{"id":576,"date":"2026-10-13T07:02:18","date_gmt":"2026-10-13T00:02:18","guid":{"rendered":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/13\/noi-soi-khop-co-chan-tai-tao-day-chang-mac-sen-truoc-va-mac-got\/"},"modified":"2026-10-13T07:02:18","modified_gmt":"2026-10-13T00:02:18","slug":"noi-soi-khop-co-chan-tai-tao-day-chang-mac-sen-truoc-va-mac-got","status":"publish","type":"post","link":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/13\/noi-soi-khop-co-chan-tai-tao-day-chang-mac-sen-truoc-va-mac-got\/","title":{"rendered":"N\u1ed9i soi kh\u1edbp c\u1ed5 ch\u00e2n t\u00e1i t\u1ea1o d\u00e2y ch\u1eb1ng m\u00e1c s\u00ean tr\u01b0\u1edbc v\u00e0 m\u00e1c g\u00f3t"},"content":{"rendered":"

N\u1ed9i soi kh\u1edbp c\u1ed5 ch\u00e2n t\u00e1i t\u1ea1o d\u00e2y ch\u1eb1ng m\u00e1c s\u00ean tr\u01b0\u1edbc v\u00e0 m\u00e1c g\u00f3t<\/strong> th\u01b0\u1eddng \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u1edf ng\u01b0\u1eddi b\u1ecb m\u1ea5t v\u1eefng c\u1ed5 ch\u00e2n ngo\u00e0i k\u00e9o d\u00e0i, \u0111au ho\u1eb7c bong g\u00e2n t\u00e1i di\u1ec5n. Hai d\u00e2y ch\u1eb1ng n\u00e0y g\u00f3p ph\u1ea7n gi\u1eef x\u01b0\u01a1ng s\u00ean \u1ed5n \u0111\u1ecbnh trong kh\u1edbp c\u1ed5 ch\u00e2n; d\u00e2y ch\u1eb1ng m\u00e1c s\u00ean tr\u01b0\u1edbc n\u1eb1m ph\u00eda tr\u01b0\u1edbc ngo\u00e0i, c\u00f2n d\u00e2y ch\u1eb1ng m\u00e1c g\u00f3t \u0111i t\u1eeb \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng m\u00e1c \u0111\u1ebfn m\u1eb7t ngo\u00e0i x\u01b0\u01a1ng g\u00f3t [1][3].<\/p>\n

N\u1ed9i soi kh\u1edbp c\u1ed5 ch\u00e2n t\u00e1i t\u1ea1o d\u00e2y ch\u1eb1ng nh\u1eb1m m\u1ee5c \u0111\u00edch g\u00ec?<\/h2>\n

Trong m\u1ea5t v\u1eefng c\u1ed5 ch\u00e2n ngo\u00e0i, b\u00e1c s\u0129 c\u1ea7n x\u00e1c \u0111\u1ecbnh t\u00ecnh tr\u1ea1ng d\u00e2y ch\u1eb1ng, m\u1ee9c \u0111\u1ed9 l\u1ecfng kh\u1edbp v\u00e0 li\u1ec7u c\u00f3 t\u1ed5n th\u01b0\u01a1ng trong kh\u1edbp \u0111i k\u00e8m hay kh\u00f4ng. N\u1ed9i soi cho ph\u00e9p \u0111\u00e1nh gi\u00e1 tr\u1ef1c ti\u1ebfp b\u1ec1 m\u1eb7t s\u1ee5n v\u00e0 c\u00e1c c\u1ea5u tr\u00fac trong kh\u1edbp khi c\u00f3 nghi ng\u1edd t\u1ed5n th\u01b0\u01a1ng n\u1ed9i kh\u1edbp d\u1ef1a tr\u00ean th\u0103m kh\u00e1m ho\u1eb7c h\u00ecnh \u1ea3nh h\u1ecdc [2].<\/p>\n

