\u01b0\u01a1ng b\u00ean trong.<\/p>\n<h2>D\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng<\/h2>\n<p>Tri\u1ec7u ch\u1ee9ng n\u1ed5i b\u1eadt nh\u1ea5t c\u1ee7a b\u1ec7nh l\u00e0 \u0111au t\u1ea1i l\u00f2ng b\u00e0n ch\u00e2n, th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n khi tr\u1ebb \u0111\u1ee9ng ho\u1eb7c \u0111i b\u1ed9. M\u1ed9t s\u1ed1 tr\u1ebb c\u00f3 th\u1ec3 kh\u00f4ng ch\u1ec9 r\u00f5 v\u1ecb tr\u00ed \u0111au c\u1ee5 th\u1ec3 m\u00e0 ch\u1ec9 bi\u1ec3u hi\u1ec7n b\u1eb1ng vi\u1ec7c qu\u1ea5y kh\u00f3c khi b\u1ecb ch\u1ea1m v\u00e0o b\u00e0n ch\u00e2n ho\u1eb7c kh\u00f3 ch\u1ecbu khi ph\u1ea3i b\u01b0\u1edbc l\u00ean m\u1eb7t ph\u1eb3ng c\u1ee9ng [2].<\/p>\n<p>Tr\u1ebb em m\u1eafc b\u1ec7nh th\u01b0\u1eddng thay \u0111\u1ed5i t\u01b0 th\u1ebf \u0111i l\u1ea1i \u0111\u1ec3 gi\u1ea3m \u00e1p l\u1ef1c l\u00ean v\u00f9ng x\u01b0\u01a1ng ghe. H\u1ecd c\u00f3 th\u1ec3 \u0111i \u1ebfch sang b\u00ean, b\u01b0\u1edbc \u0111i ch\u00f9ng ho\u1eb7c tr\u00e1nh tr\u1ecdng l\u01b0\u1ee3ng c\u01a1 th\u1ec3 \u0111\u1eb7t tr\u1ef1c ti\u1ebfp l\u00ean b\u00e0n ch\u00e2n (g\u1ecdi l\u00e0 d\u00e1ng \u0111i tr\u00e1nh t\u1ea3i tr\u1ecdng). D\u1ea5u hi\u1ec7u n\u00e0y gi\u00fap b\u00e1c s\u0129 nghi ng\u1edd s\u1ef1 t\u1ed3n t\u1ea1i c\u1ee7a b\u1ec7nh ngay c\u1ea3 khi ch\u01b0a c\u00f3 h\u00ecnh \u1ea3nh tr\u00ean phim X-quang.<\/p>\n<h2>Ch\u1ea9n \u0111o\u00e1n b\u1eb1ng h\u00ecnh \u1ea3nh<\/h2>\n<p>M\u1eb7c d\u00f9 tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng r\u1ea5t g\u1ee3i \u00fd, nh\u01b0ng ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh c\u1ea7n d\u1ef1a v\u00e0o h\u00ecnh \u1ea3nh y khoa. Ch\u1ee5p X-quang l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111\u1ea7u ti\u00ean v\u00e0 quan tr\u1ecdng nh\u1ea5t \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng c\u1ee7a x\u01b0\u01a1ng ghe [2].<\/p>\n<p>Sau khi ho\u1ea1i t\u1eed x\u1ea3y ra, c\u00e1c thay \u0111\u1ed5i tr\u00ean phim X-quang ban \u0111\u1ea7u c\u00f3 th\u1ec3 r\u1ea5t kh\u00f3 ph\u00e1t hi\u1ec7n do ph\u1ea7n th\u00e2n x\u01b0\u01a1ng ch\u01b0a li\u1ec1n m\u1ea1ch ho\u00e0n to\u00e0n. Tuy nhi\u00ean, theo th\u1eddi gian, c\u00e1c d\u1ea5u hi\u1ec7u \u0111\u1eb7c tr\u01b0ng s\u1ebd xu\u1ea5t hi\u1ec7n nh\u01b0: m\u1eadt \u0111\u1ed9 x\u01b0\u01a1ng t\u0103ng l\u00ean \u1edf v\u00f9ng th\u00e2n x\u01b0\u01a1ng ghe, h\u00ecnh \u1ea3nh l\u1ed7 h\u1ed5ng trung t\u00e2m b\u1ecb thu h\u1eb9p ho\u1eb7c bi\u1ebfn m\u1ea5t, v\u00e0 s\u1ef1 thay \u0111\u1ed5i c\u1ea5u tr\u00fac c\u1ee7a \u0111\u1ea7u x\u01b0\u01a1ng ghe [3].