{"id":460,"date":"2026-10-12T00:00:46","date_gmt":"2026-10-11T17:00:46","guid":{"rendered":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/12\/su-dung-dinh-kirschner-trong-xuyen-kim-co-dinh-xuong-nguyen-tac-va-chi-dinh\/"},"modified":"2026-10-12T00:00:46","modified_gmt":"2026-10-11T17:00:46","slug":"su-dung-dinh-kirschner-trong-xuyen-kim-co-dinh-xuong-nguyen-tac-va-chi-dinh","status":"publish","type":"post","link":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/12\/su-dung-dinh-kirschner-trong-xuyen-kim-co-dinh-xuong-nguyen-tac-va-chi-dinh\/","title":{"rendered":"S\u1eed d\u1ee5ng \u0111inh Kirschner trong xuy\u00ean kim c\u1ed1 \u0111\u1ecbnh x\u01b0\u01a1ng: nguy\u00ean t\u1eafc v\u00e0 ch\u1ec9 \u0111\u1ecbnh"},"content":{"rendered":"

\u0110inh Kirschner<\/strong> (\u0111inh K ho\u1eb7c K-wire) l\u00e0 m\u1ed9t d\u1ee5ng c\u1ee5 th\u01b0\u1eddng \u0111\u01b0\u1ee3c d\u00f9ng trong ph\u1eabu thu\u1eadt ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh \u0111\u1ec3 gi\u1eef t\u1ea1m th\u1eddi ho\u1eb7c c\u1ed1 \u0111\u1ecbnh c\u00e1c m\u1ea3nh x\u01b0\u01a1ng. T\u00f9y h\u00ecnh th\u00e1i g\u00e3y, \u0111inh c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111\u01b0a qua da, \u0111\u1eb7t trong \u1ed1ng t\u1ee7y, b\u1eaft ch\u00e9o qua \u1ed5 g\u00e3y ho\u1eb7c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u1eef m\u1ed9t kh\u1edbp \u1edf v\u1ecb tr\u00ed \u1ed5n \u0111\u1ecbnh. Tuy nhi\u00ean, l\u1ef1a ch\u1ecdn \u0111\u01b0\u1eddng \u0111i, s\u1ed1 l\u01b0\u1ee3ng v\u00e0 h\u01b0\u1edbng \u0111\u1eb7t \u0111inh ph\u1ea3i d\u1ef1a tr\u00ean h\u00ecnh th\u00e1i \u1ed5 g\u00e3y v\u00e0 m\u1ee5c ti\u00eau c\u1ed1 \u0111\u1ecbnh c\u1ee5 th\u1ec3, kh\u00f4ng n\u00ean \u00e1p d\u1ee5ng m\u1ed9t m\u1eabu xuy\u00ean kim cho m\u1ecdi tr\u01b0\u1eddng h\u1ee3p.<\/p>\n

S\u1eed d\u1ee5ng \u0111inh Kirschner trong xuy\u00ean kim c\u1ed1 \u0111\u1ecbnh x\u01b0\u01a1ng nh\u01b0 th\u1ebf n\u00e0o?<\/h2>\n

Trong nhi\u1ec1u k\u1ef9 thu\u1eadt, \u0111inh K \u0111\u01b0\u1ee3c d\u00f9ng tr\u01b0\u1edbc h\u1ebft \u0111\u1ec3 gi\u1eef t\u1ea1m th\u1eddi sau khi n\u1eafn ch\u1ec9nh<\/strong>. Khi v\u1ecb tr\u00ed c\u00e1c m\u1ea3nh x\u01b0\u01a1ng \u0111\u00e3 ph\u00f9 h\u1ee3p, b\u00e1c s\u0129 c\u00f3 th\u1ec3 \u0111\u00e1nh gi\u00e1 \u0111\u1ed9 v\u1eefng v\u00e0 quy\u1ebft \u0111\u1ecbnh duy tr\u00ec \u0111inh K nh\u01b0 ph\u01b0\u01a1ng ti\u1ec7n c\u1ed1 \u0111\u1ecbnh sau c\u00f9ng ho\u1eb7c k\u1ebft h\u1ee3p v\u1edbi v\u00edt, n\u1eb9p, v\u00f2ng d\u00e2y hay khung c\u1ed1 \u0111\u1ecbnh ngo\u00e0i. T\u00e0i li\u1ec7u v\u1ec1 c\u1ed1 \u0111\u1ecbnh qua da m\u00f4 t\u1ea3 tr\u00ecnh t\u1ef1 g\u1ed3m x\u00e1c \u0111\u1ecbnh h\u00ecnh th\u00e1i \u1ed5 g\u00e3y d\u01b0\u1edbi m\u00e0n t\u0103ng s\u00e1ng, n\u1eafn ch\u1ec9nh, \u0111\u1eb7t \u0111inh K qua da, ki\u1ec3m tra \u0111\u1ed9 v\u1eefng r\u1ed3i b\u1ea5t \u0111\u1ed9ng chi [6].<\/p>\n

