nam 2010, Ha N6i BO Y M (2006), ThOng tu, lien tich s6 02/TTLTBYT-BNV-BTC Huang din thy'c hien Quyet dinh 276/2005/QD-TTg c0a ThO tuerng Chinh 070 ve the d6 Lev dai nghe, Ha Nei 10 B6 Y M (2008), Bao cao kiem tra cOa 932 benh vien cOa Cuc quan ly Kham chaa benh, Ha N6i 11 Chinh Phi, (2006), Nghl Binh s6 43/2006/ND-CP quy dinh quyen ty' cho ty' chin trach nhiem ye thy hien nhiem vu, to chuc b() may, Wen the va tai chinh doi vai dan vi six nghiep cling lap, Ha NOi 12 Chinh Phi, (2008), Nghl djnh 13/2008/ND-CP 0402/2008 clia Chinh phO ve.viec quy dinh to chuy cac ca quan chuyen men thu6c Uy ban nhan dan tinh, phO trur thusec trung trang, Ha N6i 13 Uy ban nhan dan tinh Ha Giang (2013) Quyet djnh se 898/QD - UBND 15/5/2013 coa Uy ban nhan dan tinh Ha Giang ye ban hanh danh myc cac rnh vur can thu hat fret- ) Man ban tinh Ha Ging nam 2013 DANH GIA KET QUA DIEU TR! TRAT KHJP VAI TAI DIN RA TRU' C BANG PHAU THUR LATARJET - BRISTOW TAI BENH VIEN VICT Bit DO VAN MINH, TRAN TRUNG DUNG - Truing flai hpc Y Ha Npi NGO VAN TOAN - BOnh vien Viet DKFC TOM TAT Myc 1.MO to dac diem lam sang cila benh nhan trot khOp vai tai dien truck 2.flanh gia kat qua di& tri trat khOp vai tai dien (TKVTD) tank bang phau thuat Latarjet- Bristow Phuryng phap nghien cUu: Nghien cCru mO to vim her cCru, viva flan cCru 42 trtrong hap Ghi nhOn lan trot khOp deu tien, ca che chen thutng, tong s6 len tai trot Danh gia chCrc nang khOp vai sau m6 bang thang diem WalchDuplay Kat qua: Denh gia chung chUc nang kherp vai sau m6 la tot vai diem Walch- Duplay trung binh la 84 diem, 13 BN bat kat qua ret tot, 17 BN dot kat qua tot, 11 BN apt ket qua' trung binh va BN dot kat qua kern CO BN bi tai trot sau ph5u thuOt Kat luOn: Ph5u thuOt Latarjet- Bristow dem !pi ket qua tot cho BN TKVTD truck chen thvang TO, kh6a: Trat khop vai tai dien truck, LatarjetBristow SUMMARY Purposes: To describe the clinical characteristics of recurrent anterior glenohumeral dislocation To analyze the functional outcome of the Bristow- Latarjet procedures in patient with recurrent anterior glenohuhumeral dislocation Methods: Records of 42 patients (42 glenohumeral joints) were reviewed retrospectively and prospectively Date of first dislocation, mechanical injury, and number of recurrent dislocation before and after surgery were recorded The overall function and instability of the glenohumeral joint were evaluated Results: All of the glenohumeral joint dislocations were caused by trauma The overall functional outcome was good, with the mean Walch- Duplay scores of 84 points Scores of 13 of the patients were excellent, 17 were good, 11 were fair and was poor Conclusions: The Bristow- Latarjet procedure is a good surgical treatment for recurrent anterior dislocation of the glenohumeral joint Keywords: Recurrent anterior glenohumeral dislocation, Latarjet- Bristow Y HOC THIX HANH (922) - SO 6/2014 DAT VAN DE Trot khCrp vai tai dien (TKVTD) la tinh trang tat tai di tai lai cCia met phAn hoac toan bO chum xt.rang canh tay kh6i ch5o xtrang vai TKVTD CO the )(ay b phia trtrac, phia sau, phia &Peri hay nhieu hutmg nhu'ng chu yeu la TKVTD truck, chiern khoang 97% cac trutmg hgp C6 han 150 phipang phap m6 mer khac dieu tri TKVTD trutt cia duvc gibi thieu va ap dung ten lam sang Tuy