B\u1ec7nh nh\u00e2n ph\u00e0n n\u00e0n v\u1ec1 \u0111au c\u1ed5 tay th\u01b0\u1eddng m\u00f4 t\u1ea3 c\u01a1n \u0111au c\u1ea3n tr\u1edf c\u00e1c ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y, c\u00f4ng vi\u1ec7c ho\u1eb7c th\u1ec3 thao c\u1ee7a h\u1ecd. M\u1ed9t s\u1ed1 c\u00f3 th\u1ec3 b\u00e1o c\u00e1o ti\u1ec1n s\u1eed ch\u1ea5n th\u01b0\u01a1ng c\u1ed5 tay c\u1ee5 th\u1ec3, c\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng ph\u1ed5 bi\u1ebfn nh\u1ea5t l\u00e0 ng\u00e3 v\u1edbi b\u00e0n tay du\u1ed7i th\u1eb3ng. H\u1ecd th\u01b0\u1eddng s\u1ebd \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n th\u1eed nghi\u1ec7m bao g\u1ed3m thu\u1ed1c ch\u1ed1ng vi\u00eam kh\u00f4ng steroid, ti\u00eam steroid, ngh\u1ec9 ng\u01a1i v\u00e0 n\u1eb9p ban \u0111\u1ea7u trong kho\u1ea3ng th\u1eddi gian trung b\u00ecnh 3-6 th\u00e1ng. C\u00e1c x\u00e9t nghi\u1ec7m \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n bao g\u1ed3m ch\u1ee5p X-quang v\u00e0 ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb (MRI).<\/span><\/p>\n Khi \u0111i\u1ec1u tr\u1ecb ban \u0111\u1ea7u th\u1ea5t b\u1ea1i, ch\u00fang t\u00f4i th\u01b0\u1eddng ti\u1ebfn h\u00e0nh n\u1ed9i soi kh\u1edbp c\u1ed5 tay d\u01b0\u1edbi g\u00e2y m\u00ea to\u00e0n th\u00e2n ho\u1eb7c g\u00e2y t\u00ea v\u00f9ng. N\u1ed9i soi kh\u1edbp c\u1ed5 tay \u0111\u00e3 ph\u00e1t tri\u1ec3n t\u1eeb m\u1ed9t k\u1ef9 thu\u1eadt m\u1edbi \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 t\u1eeb nh\u1eefng n\u0103m 1970 tr\u1edf th\u00e0nh m\u1ed9t c\u00f4ng c\u1ee5 ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb thi\u1ebft y\u1ebfu trong kho v\u0169 kh\u00ed c\u1ee7a m\u1ecdi b\u00e1c s\u0129 ph\u1eabu thu\u1eadt \u0111i\u1ec1u tr\u1ecb c\u00e1c r\u1ed1i lo\u1ea1n c\u1ed5 tay kh\u00e1c nhau. N\u00f3 h\u1eefu \u00edch trong vi\u1ec7c x\u00e1c \u0111\u1ecbnh c\u00e1c m\u00f4 h\u00ecnh, s\u1ef1 k\u1ebft h\u1ee3p v\u00e0 m\u1ee9c \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng m\u00f4 m\u1ec1m, th\u01b0\u1eddng lan r\u1ed9ng h\u01a1n so v\u1edbi nghi ng\u1edd tr\u00ean l\u00e2m s\u00e0ng. Trong \u0111i\u1ec1u tr\u1ecb b\u1ec7nh nh\u00e2n b\u1ecb \u0111au c\u1ed5 tay m\u00e3n t\u00ednh kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n b\u1eb1ng n\u1ed9i soi kh\u1edbp c\u1ed5 tay, ch\u00fang t\u00f4i th\u1ea5y nhi\u1ec1u b\u1ec7nh nh\u00e2n c\u00f3 t\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng li\u00ean x\u01b0\u01a1ng (d\u00e2y ch\u1eb1ng thuy\u1ec1n-nguy\u1ec7t & d\u00e2y ch\u1eb1ng nguy\u1ec7t-th\u00e1p) \u0111\u1ed3ng th\u1eddi c\u0169ng nh\u01b0 t\u1ed5n th\u01b0\u01a1ng ph\u1ee9c h\u1ee3p s\u1ee5n s\u1ee3i tam gi\u00e1c (TFCC). C\u00e1c ph\u00e1t hi\u1ec7n kh\u00e1c bao g\u1ed3m vi\u00eam ho\u1ea1t m\u1ea1c v\u00e0 t\u1ed5n th\u01b0\u01a1ng s\u1ee5n nh\u01b0 nhuy\u1ec5n s\u1ee5n thuy\u1ec1n. Kh\u00f4ng hi\u1ebfm khi t\u00ecm th\u1ea5y hai ho\u1eb7c ba b\u1ec7nh l\u00fd c\u00f9ng l\u00fac.