\u0110inh K c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong ph\u1eabu thu\u1eadt m\u1edf. \u1ede m\u1ed9t s\u1ed1 g\u00e3y x\u01b0\u01a1ng, c\u00e1c m\u1ea3nh kh\u1edbp \u0111\u01b0\u1ee3c n\u1eafn d\u01b0\u1edbi quan s\u00e1t tr\u1ef1c ti\u1ebfp v\u00e0 gi\u1eef b\u1eb1ng \u0111inh K t\u1ea1m th\u1eddi; sau \u0111\u00f3, v\u00edt ho\u1eb7c ph\u01b0\u01a1ng ti\u1ec7n kh\u00e1c \u0111\u1ea3m nhi\u1ec7m c\u1ed1 \u0111\u1ecbnh l\u00e2u d\u00e0i [3]. C\u00e1ch ti\u1ebfp c\u1eadn n\u00e0y cho ph\u00e9p duy tr\u00ec v\u1ecb tr\u00ed m\u1ea3nh x\u01b0\u01a1ng trong l\u00fac th\u1ef1c hi\u1ec7n c\u00e1c b\u01b0\u1edbc c\u1ed1 \u0111\u1ecbnh ti\u1ebfp theo.<\/p>\n

Nh\u1eefng ki\u1ec3u \u0111\u1eb7t \u0111inh K th\u01b0\u1eddng g\u1eb7p<\/h2>\n
    \n
  • \u0110\u1eb7t song song trong \u1ed1ng t\u1ee7y:<\/strong> \u1ede ng\u00f3n tay v\u00e0 x\u01b0\u01a1ng b\u00e0n, hai \u0111inh K song song c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 c\u1ed1 \u0111\u1ecbnh theo tr\u1ee5c. M\u1ed9t \u0111inh theo tr\u1ee5c c\u00f3 th\u1ec3 ph\u1ed1i h\u1ee3p v\u1edbi \u0111inh ch\u1ebfch nh\u1eb1m ki\u1ec3m so\u00e1t xoay [1].<\/li>\n
  • Xuy\u00ean ch\u00e9o:<\/strong> M\u1ed9t s\u1ed1 g\u00e3y th\u00e2n \u0111\u1ed1t ng\u00f3n ph\u00f9 h\u1ee3p v\u1edbi k\u1ef9 thu\u1eadt c\u1ed1 \u0111\u1ecbnh b\u1eb1ng c\u00e1c \u0111inh K b\u1eaft ch\u00e9o. \u0110inh hai \u0111\u1ea7u c\u00f3 th\u1ec3 h\u1ed7 tr\u1ee3 \u0111\u01b0a \u0111inh theo h\u01b0\u1edbng xu\u00f4i ho\u1eb7c ng\u01b0\u1ee3c \u0111\u1ec3 \u0111\u1ea1t tr\u1ee5c mong mu\u1ed1n [5].<\/li>\n
  • Xuy\u00ean qua kh\u1edbp:<\/strong> Trong m\u1ed9t s\u1ed1 t\u00ecnh hu\u1ed1ng m\u1ea5t v\u1eefng, \u0111inh K c\u00f3 th\u1ec3 \u0111i qua kh\u1edbp \u0111\u1ec3 duy tr\u00ec s\u1ef1 th\u1eb3ng h\u00e0ng ho\u1eb7c ng\u0103n b\u00e1n tr\u1eadt. V\u00ed d\u1ee5 \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 \u1edf v\u00f9ng kh\u1edbp b\u00e0n-ng\u00f3n c\u00e1i v\u00e0 x\u01b0\u01a1ng thang\u2013x\u01b0\u01a1ng b\u00e0n [2].<\/li>\n
  • \u0110\u1eb7t olive wire trong khung c\u1ed1 \u0111\u1ecbnh:<\/strong> V\u1edbi m\u1ed9t s\u1ed1 g\u00e3y ph\u1ee9c t\u1ea1p \u1edf \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng ch\u00e0y, v\u1ecb tr\u00ed d\u00e2y xuy\u00ean c\u1ea7n \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn theo \u0111\u01b0\u1eddng g\u00e3y v\u00e0 d\u1eef li\u1ec7u CT thay v\u00ec d\u00f9ng m\u1ed9t s\u01a1 \u0111\u1ed3 c\u1ed1 \u0111\u1ecbnh cho m\u1ecdi ca [8].<\/li>\n<\/ul>\n