nhien, ton thtrang giai phAu benh cCia TKVTD ret phirc tap nen kh6ng mOt phirang phap phAu thuet nao (Iwo coi la toan then cho (lieu tri MQi benh nhan TKVTD Phu 0101 (PT) Latarjet- Bristow la mOt ph5u thuet kinh dien &Ivo coi la mOt phirang phap CO hieu qu5 di& tri TKVTD trirgc vgi tji 10 tai tat thap Tai benh vien Viet Dim, nal CM ap dung kha ph6 bien PT Latarjet- Bristow di& tri TKVTD trutt nhu'ng chu'a c6 met Clanh gia tong ket nao Chung toi tier) hanh nghien cCru de tai nh5m muc tieu: MO to dac diem lam sang benh nhan TKVTD truck 2.Danh gia kat qua di& tri TKVTD truck bang phau thuat Latarjet- Bristow DOI TU'gNG, PHU'O'NG PHAP NGHIEN CU'U e6i twang nghien civu: Gem 42 BN (42 khap vai) di.mc chen doan TKVTD tru,bc, cluvc tien hanh pilau thuet Latarjet- Bristow de dieu tri, tai Benh vien Viet th6i gian tir thang nam 2006 tten het than9 nam 2011 Tie u chuan lua chon: Khong phan biet tu6i, giai, Oa Ch5n Cloan xac dinh TKVTD truerc du'a tren benh sir, kham lam sang, ton thiyang X quang va ton thirang m6 Dirac tien hanh phau thuet Latarjet- Bristow de dieu tri argc kham lai, chirp X quang khdrp vai kiem tra sau phAu thuet it Met thang Tieu chug!? loci tnr Benh nhan (BN) ce tien sir phAu thuet khdep vai bubo CTO 69 BN co benh ly man tinh cCia khap vai: viem quanh khap vai, thoai h6a BN trat khap vai sau, trat da htyang Phu'o'ng ph5p nghien ciru: Nghien cCru m6 ta, khong nh6m chUng, hOi ciru va tien aru Ket qua: Dac diem lam sang cOa benh nhan TKVTD trtrac 42 BN (42 khap vai) Om 38 nam va nCr, a dO tuOi trung binh 25,7 ± 5,3 tuOi Trat khop vai cep tinh Ian dau chaff the thao: 31 BN (73,8%), tai nan giao thong: BN (14,3%), tai nan sinh hoat: BN (4,8%), tai nan hoc dirang: BN (4,8%) va tai nan lao clang: BN (2,4%) Thai gian to bi chan thu'ang den ph5u thuat trung binh 32,8 ± 25,0 thang Co 29 BN co 56 len TKVTD > 10 Ian, 12 BN tir 5• 10 Ian va BN dual Ian Trat khOp vai trail phai: 21/21 Trat khap vai tay thuan/ khOng thuan: 22/20 Ket qua dieu tri TKVTD trutc bang phAu thuat Latarjet- Bristow: Thai gian theo dal trung binh sau ph5u thuat la 30,5 ± 16,3 thang Diem Walch- Duplay trung binh sau ph5u thuat la 83,7 ± 16,3 diem, ret tOt: 13 BN, tOt: 17 BN, trung binh: 11 BN va kern: BN Danh gia muc d6 met vCrng cua khap vai sau mo: Nghiem phap e sa throng tinh b 4/42 BN, nghiem phap tao ranh &rang tinh a 2/42 BN Dau khap vai hoat dOng gang sCrc: 10/42 BN (23,8%) Bien da xoay ngoai trung binh cua khap vai ben Tac gia So BN/ S6 khc!rp vai Carol va cs [0] Banas va cs [0] Allain va cs [0] Hovelius va cs [0] Matthes va cs [0] Dossim va cs [0] Kashani va cs [0] ChOng toi 44/ 47 79/79 56/58 113/118 29/29 84/93 35/35 42/42 Theo doff x sau mo (thang) 43 103 171 182 38 98 25 30,5 Ty le tat _ trat (%) T9 le ban tat (%) 4 5,4 2,4 2,7 0 DA co nhieu nghien cCru danh gia ket qua dieu tri TKVTD trutc bang PT Latarjet- Bristow M6i tac gia sir dung cach danh gia rieng nhu'ng nhin chung cac tac gia deu ghi nhan PT Latarjet- Bristow dem lai ket qua tOt cho BN met vCrng khap vai tai dien tarac Ty le BN dupc tOt va ret tOt sau phau thuat Latarjet- Bristow theo thang diem Rowe hoac WalchDuplay giao d6ng tb, 69% den 100% Danh gia muc da virng cCia khap vai sau ph-au thuat, chOng toi ghi nhan nghiem phap e sa du'ang tinh a BN (9,5%) va nghiem