<\/span><\/p>\n Nhi\u1ec1u th\u1ee7 thu\u1eadt c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n qua n\u1ed9i soi nh\u01b0 c\u1eaft b\u1ecf ho\u1ea1t m\u1ea1c, c\u1eaft b\u1ecf b\u1eb1ng s\u00f3ng cao t\u1ea7n, l\u00e0m s\u1ea1ch b\u1ea5t k\u1ef3 khuy\u1ebft t\u1eadt s\u1ee5n n\u00e0o, s\u1eeda ch\u1eefa r\u00e1ch ngo\u1ea1i vi TFCC v\u00e0 th\u1eadm ch\u00ed h\u1ee3p nh\u1ea5t h\u1ea1n ch\u1ebf. Sau ph\u1eabu thu\u1eadt, c\u1ed5 tay \u0111\u01b0\u1ee3c \u0111\u1eb7t trong n\u1eb9p ho\u1eb7c b\u0103ng b\u1ed9t trong 6 tu\u1ea7n v\u00e0 b\u1eaft \u0111\u1ea7u li\u1ec7u ph\u00e1p v\u1eadn \u0111\u1ed9ng cho c\u00e1c b\u00e0i t\u1eadp ph\u1ea1m vi chuy\u1ec3n \u0111\u1ed9ng v\u00e0 t\u0103ng c\u01b0\u1eddng s\u1ee9c m\u1ea1nh n\u1eafm.<\/span><\/p>\n N\u1ed9i soi kh\u1edbp c\u1ed5 tay c\u00f3 vai tr\u00f2 quan tr\u1ecdng trong \u0111i\u1ec1u tr\u1ecb \u0111au c\u1ed5 tay m\u00e3n t\u00ednh. N\u00f3 cho ph\u00e9p quan s\u00e1t tr\u1ef1c ti\u1ebfp kh\u1edbp c\u1ed5 tay v\u00e0 do \u0111\u00f3 x\u00e1c \u0111\u1ecbnh nhi\u1ec1u ch\u1ea5n th\u01b0\u01a1ng m\u1ed9t ph\u1ea7n \u1edf c\u1ed5 tay, ch\u1eb3ng h\u1ea1n nh\u01b0 gi\u00e3n d\u00e2y ch\u1eb1ng v\u00e0 nhuy\u1ec5n s\u1ee5n, kh\u00f4ng d\u1ec5 th\u1ea5y r\u00f5 tr\u00ean c\u00e1c ph\u01b0\u01a1ng th\u1ee9c h\u00ecnh \u1ea3nh kh\u00e1c. Nhi\u1ec1u b\u00e1c s\u0129 ph\u1eabu thu\u1eadt coi \u0111\u00e2y l\u00e0 ti\u00eau chu\u1ea9n v\u00e0ng trong ch\u1ea9n \u0111o\u00e1n m\u1ea5t v\u1eefng kh\u1edbp c\u1ed5 tay, \u0111\u1eb7c bi\u1ec7t v\u00ec n\u00f3 c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n r\u00e1ch ri\u00eang l\u1ebb c\u1ee7a c\u00e1c d\u00e2y ch\u1eb1ng n\u1ed9i t\u1ea1i v\u00e0 cho th\u1ea5y c\u00e1c thay \u0111\u1ed5i tho\u00e1i h\u00f3a kh\u1edbp. N\u1ed9i soi kh\u1edbp c\u1ed5 tay c\u0169ng cho ph\u00e9p \u0111i\u1ec1u tr\u1ecb b\u1ec7nh l\u00fd trong qu\u00e1 tr\u00ecnh can thi\u1ec7p. Nh\u01b0\u1ee3c \u0111i\u1ec3m c\u1ee7a n\u00f3 l\u00e0 r\u1ee7i ro ph\u1eabu thu\u1eadt, nhu c\u1ea7u g\u00e2y t\u00ea v\u00f9ng ho\u1eb7c g\u00e2y m\u00ea to\u00e0n th\u00e2n c\u0169ng nh\u01b0 chi ph\u00ed.<\/span><\/p>\n H\u1ea1n ch\u1ebf ch\u00ednh c\u1ee7a n\u1ed9i soi kh\u1edbp l\u00e0 kh\u00f4ng ph\u1ea3i t\u1ea5t c\u1ea3 c\u00e1c b\u1ea5t th\u01b0\u1eddng \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh b\u1eb1ng n\u1ed9i soi kh\u1edbp nh\u1ea5t thi\u1ebft l\u00e0 b\u1ec7nh l\u00fd ho\u1eb7c ch\u1ecbu tr\u00e1ch nhi\u1ec7m cho c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh nh\u00e2n. Vi\u1ec7c \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb c\u0169ng kh\u00f3 kh\u0103n v\u00ec \u0111i\u1ec1u tr\u1ecb c\u00e1c t\u1ed5n th\u01b0\u01a1ng \u0111\u1ed3ng th\u1eddi c\u00f3 th\u1ec3 ch\u1ecbu tr\u00e1ch nhi\u1ec7m cho s\u1ef1 thay \u0111\u1ed5i c\u1ee7a c\u00e1c tri\u1ec7u ch\u1ee9ng. Tuy nhi\u00ean, nhi\u1ec1u nghi\u00ean c\u1ee9u \u0111\u00e3 ch\u1ee9ng minh n\u1ed9i soi kh\u1edbp c\u1ed5 tay l\u00e0 an to\u00e0n, \u0111\u00e1ng tin c\u1eady v\u1edbi t\u00e1c \u0111\u1ed9ng thu\u1eadn l\u1ee3i l\u00ean k\u1ebft qu\u1ea3, \u0111\u1eb7c bi\u1ec7t l\u00e0 trong vi\u1ec7c gi\u1ea3m \u0111au c\u1ed5 tay.