<\/p>\n<p>B\u00e1c s\u0129 c\u1ea7n ph\u00e2n bi\u1ec7t b\u1ec7nh Kohler v\u1edbi c\u00e1c t\u1ed5n th\u01b0\u01a1ng kh\u00e1c c\u00f3 th\u1ec3 g\u00e2y \u0111au b\u00e0n ch\u00e2n nh\u01b0 g\u00e3y x\u01b0\u01a1ng ghe (navicular fracture) hay g\u00e3y x\u01b0\u01a1ng stress. C\u00e1c t\u1ed5n th\u01b0\u01a1ng n\u00e0y c\u0169ng c\u00f3 th\u1ec3 l\u00e0m thay \u0111\u1ed5i h\u00ecnh d\u00e1ng x\u01b0\u01a1ng tr\u00ean phim X-quang, nh\u01b0ng th\u01b0\u1eddng \u0111i k\u00e8m v\u1edbi c\u00e1c v\u1ebft n\u1ee9t r\u00f5 r\u00e0ng ho\u1eb7c v\u1ecb tr\u00ed g\u00e3y c\u1ee5 th\u1ec3 [2].<\/p>\n<p>Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p ph\u1ee9c t\u1ea1p, b\u00e1c s\u0129 c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc s\u1eed d\u1ee5ng ch\u1ee5p CT ho\u1eb7c MRI \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 chi ti\u1ebft h\u01a1n v\u1ec1 c\u1ea5u tr\u00fac x\u01b0\u01a1ng v\u00e0 t\u00ecnh tr\u1ea1ng nu\u00f4i d\u01b0\u1ee1ng c\u1ee7a m\u00f4 s\u1ee5n, \u0111\u1eb7c bi\u1ec7t l\u00e0 khi c\u1ea7n lo\u1ea1i tr\u1eeb c\u00e1c t\u1ed5n th\u01b0\u01a1ng kh\u00e1c nh\u01b0 g\u00e3y x\u01b0\u01a1ng stress kh\u00f3 ph\u00e1t hi\u1ec7n tr\u00ean X-quang th\u00f4ng th\u01b0\u1eddng [2].<\/p>\n<h2>\u0110i\u1ec1u tr\u1ecb v\u00e0 ti\u00ean l\u01b0\u1ee3ng<\/h2>\n<p>M\u1ee5c ti\u00eau ch\u00ednh c\u1ee7a \u0111i\u1ec1u tr\u1ecb b\u1ec7nh Kohler l\u00e0 gi\u1ea3m \u0111au v\u00e0 duy tr\u00ec s\u1ef1 ph\u00e1t tri\u1ec3n b\u00ecnh th\u01b0\u1eddng c\u1ee7a x\u01b0\u01a1ng ghe. Ph\u1ea7n l\u1edbn c\u00e1c tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u1eb9 \u0111\u1ebfn trung b\u00ecnh c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb th\u00e0nh c\u00f4ng b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p b\u1ea3o t\u1ed3n, bao g\u1ed3m ngh\u1ec9 ng\u01a1i, b\u0103ng b\u00f3 c\u1ed1 \u0111\u1ecbnh ho\u1eb7c s\u1eed d\u1ee5ng gi\u00e0y d\u00e9p \u0111\u1eb7c bi\u1ec7t [2].<\/p>\n<p>Vi\u1ec7c gi\u1ea3m t\u1ea3i tr\u1ecdng l\u00ean b\u00e0n ch\u00e2n gi\u00fap h\u1ea1n ch\u1ebf qu\u00e1 tr\u00ecnh ho\u1ea1i t\u1eed lan r\u1ed9ng v\u00e0 cho ph\u00e9p c\u01a1 th\u1ec3 t\u00e1i t\u1ea1o l\u1ea1i m\u1ea1ch m\u00e1u nu\u00f4i d\u01b0\u1ee1ng. Trong nhi\u1ec1u tr\u01b0\u1eddng h\u1ee3p, sau khi tri\u1ec7u ch\u1ee9ng \u0111au gi\u1ea3m \u0111i v\u00e0 x\u01b0\u01a1ng ghe \u1ed5n \u0111\u1ecbnh, tr\u1ebb c\u00f3 th\u1ec3 ng\u1eebng b\u0103ng b\u00f3 v\u00e0 tr\u1edf l\u1ea1i c\u00e1c ho\u1ea1t \u0111\u1ed9ng b\u00ecnh th\u01b0\u1eddng.