phap tao ranh du'ang tinh a BN (4,8%) co BN dirang tinh vai ca hai nghiem phap Trong BN co BN co bieu hien tai trat that su' va BN cam they e sa dai clang 70 ph5u thuat Om 15, 2° ± 5,7° so vai ben kh6ng ph5u thuat 36/42 BN (khap vai) CO chaff the thao trutc mo 12,5% BN tra lai hoat dong the thao nhu, trutc, 25% van chaff duvc nhang mon the thao trutc nhu'ng khong tri dupc phong d6 nhu' truck, 21,9% benh nhan phai chuyen sang mon the thao khac it nguy ca han va 40,6% benh nhan khong tham gia chaff the thao sau mo M6t trung hop tai trat sau phau thuat 15 thang BAN LUAN Phau thuat (lieu tri TKVTD duvc biet den tir thai Hypocrats Cho den nay, co han 150 phu,ang phap mo mb khac duvc gibi thieu va ap dung tren lam sang, co nhang phau thuat dirac coi la tieu chuan yang cho dieu tri TKVTD vai tY le tai trat thap Tuy nhien, ton thlyang giai phau benh ly cCia TKVTD ret phCrc tap nen khOng mat phu'ang phap phau thuat nao disac coi la toan dien cho dieu tri moi benh nhan TKVTD MOt phu'ang phap dieu tri ly tutng cho (lieu tri TKVTD no co du,ac cac tieu chuan sau: tY le trat tai hOi thap, tY le bien chirrig thap, ty le mo lai thap, khong gay hai (viem khap), tri van d6ng khap vai, co the ap dung cho hau het cac trutng hop, de danh gia sau m6, sCra chaa cactht.rang ton giai phau va khong qua kh6 tht,rc hien Phau thuat LatarjetBristow la mat phau thuat kinh dien, duvc coi la c6 hieu qua dieu tri TKVTD Danh gia chirc nang khap vai sau phau thuat theo thang diem Walch- Duplay chung toi ghi nhan tY le BN sau phau thuat Latarjet- Bristow dat ket qua tOt va ret tOt dat 71,4%, diem Walch- Duplay trung binh la 84 diem .x Thang diem Rowe/ Walch- Duplay TB Rat tot < Kern (°/0) (%) Tot (%) (%) 62 74 64 71 59 30 31 30,9 25 11 24 15 24 43 69 40,5 11 9 11 10 16 26,2 6 10 2,4 nhu'ng chu'a Ian nao trat lai thu,c scr Allain va cong Sly theo doi 58 khap vai sau mo trung binh 14,3 nam ghi nhan, khOng CO mat BN nao tai tat, co 1BN cam they met yang dai dang va ban trat Tuy nhien them kham lam sang kh6ng xac Binh duvc tinh trang met vCmg khap vai bai nghiem phap e sa am tinh va kh6ng tim they dau hieu long bao khap phia trutc khap vai (10%) co cam giac e sa nhu'ng chi co BN du'ang tinh vai nghiem phap e sa va khOng co BN nao co bleu hien long bao khap phia truck tren lam sang 51 BN (88%) cam they khap vai yang, tham kharn lam sang kh6ng co BN nao co dau hieu met yang khap vai Danh gia mCrc d6 dau hoat clang khap vai sau Y HOC THIX HANH (922) - SO 6/2014 ph5u thuat, chung toi ghi nhan co 10 BN, chiem 23,8%, c6 bieu hien dau mai khdep vai hoat dOng gang Stk Tat ca nhirng BN cleu c6 thOi gian sau ph5u thuat it nhat 30 thang Juy nhien bleu chirng xuat hien khong thut,ng xuyen va BN khong phai dieu tri bang bat cir lopi thu6c giam dau nao Danh gia chCrc nang kherp vai c6a nh6m BN chCing t6i nhan thay c6 BN a nh6m tot va BN b nhOm trung binh Allain va cong sty, theo dOi 58 khap vai &rot ph5u thuat Latarjet- Bristow theri gian trung binh 14,3 nam nhan thay, c6 38 BN (chiem 66%) khong c6 bleu hien dau khOp vai, 15 BN (chiem 26%) c6 bleu hien dau khO,p vai van clang the tut va khdep vai (chiem 9%) dau khc5p vai hang ve phai dieu tri bang thuOc giam dau Bien CIO xoay ngoai cCia khcYp vai sau phAu thuat han the han so vdei ben khdep vai khong phAu