Tuy nhi\u00ean, n\u1ed9i soi kh\u00f4ng nh\u1ea5t thi\u1ebft ph\u1ea3i th\u1ef1c hi\u1ec7n \u1edf m\u1ecdi ca s\u1eeda ch\u1eefa d\u00e2y ch\u1eb1ng b\u00ean ngo\u00e0i. T\u00e0i li\u1ec7u chuy\u00ean m\u00f4n cho bi\u1ebft n\u1ed9i soi \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc nhi\u1ec1u h\u01a1n khi c\u00f3 d\u1ea5u hi\u1ec7u g\u1ee3i \u00fd b\u1ec7nh l\u00fd trong kh\u1edbp; trong tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng l\u00e2m s\u00e0ng ho\u1eb7c h\u00ecnh \u1ea3nh r\u00f5 r\u00e0ng, l\u1ee3i \u00edch c\u1ee7a n\u1ed9i soi th\u01b0\u1eddng quy v\u1eabn c\u00f2n \u0111\u01b0\u1ee3c xem x\u00e9t [2].<\/p>\n

Khi n\u00e0o c\u00f3 th\u1ec3 c\u1ea7n t\u00e1i t\u1ea1o d\u00e2y ch\u1eb1ng m\u00e1c s\u00ean tr\u01b0\u1edbc v\u00e0 m\u00e1c g\u00f3t?<\/h2>\n

Kh\u00f4ng ph\u1ea3i m\u1ecdi tr\u01b0\u1eddng h\u1ee3p bong g\u00e2n c\u1ed5 ch\u00e2n \u0111\u1ec1u c\u1ea7n ph\u1eabu thu\u1eadt. V\u1edbi t\u00ecnh tr\u1ea1ng suy y\u1ebfu ch\u1ee9c n\u0103ng ho\u1eb7c m\u1ea5t v\u1eefng m\u1ee9c \u0111\u1ed9 n\u1eb7ng, ch\u01b0\u01a1ng tr\u00ecnh t\u0103ng c\u01b0\u1eddng s\u1ee9c c\u01a1 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1eed trong v\u00e0i th\u00e1ng. M\u1ed9t s\u1ed1 ng\u01b0\u1eddi c\u1ea3i thi\u1ec7n \u0111\u1ee7 \u0111\u1ec3 kh\u00f4ng c\u1ea7n t\u00e1i t\u1ea1o d\u00e2y ch\u1eb1ng [4].<\/p>\n

Ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111\u1eb7t ra khi ng\u01b0\u1eddi b\u1ec7nh v\u1eabn c\u00f2n \u0111au, c\u1ea3m gi\u00e1c c\u1ed5 ch\u00e2n l\u1ecfng ho\u1eb7c m\u1ea5t v\u1eefng ch\u1ee9c n\u0103ng k\u00e9o d\u00e0i. M\u1ea5t v\u1eefng ch\u1ee9c n\u0103ng \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 l\u00e0 c\u1ea3m gi\u00e1c ch\u1ee7 quan c\u1ed5 ch\u00e2n kh\u00f4ng ch\u1eafc ho\u1eb7c bong g\u00e2n t\u00e1i di\u1ec5n do thi\u1ebfu h\u1ee5t ki\u1ec3m so\u00e1t th\u1ea7n kinh\u2013c\u01a1 hay c\u1ea3m th\u1ee5 b\u1ea3n th\u1ec3 [4]. Bong g\u00e2n t\u00e1i di\u1ec5n c\u0169ng c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn t\u1ed5n th\u01b0\u01a1ng kh\u00e1c, ch\u1eb3ng h\u1ea1n t\u1ed5n th\u01b0\u01a1ng x\u01b0\u01a1ng\u2013s\u1ee5n, n\u00ean vi\u1ec7c \u0111\u00e1nh gi\u00e1 to\u00e0n di\u1ec7n tr\u01b0\u1edbc m\u1ed5 l\u00e0 c\u1ea7n thi\u1ebft [4].<\/p>\n