    Nguy\u00ean t\u1eafc ki\u1ec3m so\u00e1t tr\u1ee5c v\u00e0 xoay<\/h2>\n

    Gi\u1eef \u0111\u00fang chi\u1ec1u d\u00e0i, tr\u1ee5c v\u00e0 xoay l\u00e0 ph\u1ea7n quan tr\u1ecdng c\u1ee7a xuy\u00ean kim c\u1ed1 \u0111\u1ecbnh x\u01b0\u01a1ng. Trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p t\u1ed5n th\u01b0\u01a1ng nhi\u1ec1u ng\u00f3n, t\u00e0i li\u1ec7u nh\u1ea5n m\u1ea1nh c\u1ea7n duy tr\u00ec th\u1eb3ng h\u00e0ng theo tr\u1ee5c v\u00e0 ki\u1ec3m so\u00e1t xoay [1]. \u0110\u1ed1i v\u1edbi g\u00e3y c\u00f3 t\u1ed5n th\u01b0\u01a1ng kh\u1edbp, n\u1eafn ch\u1ec9nh ch\u00ednh x\u00e1c \u0111\u1eb7c bi\u1ec7t quan tr\u1ecdng v\u00ec nh\u1eefng t\u1ed5n th\u01b0\u01a1ng n\u00e0y c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn nguy c\u01a1 tho\u00e1i h\u00f3a kh\u1edbp sau ch\u1ea5n th\u01b0\u01a1ng [2].<\/p>\n

    H\u01b0\u1edbng \u0111\u1eb7t \u0111inh n\u00ean \u0111\u01b0\u1ee3c quy\u1ebft \u0111\u1ecbnh t\u1eeb h\u00ecnh th\u00e1i \u1ed5 g\u00e3y tr\u00ean h\u00ecnh \u1ea3nh h\u1ecdc. \u1ede v\u00f9ng c\u1ed5 ch\u00e2n, tr\u01b0\u1edbc khi \u0111\u1eb7t d\u00e2y xuy\u00ean qua ch\u00e0y\u2013m\u00e1c, c\u1ea7n duy tr\u00ec chi\u1ec1u d\u00e0i v\u00e0 xoay ph\u00f9 h\u1ee3p c\u1ee7a x\u01b0\u01a1ng m\u00e1c; vi\u1ec7c c\u0103ng d\u00e2y trong khung c\u0169ng \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n d\u01b0\u1edbi ki\u1ec3m so\u00e1t m\u00e0n t\u0103ng s\u00e1ng \u0111\u1ec3 h\u1ea1n ch\u1ebf ch\u00e8n \u00e9p kh\u00f4ng \u0111\u1ed1i x\u1ee9ng l\u00ean \u0111\u01b0\u1eddng g\u00e3y [9]. Nh\u1eefng chi ti\u1ebft n\u00e0y cho th\u1ea5y \u0111inh K kh\u00f4ng ch\u1ec9 c\u00f3 nhi\u1ec7m v\u1ee5 \u201cgi\u1eef m\u1ea3nh x\u01b0\u01a1ng\u201d, m\u00e0 c\u00f2n g\u00f3p ph\u1ea7n thi\u1ebft l\u1eadp tr\u1ee5c c\u01a1 h\u1ecdc v\u00e0 quan h\u1ec7 kh\u00f4ng gian gi\u1eefa c\u00e1c \u0111o\u1ea1n x\u01b0\u01a1ng.<\/p>\n