thuat Dieu cOng duvc ghi nhan beri nhieu tac gia Dart gia Clang tac xoay ngoai c6a khdep vai qua tu' the 16 canh tay khep vao than minh va canh tay clang 90°, chCing toi nhan they, bien d6 xoay ngoai cua khap vai ben phAu thuat bi han the han so vCri ben lanh khoang 15° H&J het cac tac gia ghi nhan han the bien CIO xoay ngoai trung binht6a kherp vai sau ph5u thuat Latarjet- Bristow so vai ben khOng phAu thuat la 6°- 12° va cung c6 mat so th6ng bao rang so c6 the len den 20° Carol va cOng su' theo del 44 BN trung binh 3,7 nam sau PT Latarjet- Bristow nhan they hpn the bien c10 xoay ngoai to the canh tay dpng 90° la 12° Allain va cOng sly theo del 58 khap vai (lox PT Latarjet- Bristow sau th61 gian trung binh 14,3 nam nhan they, bien xoay ngoai cua khdep vai sau ph5u thuat la 42° ± 17° so vai khap vai khong phAu thuat la 63° ± 14° -lac gia cung ghi nhan bien xoay ngoai cua nh6m BN dirac phau thuat c6 khau chang mep On co' du'O'i vai kieu khau to ao la 35° ± 12°, so vai ben khau gan co' vai kieu not tan- ten la 48° ± 18° Nhu' vay, khdep vai ben ph5u thuat c6 bien xoay ngoai giam khoang 21° so vOi ben khOng ph5u thuat 18 khap vai sauphau thuat duvc khau ch6ng mep gan ca dui vai kieu to ao bi giam bien dO xoay ngoti trung binh khoang 29°, 36 khOep vai sau phAu thuat &tit khau gan ca du,dei vai kieu nOi tan - tan 131 OM bien dO xoay ngoai khoang 15° Han the van efOng xoay gap Cr 19 khdep vai, chiem 33% va cach khau n6i gan co' &poi vai khong anh hty&ng den bien da xoay Matthes va Ong sty theo dal 29 khdep vai &rot PT Latarjet- Bristow nhan they, bien xoay ngoai trung binh cua khOp vai sau phAu thuat la 32° so vdri ben khOng ph5u thuat la 43u, nhien, si,r khac biet la kh6ng c6 nghia thong ice DAM gia mire tro' lai hopt Ct6ng the thao c6a BN sau ph5u thuat Latarjet- Bristow duvc ghi nhan khac tiny *rig tac gia Trong nghien cCru cua chung toi chi c6 36/ 42 BN trutt phAu thuat c6 tham gia chai the thao ranh r6i, chiem 78,6% cac truteng hap Trong so BN chiing tai ghi nhan c6 12,5% BN sau phAu thuat trO lai hopt Clang the thao Y HOC MCC HANH (922) - SO 6/2014 nhu, tank ph5u thuat, 25% BN sau phau thuat c6 tham gia the thao tro, Ipi nhu'ng phong kh6ng duvc nhu' trutec, 21,9% BN sau phAu thuat phai chuyen sang chai mon the thao khac thuac nh6m it c6 nguy ca han va c6 40,6% BN sau phAu thuat kh6ng chai the thao tro' Ipi Theo Allain va cOng si,r, c6 49/ 56 BN (vdei 51/ 58 khOp vai) co tham gia the thao truck ph5u thuat, 40 BN (vc5'i 41 khap vai, 80%) tro' 1pi hopt (ging the thao nhu' trutt va BN (vCri khOp vai, 12%) chai lai &rot the thao nhu'ng mut CIO that) han; c6 BN m6 ca hai khOp vai (2%) khOng the trer lai chai the thao va BN (6%) phai chuyen sang mon the thao khac it nguy ca han Cac BN tra lai hopt Ong the thao sau phAu thuat thang ChCing toi ghi nhan BN bi Vat khap vai tai dien sau ph5u thuat DO la truteng hap BN nam, bi Vat khdrp vai tai dien thrac sau tai nan eta b6ng nga BN bi tat tai dien ret nhieu Ian nam BN duvc dieu tri TKVTD thrOt bang PT Latarjet- Bristow nam 19 tuOi Sau ph5u thuat 15 thang BN bi tai tat Ian deu ben Clang nem ng6 Theo dOi BN den duvc 25 thang sau mO, BN c6 tat a len tai tat Tham kham lam sang cho they benh nhan c6 long khdep town than Danh gia X quang b len than) kham cu6i cOng cho