- Theo doi thifdng xuyen mach, HADM ap kpe TM TW vit so lifting nude til u, day la chi so danh gia b^nh nhan diityc truy&i du djch hay khfing.
4.CHAN DOAN: dtfa vao lam sang v aX quang
4.1. Lam sang
- Gay 2 xUdng cang tay di lech nhieu - C in g tay stfng ne bien dang ro
- C^ng tay nhtf mot ong tron, bam tim rong lan tdi tan khuyu - Benh nhan rat dau va khong sap-ngtfa dtfdc c&ng tay
- Cd the thay ctf dong bat thtfdng va tieng lao xao xtfdng
Ltfu y: Kiem tra mach va th in kinh vung co tay-ban tay (xem them phan hoi chtfng chen ep khoang chug tay)
4.1.2. Gay canh tifoi o tre em hoac gay ft di lech angiscri ldn
- Trieu chtfng lam sang ngheo nan
- Tai vung gay dau choi, stfng ne, cd bam tim muon
4.2. X quang
- Nguyen tac: phai lay het khdp khuyu va khdp co tay de tranh bd sot thtfdng ton nhtf trat khdp quay-tru tren, quay-tru dtfdi. Chup phim thang va nghieng.
- Doc ket qua: gay ddn gian hay phtic tap, gay 1 hay ca 2 xtfdng. - Di lech dau xtfdng
5. DIEU TR|
5.1. Dieu tri chinh hinh
5.1.1. Gay it di l$ch hoac khong di lech
Nan nhe nhang theo true chi
Bd bot canh-c&ng-b&n tay rach doc, khuyu de gap 90°, bot de 6-8 tuan (tre em); 10-12 tu&n (ngtfdi ldn).
5.1.2. Gay di lech: (chi ap dung vdi gay 1/3 dudi cang tay)Vo cam: Tre em: gay me tinh mach Vo cam: Tre em: gay me tinh mach
NgUdi ldn: gay te tai cho, hoac te dam roi than kinh canh tay Benh nhan nam ngtia, vai dang 90°, khuyu gap 90°
NgUdi phu nan, 1 tay nam ngon cai keo thang theo true cang tay. 1 tay nam cac ngon con lai keo ve phfa tru.
Ngtfdi n ln : stia het di lech, tach rong mang lien cot
Dat 2 nep bot trtfdc va sau cang tay, dat dua tach mang lien cot tren 2 nep bot. Bo bot canh-cang-ban tay rach doc, khuyu 90°, de bot 10-12 tuan.
5.2. Dieu trj phau thuat
5.2.1. Chi djnh
Gay cao 2 xUdng cang tay di lech (1/3 tren, 1/3 gitia) Gay co bien chting: gay hd, chen ep khoang
Dieu tri bao ton: khong ket qua
5.2.2. Cac phuvng phap phau thuat
Dtfdng vao xUdng quay la dtfdng thang noi chom quay vdi mom tram quay (dtfdng Thom pson) hoac dtfdng Henry. Dtfdng vao xUdng tru la dtfdng phia sau, di theo mao tru.
Ket hdp xUdng bang nep-vit la phtfdng phap tot nhat. Nep vit thtfdng dung 1& A.O loai co ep (D C P). Nep vit ket hdp xtfdng viing, ton trong cac doan cong sinh ly cua xtfdng quay, benh nhan tap phuc hoi chtic nang sdm (hinh 18.5).
Dong dinh noi tuy co Uu diem it anh htfdng tdi m ang xtfdng, vet mo nho, nhtfng ket hdp xtfdng thtfdng khong vting, dac biet khi sap-ngtia cang tay. vi vay phai bo bot tang ctfdng them 3 tuan (hinh 18.6).
Dong dinh kin co chot dtfdi man huynh quang tang sang, ngay nay hay dung, khac phuc dtfdc cac nhtfdc diem cua cac phUdng phap tren (hinh 18.7)
Hinh 18.7. Dong dinh co chot (adsbygoogle = window.adsbygoogle || []).push({});