<\/span>When initial management fails, we usually proceed to perform wrist arthroscopy under general or regional anesthesia. Wrist arthroscopy has progressed from a newly described technique since the 1970s to become an essential diagnostic and therapeutic tool in the armamentarium of every surgeon treating various wrist disorders. It is useful in defining the patterns, combinations and extent of soft tissue injuries which are often more extensive than clinically suspected. In treating patients with chronic wrist pain recalcitrant to conservative treatment with wrist arthroscopy, we found many patients having concomitant intercarpal ligament (scapholunate & lunotriquetral ligament) injuries as well as triangular fibrocartilage complex (TFCC) injuries. Other findings included synovitis and chondral lesions such as lunate chondromalacia. It is not uncommon to find double or triple pathologies.<\/span><\/p>\n Many procedures can be performed arthroscopically such as synovectomy, radiofrequency ablation, debridement of any chondral defects, repair of peripheral TFCC tears and even limited fusion. Postoperatively the wrist was placed in a brace or splint for 6 weeks and started on occupational therapy for range of motion and grip-strengthening exercises.<\/span><\/p>\n Wrist arthroscopy has a valuable role in the treatment of chronic wrist pain. It allows direct visualization of the wrist joint and therefore identification of multiple partial injuries in the wrist, such as ligament attenuations and chondromalacia, not readily apparent on other imaging modalities. Many surgeons regard it as the gold standard investigation in the diagnosis of carpal instability, especially as it can detect isolated tears of intrinsic ligaments and demonstrate degenerative joint changes. Wrist arthroscopy also enables one to treat the pathology during the intervention. Its disadvantages are the surgical risks, the need for regional or general anesthesia as well as its costs.<\/span><\/p>\n The main limitation of arthroscopy is that not all abnormalities identified by arthroscopy are necessarily pathologic or responsible for the patient\u2019s symptoms. Evaluation of the results of treatment is also difficult because treatment of coexistent injuries may be responsible for the alteration of symptoms. However, many studies have proven wrist arthroscopy to be a safe, reliable with a favorable impact upon the outcomes, especially in relieving wrist pain. <\/span><\/p>\n","protected":false},"excerpt":{"rendered":" Vai tr\u00f2 c\u1ee7a n\u1ed9i soi kh\u1edbp c\u1ed5 tay \u0111\u1ed1i v\u1edbi ch\u1ee9ng \u0111au c\u1ed5 tay B\u1ec7nh nh\u00e2n ph\u00e0n n\u00e0n v\u1ec1 \u0111au c\u1ed5 tay th\u01b0\u1eddng m\u00f4 t\u1ea3 c\u01a1n \u0111au c\u1ea3n tr\u1edf c\u00e1c ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y, c\u00f4ng vi\u1ec7c ho\u1eb7c th\u1ec3 thao c\u1ee7a h\u1ecd. M\u1ed9t s\u1ed1 c\u00f3 th\u1ec3 b\u00e1o c\u00e1o ti\u1ec1n s\u1eed ch\u1ea5n th\u01b0\u01a1ng c\u1ed5 tay c\u1ee5 th\u1ec3, […]<\/p>\n","protected":false},"author":3,"featured_media":930,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_seopress_titles_title":"","_seopress_titles_desc":"\u0110au c\u1ed5 tay? 