they vi tri mom qua tot va da c6 su' lien xtyang giCra mom qua va chao xtyang vai Danh gia tje la tai tat sau mO thirang duvc ghi nhan la co gia tri sau theri gian theo dOi it nhat IA nam -19 la tai trot sau phAu thuat Latarjet- Bristow duvc ghi nhan khac tirng tac gia, giao Ong tO, 0% den 6% C6 nhieu yeu to duvc chi rang co lien quan mat cach c6 nghia den kat qua kern sau m6, bao g6m: BN met virng khop vai to 9, BN da ph5u thuat lam virrig khaep vai trutt d6 nhu'ng that bpi, tu6i cCia BN va thoei gian bet Clang khOy vai sau m6 qua ngen KET LUAN Ph5u thuat Latarjet- Bristow dem Ipi kat qua tOt cho BN tat kh6,p vai tai dien nguyen nhan chen thLrang Day la mot ph5u thuat khong qua phirc tap, khong doi h6i nhieu phtyang tian, dung cu va khOng c6 nhieu bier) chCrng TAI LIEU THAM KHAO Allain J, Goutallier D, Glorion C (1998): Long- term result of the Latarjet proceduce for the treatment of anterior instability of the shoulder J Bone Joint Surg Am, 80: 841- 852 Bannas M.P, Dalldorf P.G, Sebastianelli W.J et al (1993): Long- term follow up of the modified Bristow proceduce Am J Sport Med, 37 (9): 1792- 1797 Carol E.J, Falke L.M, Kortmann J.H.J.P.M et al (1985): Bristow- Latarjet repair for recurrent anterior shoulder instability An eight- year study Netherlands J Surg, 37: 109- 113 Dossim A, Abalo A, Dosseh E et al (2008): Bristow- Latarjet repair for anterior instability of the shoulder: clinical and radiographic result at mean 8.2 years follow- up Chir Main, 27 (1): 26- 30 Hovelius L, Sandstrom B, Sundgren K, Saebo M (2004): One hundred eighteen Bristow- Latarjet repairs for recurent anterior dislocation of the shoulder 71 prospectively followed for fifteen years: Study I- clinical results J Shoulder Elbow Surg, 13: 509- 516 Kashani F.0, Eghbal S, Seyed, Hadi M (2008): Is the Bristow- Latarjet operation effective for every recurrent anterior shoulder dislocation? Iranian Med, 11 (3): 270- 273 Matthes G et al (2007): Oldie but goldie: BristowLatarjet proceduce for anterior shoulder instability J Orth Surg, 15 (1): 4- DANH GIA KET QUA DIEU TR! LICE THAN KINH QUAY CAO THEO MUTING PHAP BOYES TAI BNB VIM VICT DOC TRAN MANH HUNG - Benh vien Viet Di TRAN TRUNG DUNG, NGUYEN XUAN THOY - Trtpdyig OH Y Ha NCli HOANG VAN - Benh vien tinh Thanh Hod TOM TAT: Ma dew Lift than kinh quay cao thuang gap lam sang, vifc chuy4n gan theo phuang phap Boyes la can thief Muc tieu: Danh gia ket qua ph3u thuft chuyen gan dieu tri lift then kinh quay cao theo phuang phap chuAn gan Boyes D61 tuang va phuang phap nghien ciru: Nghien aru h6i cut' tren 32 BN lift then kinh quay dupe ph3u thuat chuyen gan theo phuang phap Boyes tai bfnh WO Viet Derc.Ket qua nghien caw D6 tudi trung binh la 28, Ty If nam/nCe la 5,4, 31/32 BN lift then kinh truac mo, K4t qua ph3u thuat dot rit tot va tot la 82,1% Phyc h6i cht'rc nang lien quan chat the tbi ket qua phau thuat Ket Juan: Ph3u thuat chuydn gan theo k37 thuat Boyes cho ket qua tot d6i vai dieu hi lift then kinh quay Td khda: Lift then kinh qbay cao, ky thuat Boyes, chuyen gan SUMMARY Introductions: High level radial nerve paralysis is quiet common in clinical, Boyes method tendon transfer is necessary Objectives: To assess the results of Boyes method tendon transfer surgery for radial nerve paralysis