{"id":461,"date":"2026-10-12T00:03:28","date_gmt":"2026-10-11T17:03:28","guid":{"rendered":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/12\/gay-loi-cu-chay-o-thanh-thieu-nien-nguyen-nhan-co-che-chan-thuong-va-nguy-co\/"},"modified":"2026-10-12T00:03:28","modified_gmt":"2026-10-11T17:03:28","slug":"gay-loi-cu-chay-o-thanh-thieu-nien-nguyen-nhan-co-che-chan-thuong-va-nguy-co","status":"publish","type":"post","link":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/12\/gay-loi-cu-chay-o-thanh-thieu-nien-nguyen-nhan-co-che-chan-thuong-va-nguy-co\/","title":{"rendered":"G\u00e3y l\u1ed3i c\u1ee7 ch\u00e0y \u1edf thanh thi\u1ebfu ni\u00ean: Nguy\u00ean nh\u00e2n, c\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng v\u00e0 nguy c\u01a1"},"content":{"rendered":"

\u0110\u1eb7c \u0111i\u1ec3m d\u1ecbch t\u1ec5 h\u1ecdc c\u1ee7a g\u00e3y l\u1ed3i c\u1ee7 ch\u00e0y \u1edf thanh thi\u1ebfu ni\u00ean<\/h2>\n

G\u00e3y l\u1ed3i c\u1ee7 ch\u00e0y (tibial tubercle fracture) l\u00e0 m\u1ed9t lo\u1ea1i ch\u1ea5n th\u01b0\u01a1ng \u0111\u1eb7c bi\u1ec7t th\u01b0\u1eddng g\u1eb7p ch\u1ee7 y\u1ebfu \u1edf nh\u00f3m thanh thi\u1ebfu ni\u00ean, tr\u00e1i ng\u01b0\u1ee3c v\u1edbi c\u00e1c t\u1ed5n th\u01b0\u01a1ng x\u01b0\u01a1ng s\u1ed1ng (proximal tibial metaphysis) v\u1ed1n ph\u1ed5 bi\u1ebfn h\u01a1n \u1edf tr\u1ebb em t\u1eeb 3 \u0111\u1ebfn 6 tu\u1ed5i [1].<\/p>\n

D\u1ecbch v\u1ee5 ch\u1ec9nh h\u00ecnh nh\u1eadn th\u1ea5y \u0111\u00e2y l\u00e0 lo\u1ea1i g\u00e3y \u00edt g\u1eb7p h\u01a1n so v\u1edbi c\u00e1c ch\u1ea5n th\u01b0\u01a1ng kh\u00e1c c\u1ee7a v\u00f9ng ch\u00e0y, chi\u1ebfm d\u01b0\u1edbi 1% t\u1ea5t c\u1ea3 c\u00e1c t\u1ed5n th\u01b0\u01a1ng x\u01b0\u01a1ng s\u1ed1ng v\u00e0 kho\u1ea3ng 3% t\u1ed5ng s\u1ed1 g\u00e3y ch\u00e0y g\u1ea7n tr\u00ean [6]. Tuy nhi\u00ean, do \u0111\u1eb7c th\u00f9 gi\u1ea3i ph\u1eabu c\u1ee7a thanh thi\u1ebfu ni\u00ean \u0111ang trong giai \u0111o\u1ea1n ph\u00e1t tri\u1ec3n x\u01b0\u01a1ng (skeletally immature), t\u1ef7 l\u1ec7 n\u00e0y c\u00f3 th\u1ec3 cao h\u01a1n khi x\u00e9t ri\u00eang cho nh\u00f3m nam gi\u1edbi tham gia c\u00e1c ho\u1ea1t \u0111\u1ed9ng th\u1ec3 thao c\u01b0\u1eddng \u0111\u1ed9 cao.<\/p>\n

Nguy\u00ean nh\u00e2n v\u00e0 c\u01a1 ch\u1ebf g\u00e2y ch\u1ea5n th\u01b0\u01a1ng<\/h2>\n