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L\u1eddi khuy\u00ean chuy\u00ean gia t\u1eeb b\u00e1c s\u0129 chuy\u00ean khoa tay t\u1ea1i Singapore v\u1ec1 c\u00e1c l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb v\u00e0 ph\u1ee5c h\u1ed3i.","_seopress_robots_index":"","_seopress_robots_follow":"","_seopress_robots_imageindex":"","_seopress_robots_snippet":"","_seopress_robots_primary_cat":"none","_seopress_robots_breadcrumbs":"","_seopress_robots_freeze_modified_date":"","_seopress_robots_custom_modified_date":"","_seopress_robots_canonical":"","_seopress_social_fb_title":"","_seopress_social_fb_desc":"","_seopress_social_fb_img":"","_seopress_social_fb_img_attachment_id":0,"_seopress_social_fb_img_width":0,"_seopress_social_fb_img_height":0,"_seopress_social_twitter_title":"","_seopress_social_twitter_desc":"","_seopress_social_twitter_img":"","_seopress_social_twitter_img_attachment_id":0,"_seopress_social_twitter_img_width":0,"_seopress_social_twitter_img_height":0,"_seopress_redirections_value":"","_seopress_redirections_enabled":"","_seopress_redirections_enabled_regex":"","_seopress_redirections_logged_status":"both","_seopress_redirections_param":"","_seopress_redirections_type":301,"_seopress_analysis_target_kw":"","inline_featured_image":false,"footnotes":""},"categories":[83],"tags":[],"class_list":["post-8854","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-wrist-specialist-singapore"],"acf":[],"_links":{"self":[{"href":"https:\/\/advancedhand-stg.sgestaging.com\/vi\/wp-json\/wp\/v2\/posts\/8854","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/advancedhand-stg.sgestaging.com\/vi\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/advancedhand-stg.sgestaging.com\/vi\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/advancedhand-stg.sgestaging.com\/vi\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/advancedhand-stg.sgestaging.com\/vi\/wp-json\/wp\/v2\/comments?post=8854"}],"version-history":[{"count":2,"href":"https:\/\/advancedhand-stg.sgestaging.com\/vi\/wp-json\/wp\/v2\/posts\/8854\/revisions"}],"predecessor-version":[{"id":9503,"href":"https:\/\/advancedhand-stg.sgestaging.com\/vi\/wp-json\/wp\/v2\/posts\/8854\/revisions\/9503"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/advancedhand-stg.sgestaging.com\/vi\/wp-json\/wp\/v2\/media\/930"}],"wp:attachment":[{"href":"https:\/\/advancedhand-stg.sgestaging.com\/vi\/wp-json\/wp\/v2\/media?parent=8854"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/advancedhand-stg.sgestaging.com\/vi\/wp-json\/wp\/v2\/categories?post=8854"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/advancedhand-stg.sgestaging.com\/vi\/wp-json\/wp\/v2\/tags?post=8854"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}