Patients and methods: retrospective study 32 patients underwent tendon transfer for radial nerve paralysis with Boyes technique in Viet Duc University Hospital Results: average age is 28, male/female ratio is 5.4, surgical results achieved very good and good are 82.1% Rehabilitation is closely related to surgical results Conclusions:Tendon transfer with Boyes technique is useful for radial nerve paralysis treatment Keywords: Radial nerve paralysis, Boyes technique, tendon transfer DAT VAN DE Liet then kinh quay cao la ton thuvng tht.rerng gap, nguyen nhan chinh la cheri thuvng, dac biet gay than Arang canh tay Theo nhieu nghien aru, tY le ton thuvng then kinh quay gay than nrang canh tay tir 1,8% den 16% [1], 10% den 20% tOn thutrng then kinh quay la khong h6i phgc Liet then kinh quay cao la mOt tOn thirang an den tan tat nghiem tong ve chive nang ban tay, anh hverng Ibn tbi sinh hoat va lao d6ng cua ngutri benh Nguti benh khong the du6i dot I cac ng6n tay va dang du6i ngOn cai, met du& chit d6ng co tay, lam anh throng 72 nghiern den chU'c nang cern nem va lam Om ly'c bhp ban tay Do vey ph5u thuet chuyen gan liet then kinh quay khOng h6i phyc la can thiet Vi vey nghien aru "flanh gia ket qua dieu tri ph5u thuat liet then kinh quay cao theo phuang phap Boyes tai Benh vien him nghi Viet arc" thyt hien vdri muc tieu: Ohnh gid ket qud phiu thuOt chuyen gan dik tri liet thhn kinh quay cao theo pinpang phdp chuyen gan Boyes DOI TU'Q'NG, PHU'O'NG PHAP NGHIEN CU'U Nghien CO'll m6 to cat ngang 32 BN het then kinh quay cao khOng h6i phuc duvc phau thuat chuyen gan theo phuvng phap cua Boyes tai Benh vien Viet Din tir nam 2008 den nam 2013 chon benh nhan Tieu chuen Benh nhan duvc chen doan liet then kinh quay cao kh6ng h6i phuc Benh nhan duvc ph5u thuet chuyen gan theo phirang phap BOYES Day du h6 sa benh an Quy trinh nghien dru: BN duvc chen doan 'let then kinh quay cao khong h6i phuc, nguyen nhan, ca the chart thirang, chup XQ PhAu thuet: BN duvc gay to dam r6i, du6i mau va garo canh tay; b6c 10 va chuyen gan gep nong ngon III cho gan duoi chung cac ng6n, gan gep nong ng6n IV cho gan du6i ng6n cai va duOi rieng ngon tro, gan gep co tay quay cho gan clang dai va duoi ngan ngon cai, gan ca sap ton cho gan duoi co tay quay ngan va co tay quay dai [2] ; that) garo, bum rim va dong vet thuvng; dat mang b6t CBT the tuen Tap PHCN theo bai tap Danh gia ket qua Bien (10 van d6ng cac kherp theo bang phan lopi ket qua cua Chuinard 131 Ng6n cai NgOn tay CO tay Gap DuOi Mk Du6i deu ban ngon Dang khaep dO Du6i Gap lien d6t ngOn t6i nep gan tay 50° >30° 10 - 0- 1.25 30°25°- 10°n 0°15° TOt 25° cm 4050° 30° Y HOC THIJC HANH (922) - SO 6/2014 ... tir 5• 10 Ian va BN dual Ian Trat khOp vai trail phai: 21/21 Trat khap vai tay thuan/ khOng thuan: 22/20 Ket qua dieu tri TKVTD trutc bang phAu thuat Latarjet- Bristow: Thai gian theo dal trung... chung cac tac gia deu ghi nhan PT Latarjet- Bristow dem lai ket qua tOt cho BN met vCrng khap vai tai dien tarac Ty le BN dupc tOt va ret tOt sau phau thuat Latarjet- Bristow theo thang diem Rowe... cOng sly theo del 58 khap vai (lox PT Latarjet- Bristow sau th61 gian trung binh 14,3 nam nhan they, bien xoay ngoai cua khdep vai sau ph5u thuat la 42° ± 17° so vai khap vai khong phAu thuat la