\u1ede m\u1ea5t v\u1eefng c\u01a1 h\u1ecdc, phim X-quang ch\u1ecbu l\u1ef1c c\u00f3 th\u1ec3 cho th\u1ea5y \u0111\u1ed9 nghi\u00eang x\u01b0\u01a1ng s\u00ean t\u0103ng so v\u1edbi b\u00ean l\u00e0nh. M\u1ed9t t\u00e0i li\u1ec7u s\u1eed d\u1ee5ng m\u1ee9c t\u0103ng kho\u1ea3ng 8\u201310 \u0111\u1ed9 nh\u01b0 d\u1ea5u hi\u1ec7u g\u1ee3i \u00fd m\u1ea5t v\u1eefng c\u01a1 h\u1ecdc; con s\u1ed1 n\u00e0y c\u1ea7n \u0111\u01b0\u1ee3c b\u00e1c s\u0129 di\u1ec5n gi\u1ea3i c\u00f9ng tri\u1ec7u ch\u1ee9ng, kh\u00e1m l\u00e2m s\u00e0ng v\u00e0 c\u00e1c x\u00e9t nghi\u1ec7m h\u00ecnh \u1ea3nh kh\u00e1c, kh\u00f4ng n\u00ean d\u00f9ng \u0111\u01a1n \u0111\u1ed9c \u0111\u1ec3 t\u1ef1 quy\u1ebft \u0111\u1ecbnh ph\u1eabu thu\u1eadt [4].<\/p>\n

Vai tr\u00f2 c\u1ee7a hai d\u00e2y ch\u1eb1ng b\u00ean ngo\u00e0i c\u1ed5 ch\u00e2n<\/h2>\n
    \n
  • D\u00e2y ch\u1eb1ng m\u00e1c s\u00ean tr\u01b0\u1edbc (ATFL):<\/strong> b\u00e1m t\u1eeb v\u00f9ng \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng m\u00e1c \u0111\u1ebfn ph\u1ea7n tr\u01b0\u1edbc c\u1ed5 x\u01b0\u01a1ng s\u00ean v\u00e0 li\u00ean quan v\u1edbi bao kh\u1edbp tr\u01b0\u1edbc ngo\u00e0i [1][3].<\/li>\n
  • D\u00e2y ch\u1eb1ng m\u00e1c g\u00f3t (CFL):<\/strong> ch\u1eafc h\u01a1n ATFL, \u0111i t\u1eeb v\u00f9ng \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng m\u00e1c xu\u1ed1ng m\u1eb7t ngo\u00e0i x\u01b0\u01a1ng g\u00f3t; \u0111\u00e2y l\u00e0 d\u00e2y ch\u1eb1ng b\u00ean ngo\u00e0i duy nh\u1ea5t n\u1eb1m ngo\u00e0i bao kh\u1edbp [3].<\/li>\n
  • D\u00e2y ch\u1eb1ng m\u00e1c s\u00ean sau:<\/strong> l\u00e0 m\u1ed9t th\u00e0nh ph\u1ea7n kh\u00e1c c\u1ee7a ph\u1ee9c h\u1ee3p d\u00e2y ch\u1eb1ng b\u00ean ngo\u00e0i v\u00e0 \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 l\u00e0 d\u00e2y ch\u1eb1ng kh\u1ecfe nh\u1ea5t trong nh\u00f3m n\u00e0y [3].<\/li>\n<\/ul>\n

    V\u00ec v\u1eady, c\u1ee5m t\u1eeb \u201ct\u00e1i t\u1ea1o d\u00e2y ch\u1eb1ng m\u00e1c s\u00ean m\u00e1c g\u00f3t\u201d th\u01b0\u1eddng \u0111\u1ec1 c\u1eadp \u0111\u1ebfn vi\u1ec7c ph\u1ee5c h\u1ed3i s\u1ef1 \u1ed5n \u0111\u1ecbnh c\u1ee7a ph\u1ee9c h\u1ee3p d\u00e2y ch\u1eb1ng b\u00ean ngo\u00e0i, ch\u1ee9 kh\u00f4ng ch\u1ec9 x\u1eed l\u00fd m\u1ed9t \u0111i\u1ec3m \u0111au ri\u00eang l\u1ebb.<\/p>\n