<\/p>\n<p>Ph\u1eabu thu\u1eadt ch\u1ec9 \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p hi\u1ebfm g\u1eb7p khi b\u1ec7nh kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n ho\u1eb7c khi c\u00f3 bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng kh\u00e1c. Vi\u1ec7c can thi\u1ec7p s\u1edbm gi\u00fap tr\u00e1nh c\u00e1c h\u1eadu qu\u1ea3 l\u00e2u d\u00e0i nh\u01b0 \u0111au m\u00e3n t\u00ednh ho\u1eb7c d\u1ecb d\u1ea1ng b\u00e0n ch\u00e2n sau n\u00e0y [2].<\/p>\n<h2>K\u1ebft lu\u1eadn<\/h2>\n<p>B\u1ec7nh ho\u1ea1i t\u1eed x\u01b0\u01a1ng ghe b\u00e0n ch\u00e2n (B\u1ec7nh Kohler) l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng c\u1ea7n \u0111\u01b0\u1ee3c nh\u1eadn bi\u1ebft \u0111\u00fang \u0111\u1eafn t\u1ea1i \u0111\u1ed9 tu\u1ed5i ph\u00e1t tri\u1ec3n c\u1ee7a tr\u1ebb. Vi\u1ec7c hi\u1ec3u r\u00f5 tri\u1ec7u ch\u1ee9ng \u0111au \u0111i l\u1ea1i v\u00e0 t\u1ea7m quan tr\u1ecdng c\u1ee7a vi\u1ec7c ch\u1ee5p X-quang gi\u00fap cha m\u1eb9 v\u00e0 b\u00e1c s\u0129 \u0111\u01b0a ra quy\u1ebft \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p, \u0111\u1ea3m b\u1ea3o s\u1ef1 ph\u00e1t tri\u1ec3n l\u00e0nh m\u1ea1nh c\u1ee7a b\u00e0n ch\u00e2n cho tr\u1ebb.<\/p>\n<h2>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n<ul>\n<li>[1] Rockwood and Green&#x27;s Fractures in Adults, 10th Edition, 2025, trang 2821<\/li>\n<li>[2] Rockwood and Green&#x27;s Fractures in Children, 9th Edition, 2020, trang 1919<\/li>\n<li>[3] Rockwood and Green&#x27;s Fractures in Adults, 10th Edition, 2025, trang 3390<\/li>\n<\/ul>\n<p><!-- aiwriter:095d5ec82f3348c3be9bec9a --><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Hi\u1ec3u r\u00f5 b\u1ec7nh ho\u1ea1i t\u1eed x\u01b0\u01a1ng ghe b\u00e0n ch\u00e2n (Kohler) gi\u00fap cha m\u1eb9 nh\u1eadn bi\u1ebft tri\u1ec7u ch\u1ee9ng \u0111au, \u0111i l\u1ea1i kh\u00f3 v\u00e0 t\u1ea7m quan tr\u1ecdng c\u1ee7a ch\u1ee5p X-quang \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[12],"tags":[],"class_list":["post-411","post","type-post","status-publish","format-standard","hentry","category-chi-duoi"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - 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