Mechanism c\u1ee7a g\u00e3y l\u1ed3i c\u1ee7 ch\u00e0y th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn c\u00e1c ho\u1ea1t \u0111\u1ed9ng nh\u1ea3y v\u00e0 co c\u01a1 m\u1ea1nh, \u0111\u00f2i h\u1ecfi l\u1ef1c l\u1edbn \u0111\u1ec3 l\u00e0m v\u1ee1 \u0111\u1ea7u n\u1ed1i (apophysis) gi\u1eefa x\u01b0\u01a1ng v\u00e0 d\u00e2y ch\u1eb1ng [4]. Hai c\u01a1 ch\u1ebf ph\u1ed5 bi\u1ebfn nh\u1ea5t \u0111\u01b0\u1ee3c ghi nh\u1eadn l\u00e0:<\/p>\n

    \n
  1. C\u00f4 tr\u1eeb m\u1ea1nh c\u1ee7a c\u01a1 t\u1ee9 \u0111\u1ea7u (quadriceps contracture) trong qu\u00e1 tr\u00ecnh th\u1ef1c hi\u1ec7n nh\u1ea3y ho\u1eb7c k\u00e9o c\u0103ng c\u01a1 khi b\u01b0\u1edbc \u0111i [2] [4];<\/li>\n
  2. L\u1ef1c k\u00e9o th\u1ee5 \u0111\u1ed9ng l\u00e0m g\u1eadp \u0111\u1ea7u g\u1ed1i nhanh ch\u00f3ng \u0111\u1ed1i kh\u00e1ng v\u1edbi s\u1ef1 co th\u1eaft c\u1ee7a c\u01a1 t\u1ee9 \u0111\u1ea7u khi ti\u1ebfp \u0111\u1ea5t [2] [4].<\/li>\n<\/ol>\n

    D\u1eef li\u1ec7u cho th\u1ea5y t\u1ed5n th\u01b0\u01a1ng n\u00e0y x\u1ea3y ra g\u1ea7n nh\u01b0 ch\u1ec9 \u1edf nam gi\u1edbi thanh thi\u1ebfu ni\u00ean, nh\u00f3m c\u00f3 s\u1ee9c m\u1ea1nh c\u01a1 t\u1ee9 \u0111\u1ea7u l\u1edbn h\u01a1n v\u00e0 c\u00f3 xu h\u01b0\u1edbng v\u01b0\u1ee3t qua \u0111\u1ed9 \u1ed5n \u0111\u1ecbnh c\u1ee7a apophysis b\u1eb1ng l\u1ef1c co th\u1eaft c\u01a1 d\u1eef d\u1ed9i [4]. L\u1ef1c t\u00e1c \u0111\u1ed9ng \u0111\u1ee7 l\u1edbn \u0111\u1ec3 g\u00e2y g\u00e3y th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn c\u00e1c ch\u1ea5n th\u01b0\u01a1ng th\u1ec3 thao ho\u1eb7c tai n\u1ea1n xe c\u1ed9, nh\u01b0ng c\u0169ng c\u00f3 th\u1ec3 do l\u1ea1m d\u1ee5ng trong m\u00f4n b\u00f3ng ch\u00e0y [7].<\/p>\n

    M\u1ed1i li\u00ean h\u1ec7 v\u1edbi t\u01b0 th\u1ebf \u0111\u1ea7u g\u1ed1i v\u00e0 m\u1ee9c \u0111\u1ed9 \u0111\u00f3ng x\u01b0\u01a1ng s\u1ed1ng<\/h3>\n

    Ph\u00e2n lo\u1ea1i h\u00ecnh th\u00e1i g\u00e3y ph\u1ee5 thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 \u0111\u00f3ng c\u1ee7a physis (x\u01b0\u01a1ng s\u1ed1ng) t\u1ea1i th\u1eddi \u0111i\u1ec3m ch\u1ea5n th\u01b0\u01a1ng v\u00e0 g\u00f3c g\u1eadp \u0111\u1ea7u g\u1ed1i [4]:<\/p>\n