    L\u1ef1a ch\u1ecdn k\u1ef9 thu\u1eadt v\u00e0 nh\u1eefng \u0111i\u1ec3m c\u1ea7n c\u00e2n nh\u1eafc<\/h2>\n

    C\u00e1c ph\u01b0\u01a1ng ph\u00e1p t\u00e1i t\u1ea1o kh\u00f4ng gi\u1ea3i ph\u1eabu tr\u01b0\u1edbc \u0111\u00e2y c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng g\u00e2n c\u01a1 m\u00e1c ng\u1eafn \u0111\u1ec3 t\u00e1i t\u1ea1o ATFL v\u00e0 CFL. Tuy nhi\u00ean, nh\u1eefng k\u1ef9 thu\u1eadt n\u00e0y c\u00f3 th\u1ec3 l\u00e0m thay \u0111\u1ed5i c\u01a1 h\u1ecdc v\u1eadn \u0111\u1ed9ng c\u1ee7a c\u1ed5 ch\u00e2n v\u00e0 \u1ea3nh h\u01b0\u1edfng ch\u1ee9c n\u0103ng b\u00e0n ch\u00e2n; m\u1ed9t ngu\u1ed3n tham kh\u1ea3o khuy\u1ebfn ngh\u1ecb ch\u1ec9 d\u00f9ng ph\u01b0\u01a1ng ph\u00e1p Evans khi t\u00e1i t\u1ea1o gi\u1ea3i ph\u1eabu d\u00e2y ch\u1eb1ng b\u00ean ngo\u00e0i kh\u00f4ng kh\u1ea3 thi [2][5].<\/p>\n

    Do \u0111\u00f3, l\u1ef1a ch\u1ecdn gi\u1eefa s\u1eeda ch\u1eefa, t\u00e1i t\u1ea1o gi\u1ea3i ph\u1eabu, ph\u1ed1i h\u1ee3p n\u1ed9i soi ho\u1eb7c x\u1eed l\u00fd t\u1ed5n th\u01b0\u01a1ng trong kh\u1edbp c\u1ea7n d\u1ef1a tr\u00ean tu\u1ed5i, m\u1ee9c \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng, ch\u1ea5t l\u01b0\u1ee3ng m\u00f4 d\u00e2y ch\u1eb1ng, t\u00ecnh tr\u1ea1ng s\u1ee5n, bi\u1ebfn d\u1ea1ng b\u00e0n ch\u00e2n v\u00e0 y\u00eau c\u1ea7u v\u1eadn \u0111\u1ed9ng. C\u00e1c \u0111o\u1ea1n t\u00e0i li\u1ec7u \u0111\u01b0\u1ee3c cung c\u1ea5p kh\u00f4ng m\u00f4 t\u1ea3 \u0111\u1ea7y \u0111\u1ee7 quy tr\u00ecnh ph\u1eabu thu\u1eadt n\u1ed9i soi, lo\u1ea1i m\u1ea3nh gh\u00e9p, ph\u01b0\u01a1ng \u00e1n c\u1ed1 \u0111\u1ecbnh hay ch\u01b0\u01a1ng tr\u00ecnh ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng sau m\u1ed5; ng\u01b0\u1eddi b\u1ec7nh kh\u00f4ng n\u00ean t\u1ef1 suy ra c\u00e1c th\u00f4ng tin n\u00e0y t\u1eeb t\u00ean k\u1ef9 thu\u1eadt.<\/p>\n