    Khi n\u00e0o \u0111inh K \u0111\u01b0\u1ee3c ph\u1ed1i h\u1ee3p v\u1edbi ph\u01b0\u01a1ng ti\u1ec7n kh\u00e1c?<\/h2>\n

    \u0110inh K c\u00f3 th\u1ec3 l\u00e0 ph\u01b0\u01a1ng ti\u1ec7n c\u1ed1 \u0111\u1ecbnh t\u1ea1m th\u1eddi ho\u1eb7c m\u1ed9t ph\u1ea7n c\u1ee7a c\u1ea5u h\u00ecnh c\u1ed1 \u0111\u1ecbnh ho\u00e0n ch\u1ec9nh. \u1ede g\u00e3y n\u1ec1n x\u01b0\u01a1ng b\u00e0n ng\u00f3n c\u00e1i ki\u1ec3u Rolando, c\u00e1c d\u00e2y nh\u1ecf c\u00f3 th\u1ec3 gi\u1eef nh\u1eefng m\u1ea3nh kh\u1edbp tr\u01b0\u1edbc, sau \u0111\u00f3 k\u1ebft h\u1ee3p xuy\u00ean c\u1ed1 \u0111\u1ecbnh v\u00f9ng kh\u1edbp b\u00e0n\u2013x\u01b0\u01a1ng thang b\u1eb1ng \u0111inh l\u1edbn h\u01a1n [7]. Trong m\u1ed9t s\u1ed1 g\u00e3y kh\u00e1c, \u0111inh K \u0111\u01b0\u1ee3c d\u00f9ng c\u00f9ng v\u00edt, n\u1eb9p, d\u00e2y v\u00f2ng ho\u1eb7c khung c\u1ed1 \u0111\u1ecbnh ngo\u00e0i \u0111\u1ec3 c\u1ea3i thi\u1ec7n \u0111\u1ed9 \u1ed5n \u0111\u1ecbnh [4][6].<\/p>\n

    Vi\u1ec7c ch\u1ecdn \u0111inh K \u0111\u01a1n thu\u1ea7n hay ph\u1ed1i h\u1ee3p ph\u1ee5 thu\u1ed9c v\u00e0o k\u00edch th\u01b0\u1edbc m\u1ea3nh x\u01b0\u01a1ng, m\u1ee9c \u0111\u1ed9 v\u1ee5n, v\u1ecb tr\u00ed g\u00e3y v\u00e0 y\u00eau c\u1ea7u duy tr\u00ec v\u1eadn \u0111\u1ed9ng kh\u1edbp. Khi c\u00f3 th\u1ec3, \u0111\u01b0\u1eddng \u0111\u1eb7t \u0111inh n\u00ean cho ph\u00e9p kh\u1edbp v\u1eadn \u0111\u1ed9ng; \u0111\u00e2y l\u00e0 nguy\u00ean t\u1eafc \u0111\u01b0\u1ee3c n\u00eau trong c\u1ed1 \u0111\u1ecbnh x\u01b0\u01a1ng ng\u00f3n v\u00e0 x\u01b0\u01a1ng b\u00e0n khi t\u00e1i t\u1ea1o chi [1].<\/p>\n