      \n
    • Khi ch\u1ea5n th\u01b0\u01a1ng x\u1ea3y ra v\u1edbi \u0111\u1ea7u g\u1ed1i \u1edf t\u01b0 th\u1ebf du\u1ed7i ho\u00e0n to\u00e0n ho\u1eb7c g\u1eadp t\u1eeb 0 \u0111\u1ebfn 30 \u0111\u1ed9: Th\u01b0\u1eddng d\u1eabn \u0111\u1ebfn \u0111\u1ee9t l\u1ed3i c\u1ee7 ch\u00e0y m\u00e0 kh\u00f4ng g\u00e3y physis, do l\u1ef1c k\u00e9o ch\u1ee7 y\u1ebfu t\u00e1c \u0111\u1ed9ng v\u00e0o ph\u1ea7n apophysis [4];<\/li>\n
    • Khi ch\u1ea5n th\u01b0\u01a1ng x\u1ea3y ra v\u1edbi g\u00f3c g\u1eadp l\u1edbn h\u01a1n 30 \u0111\u1ed9: D\u1eabn \u0111\u1ebfn s\u1ef1 b\u00f3c t\u00e1ch (avulsion) c\u1ee7a c\u1ea3 l\u1ed3i c\u1ee7 ch\u00e0y v\u00e0 ph\u1ea7n epiphysis g\u1ea7n tr\u00ean, trong \u0111\u00f3 \u0111a s\u1ed1 c\u00e1c tr\u01b0\u1eddng h\u1ee3p thu\u1ed9c lo\u1ea1i Salter-Harris III [2] [4].<\/li>\n<\/ul>\n

      Do physis \u0111\u00f3ng t\u1eeb ph\u00eda sau sang ph\u00eda tr\u01b0\u1edbc, h\u00ecnh th\u00e1i g\u00e3y c\u00f2n ph\u1ee5 thu\u1ed9c v\u00e0o l\u01b0\u1ee3ng x\u01b0\u01a1ng s\u1ed1ng \u0111\u00e3 \u0111\u00f3ng t\u1ea1i th\u1eddi \u0111i\u1ec3m x\u1ea3y ra ch\u1ea5n th\u01b0\u01a1ng [4].<\/p>\n

      Nguy c\u01a1 v\u00e0 bi\u1ebfn ch\u1ee9ng \u0111\u1eb7c bi\u1ec7t<\/h2>\n

      M\u1eb7c d\u00f9 hi\u1ebfm g\u1eb7p, c\u00e1c t\u1ed5n th\u01b0\u01a1ng n\u00e0y ti\u1ec1m \u1ea9n nh\u1eefng r\u1ee7i ro nghi\u00eam tr\u1ecdng c\u1ea7n \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 k\u1ef9 l\u01b0\u1ee1ng:<\/p>\n