    Ng\u01b0\u1eddi b\u1ec7nh n\u00ean trao \u0111\u1ed5i g\u00ec tr\u01b0\u1edbc khi ph\u1eabu thu\u1eadt?<\/h2>\n
      \n
    • Tri\u1ec7u ch\u1ee9ng l\u00e0 m\u1ea5t v\u1eefng c\u01a1 h\u1ecdc hay ch\u1ee7 y\u1ebfu do thi\u1ebfu ki\u1ec3m so\u00e1t th\u1ea7n kinh\u2013c\u01a1?<\/li>\n
    • C\u00f3 c\u1ea7n ch\u1ee5p ho\u1eb7c \u0111\u00e1nh gi\u00e1 th\u00eam \u0111\u1ec3 t\u00ecm t\u1ed5n th\u01b0\u01a1ng s\u1ee5n v\u00e0 t\u1ed5n th\u01b0\u01a1ng trong kh\u1edbp kh\u00f4ng?<\/li>\n
    • D\u00e2y ch\u1eb1ng n\u00e0o b\u1ecb t\u1ed5n th\u01b0\u01a1ng, ch\u1ea5t l\u01b0\u1ee3ng m\u00f4 c\u00f2n \u0111\u1ee7 \u0111\u1ec3 s\u1eeda ch\u1eefa hay c\u1ea7n t\u00e1i t\u1ea1o?<\/li>\n
    • Ph\u01b0\u01a1ng ph\u00e1p \u0111\u01b0\u1ee3c \u0111\u1ec1 xu\u1ea5t c\u00f3 ph\u1ea3i l\u00e0 k\u1ef9 thu\u1eadt gi\u1ea3i ph\u1eabu hay kh\u00f4ng gi\u1ea3i ph\u1eabu, v\u00e0 v\u00ec sao?<\/li>\n
    • K\u1ebf ho\u1ea1ch b\u1ea5t \u0111\u1ed9ng, t\u1eadp v\u1eadn \u0111\u1ed9ng, ch\u1ecbu l\u1ef1c v\u00e0 theo d\u00f5i sau m\u1ed5 c\u1ee5 th\u1ec3 ra sao?<\/li>\n<\/ul>\n

      K\u1ebft lu\u1eadn:<\/strong> N\u1ed9i soi kh\u1edbp c\u1ed5 ch\u00e2n c\u00f3 th\u1ec3 h\u1ed7 tr\u1ee3 \u0111\u00e1nh gi\u00e1 v\u00e0 x\u1eed l\u00fd b\u1ec7nh l\u00fd trong kh\u1edbp \u1edf ng\u01b0\u1eddi c\u1ea7n t\u00e1i t\u1ea1o d\u00e2y ch\u1eb1ng b\u00ean ngo\u00e0i, nh\u01b0ng kh\u00f4ng ph\u1ea3i tr\u01b0\u1eddng h\u1ee3p n\u00e0o c\u0169ng c\u1ea7n n\u1ed9i soi th\u01b0\u1eddng quy. Quy\u1ebft \u0111\u1ecbnh t\u00e1i t\u1ea1o ATFL v\u00e0 CFL n\u00ean d\u1ef1a tr\u00ean tri\u1ec7u ch\u1ee9ng k\u00e9o d\u00e0i, d\u1ea5u hi\u1ec7u m\u1ea5t v\u1eefng, k\u1ebft qu\u1ea3 kh\u00e1m v\u00e0 h\u00ecnh \u1ea3nh h\u1ecdc, \u0111\u1ed3ng th\u1eddi \u0111\u00e1nh gi\u00e1 nguy c\u01a1 t\u1ed5n th\u01b0\u01a1ng \u0111i k\u00e8m.<\/p>\n

      T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n
        \n
      • [1] Rockwood and Green's Fractures in Adults, 10th Edition, 2025, trang 3252<\/li>\n
      • [2] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 5250<\/li>\n
      • [3] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 5235<\/li>\n
      • [4] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 5250<\/li>\n
      • [5] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 5251<\/li>\n<\/ul>\n

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