    L\u01b0u \u00fd \u0111\u1ed1i v\u1edbi ng\u01b0\u1eddi b\u1ec7nh<\/h2>\n
      \n
    • Xuy\u00ean kim l\u00e0 k\u1ef9 thu\u1eadt ph\u1eabu thu\u1eadt, c\u1ea7n \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh v\u00e0 th\u1ef1c hi\u1ec7n b\u1edfi b\u00e1c s\u0129 ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh.<\/li>\n
    • Kh\u00f4ng th\u1ec3 x\u00e1c \u0111\u1ecbnh s\u1ed1 l\u01b0\u1ee3ng, \u0111\u01b0\u1eddng k\u00ednh ho\u1eb7c h\u01b0\u1edbng \u0111inh ch\u1ec9 d\u1ef1a tr\u00ean v\u1ecb tr\u00ed \u0111au; c\u1ea7n \u0111\u00e1nh gi\u00e1 h\u00ecnh \u1ea3nh v\u00e0 \u0111\u1ed9 v\u1eefng c\u1ee7a \u1ed5 g\u00e3y.<\/li>\n
    • Vi\u1ec7c b\u1ea5t \u0111\u1ed9ng, theo d\u00f5i h\u00ecnh \u1ea3nh v\u00e0 th\u1eddi \u0111i\u1ec3m b\u1eaft \u0111\u1ea7u v\u1eadn \u0111\u1ed9ng ph\u1ea3i tu\u00e2n theo k\u1ebf ho\u1ea1ch c\u1ee7a ph\u1eabu thu\u1eadt vi\u00ean. M\u1ed9t t\u00e0i li\u1ec7u v\u1ec1 ch\u0103m s\u00f3c sau m\u1ed5 b\u00e0n tay ghi nh\u1eadn v\u1eadn \u0111\u1ed9ng kh\u1edbp c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c b\u1eaft \u0111\u1ea7u sau m\u1ed9t tu\u1ea7n trong m\u1ed9t k\u1ef9 thu\u1eadt c\u1ee5 th\u1ec3, nh\u01b0ng \u0111i\u1ec1u n\u00e0y kh\u00f4ng \u00e1p d\u1ee5ng chung cho m\u1ecdi lo\u1ea1i g\u00e3y [10].<\/li>\n<\/ul>\n

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

      S\u1eed d\u1ee5ng \u0111inh Kirschner trong xuy\u00ean kim c\u1ed1 \u0111\u1ecbnh x\u01b0\u01a1ng<\/strong> \u0111\u00f2i h\u1ecfi \u0111\u00e1nh gi\u00e1 ri\u00eang cho t\u1eebng \u1ed5 g\u00e3y. \u0110inh K c\u00f3 th\u1ec3 gi\u1eef t\u1ea1m th\u1eddi, c\u1ed1 \u0111\u1ecbnh song song ho\u1eb7c b\u1eaft ch\u00e9o, ki\u1ec3m so\u00e1t xoay, xuy\u00ean qua kh\u1edbp hay ph\u1ed1i h\u1ee3p v\u1edbi v\u00edt v\u00e0 khung c\u1ed1 \u0111\u1ecbnh. M\u1ee5c ti\u00eau c\u1ed1t l\u00f5i l\u00e0 kh\u00f4i ph\u1ee5c v\u00e0 duy tr\u00ec chi\u1ec1u d\u00e0i, tr\u1ee5c, xoay c\u00f9ng s\u1ef1 ph\u00f9 h\u1ee3p c\u1ee7a m\u1eb7t kh\u1edbp, \u0111\u1ed3ng th\u1eddi l\u1ef1a ch\u1ecdn c\u1ea5u h\u00ecnh cho ph\u00e9p v\u1eadn \u0111\u1ed9ng khi \u0111i\u1ec1u ki\u1ec7n gi\u1ea3i ph\u1eabu v\u00e0 \u0111\u1ed9 v\u1eefng cho ph\u00e9p.<\/p>\n

      T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n
        \n
      • [1] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 3904<\/li>\n
      • [2] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 4102<\/li>\n
      • [3] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 3347<\/li>\n
      • [4] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 4102<\/li>\n
      • [5] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 4127<\/li>\n
      • [6] Rockwood and Green's Fractures in Adults, 10th Edition, 2025, trang 1980<\/li>\n
      • [7] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 4102<\/li>\n
      • [8] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 3347<\/li>\n
      • [9] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 3347<\/li>\n
      • [10] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 4126<\/li>\n<\/ul>\n

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

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