        \n
      • T\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u:<\/strong> Physis g\u1ea7n tr\u00ean c\u00f3 t\u00ednh \u1ed5n \u0111\u1ecbnh v\u1ec1 m\u1eb7t d\u1ecbch chuy\u1ec3n ngang v\u00e0 ch\u00e9o nh\u1edd li\u00ean k\u1ebft ch\u00e9o v\u00e0 \u0111\u1ec7m ch\u00e0y b\u00ean. Tuy nhi\u00ean, trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p hi\u1ebfm g\u1eb7p v\u1edbi d\u1ecbch chuy\u1ec3n ph\u00eda sau, epiphysis v\u00e0 l\u1ed3i c\u1ee7 ch\u00e0y c\u00f3 th\u1ec3 di chuy\u1ec3n nh\u01b0 m\u1ed9t \u0111\u01a1n v\u1ecb duy nh\u1ea5t, \u0111e d\u1ecda \u0111\u1ed9ng m\u1ea1ch poplitea b\u1ecb neo gi\u1eef [1] [6]. D\u1ecbch chuy\u1ec3n n\u00e0y c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn h\u1ed9i ch\u1ee9ng khoang (compartment syndrome) do s\u01b0ng n\u1ec1 ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u nghi\u00eam tr\u1ecdng [1] [8];<\/li>\n
      • T\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng v\u00e0 kh\u1edbp:<\/strong> C\u00e1c ch\u1ea5n th\u01b0\u01a1ng Salter-Harris III v\u00e0 IV c\u1ee7a physis g\u1ea7n tr\u00ean c\u00f3 nguy c\u01a1 40% b\u1ecb t\u1ed5n th\u01b0\u01a1ng li\u00ean k\u1ebft ho\u1eb7c r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng kh\u1edbp [8]. C\u00e1c bi\u1ebfn ch\u1ee9ng nh\u01b0 r\u00e1ch men, l\u1ecfng l\u1ebbo d\u00e2y ch\u00e9o (cruciate ligament laxity) ho\u1eb7c \u0111\u1ee9t d\u00e2y ch\u1eb1ng t\u1ee9 \u0111\u1ea7u c\u0169ng \u0111\u00e3 \u0111\u01b0\u1ee3c ghi nh\u1eadn [8];<\/li>\n
      • H\u1ed9i ch\u1ee9ng khoang:<\/strong> \u0110\u00e2y l\u00e0 bi\u1ebfn ch\u1ee9ng \u0111\u1eb7c bi\u1ec7t th\u01b0\u1eddng g\u1eb7p v\u1edbi g\u00e3y l\u1ed3i c\u1ee7 ch\u00e0y so v\u1edbi c\u00e1c t\u1ed5n th\u01b0\u01a1ng physis kh\u00e1c, do v\u1ecb tr\u00ed g\u1ea7n c\u1ee7a c\u01a1 t\u1ee9 \u0111\u1ea7u v\u00e0 m\u00f4 m\u1ec1m xung quanh [8].<\/li>\n<\/ul>\n

        D\u00f9 t\u1ef7 l\u1ec7 \u0111\u1ee9t d\u00e2y ch\u1eb1ng t\u1ee9 \u0111\u1ea7u trong m\u1ed9t s\u1ed1 t\u1ed5ng quan h\u1ec7 th\u1ed1ng g\u1ea7n \u0111\u00e2y ch\u1ec9 kho\u1ea3ng 2%, nguy c\u01a1 h\u1ed9i ch\u1ee9ng khoang v\u1eabn \u0111\u01b0\u1ee3c xem l\u00e0 m\u1ed1i lo ng\u1ea1i h\u00e0ng \u0111\u1ea7u c\u1ea7n theo d\u00f5i s\u00e1t sao sau ch\u1ea5n th\u01b0\u01a1ng [8].<\/p>\n

        T\u00ednh ch\u1ea5t c\u1ee7a t\u1ed5n th\u01b0\u01a1ng v\u00e0 xu h\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb<\/h2>\n

        Vi\u1ec7c x\u1eed l\u00fd g\u00e3y l\u1ed3i c\u1ee7 ch\u00e0y \u1edf tr\u1ebb em v\u00e0 thanh thi\u1ebfu ni\u00ean v\u1eabn l\u00e0 m\u1ed9t l\u0129nh v\u1ef1c \u0111\u1ea7y tranh c\u00e3i trong ch\u1ec9nh h\u00ecnh nhi khoa v\u00e0 y h\u1ecdc th\u1ec3 thao, cho \u0111\u1ebfn khi c\u00f3 th\u00eam b\u1eb1ng ch\u1ee9ng ph\u01b0\u01a1ng ph\u00e1p lu\u1eadn ch\u1eb7t ch\u1ebd h\u01a1n v\u1ec1 chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb t\u1ed1i \u01b0u [3].<\/p>\n

        \u0110\u1ed1i v\u1edbi thanh thi\u1ebfu ni\u00ean tham gia c\u00e1c m\u00f4n th\u1ec3 thao nh\u01b0 b\u00f3ng ch\u00e0y ho\u1eb7c b\u00f3ng r\u1ed5, l\u1ef1c c\u0103ng l\u1eb7p \u0111i l\u1eb7p l\u1ea1i tr\u00ean c\u01a1 t\u1ee9 \u0111\u1ea7u c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn c\u00e1c t\u1ed5n th\u01b0\u01a1ng m\u00e3n t\u00ednh ho\u1eb7c t\u00e1i ph\u00e1t. C\u00e1c nghi\u00ean c\u1ee9u cho th\u1ea5y c\u1ea7n c\u00f3 ch\u01b0\u01a1ng tr\u00ecnh ph\u00f2ng ng\u1eeba v\u00e0 qu\u1ea3n l\u00fd t\u1ea3i tr\u1ecdng \u0111\u1ec3 ng\u0103n ch\u1eb7n s\u1ef1 gia t\u0103ng \u00e1p l\u1ef1c l\u00ean apophysis \u0111ang \u0111\u00f3ng [5]. Vi\u1ec7c hi\u1ec3u r\u00f5 c\u01a1 ch\u1ebf <\/p>\n

        T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n
          \n
        • [1] Rockwood and Green's Fractures in Children, 9th Edition, 2020, trang 1592<\/li>\n
        • [2] Rockwood and Green's Fractures in Children, 9th Edition, 2020, trang 1593<\/li>\n
        • [3] Rockwood and Green's Fractures in Children, 9th Edition, 2020, trang 1155<\/li>\n
        • [4] Rockwood and Green's Fractures in Children, 9th Edition, 2020, trang 1593<\/li>\n
        • [5] Rockwood and Green's Fractures in Children, 9th Edition, 2020, trang 956<\/li>\n
        • [6] Rockwood and Green's Fractures in Children, 9th Edition, 2020, trang 1592<\/li>\n
        • [7] Rockwood and Green's Fractures in Children, 9th Edition, 2020, trang 1592<\/li>\n
        • [8] Rockwood and Green's Fractures in Children, 9th Edition, 2020, trang 1594<\/li>\n<\/ul>\n

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          Ph\u00e2n t\u00edch chi ti\u1ebft v\u1ec1 g\u00e3y l\u1ed3i c\u1ee7 ch\u00e0y (tibial tubercle fracture) \u1edf thanh thi\u1ebfu ni\u00ean ch\u01a1i th\u1ec3 thao, nguy\u00ean nh\u00e2n do co c\u01a1 t\u1ee9 \u0111\u1ea7u v\u00e0 c\u01a1 ch\u1ebf t\u1ed5n th\u01b0\u01a1ng \u0111\u1eb7c th\u00f9.<\/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-461","post","type-post","status-publish","format-standard","hentry","category-gay-xuong"],"yoast_head":"\nG\u00e3y l\u1ed3i c\u1ee7 ch\u00e0y \u1edf thanh thi\u1ebfu ni\u00ean: Nguy\u00ean nh\u00e2n, c\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng v\u00e0 nguy c\u01a1 - BS NGUY\u1ec4N TH\u00c0NH LONG - BS C\u01a0 X\u01af\u01a0NG KH\u1edaP - CH\u1ea4N TH\u01af\u01a0NG CH\u1ec8NH H\u00ccNH<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/12\/gay-loi-cu-chay-o-thanh-thieu-nien-nguyen-nhan-co-che-chan-thuong-va-nguy-co\/\" \/>\n<meta property=\"og:locale\" content=\"vi_VN\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"G\u00e3y l\u1ed3i c\u1ee7 ch\u00e0y \u1edf thanh thi\u1ebfu ni\u00ean: Nguy\u00ean nh\u00e2n, c\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng v\u00e0 nguy c\u01a1 - 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