{"id":1268,"date":"2026-01-17T12:00:54","date_gmt":"2026-01-17T05:00:54","guid":{"rendered":"https:\/\/cdha.edu.vn\/cdha\/?p=1268"},"modified":"2026-01-17T17:04:06","modified_gmt":"2026-01-17T10:04:06","slug":"sieu-am-ngon-tay-giai-phau-va-benh-ly","status":"publish","type":"post","link":"https:\/\/cdha.edu.vn\/cdha\/sieu-am-ngon-tay-giai-phau-va-benh-ly\/","title":{"rendered":"Si\u00eau \u00e2m ng\u00f3n tay: gi\u1ea3i ph\u1eabu v\u00e0 b\u1ec7nh l\u00fd"},"content":{"rendered":"\n<h3 class=\"wp-block-heading\">T\u00f3m t\u1eaft<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">S\u1ef1 ph\u00e1t tri\u1ec3n v\u00e0 c\u1ea3i ti\u1ebfn c\u1ee7a c\u00e1c \u0111\u1ea7u d\u00f2 t\u1ea7n s\u1ed1 cao trong c\u00e1c h\u1ec7 th\u1ed1ng si\u00eau \u00e2m hi\u1ec7n nay \u0111\u00e3 cho ph\u00e9p ch\u00fang ta thu \u0111\u01b0\u1ee3c th\u00f4ng tin chi ti\u1ebft h\u01a1n v\u1ec1 c\u00e1c c\u1ea5u tr\u00fac nh\u1ecf v\u00e0 n\u00f4ng, ch\u1eb3ng h\u1ea1n nh\u01b0 c\u00e1c ng\u00f3n tay, v\u1ed1n l\u00e0 v\u1ecb tr\u00ed th\u01b0\u1eddng xuy\u00ean b\u1ecb t\u1ed5n th\u01b0\u01a1ng \u1edf m\u1ed9t b\u1ed9 ph\u1eadn l\u1edbn d\u00e2n s\u1ed1 (ch\u1ea5n th\u01b0\u01a1ng do sang ch\u1ea5n chi\u1ebfm 28% c\u00e1c ch\u1ea5n th\u01b0\u01a1ng h\u1ec7 c\u01a1 x\u01b0\u01a1ng kh\u1edbp) v\u00e0 c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u00e0n t\u1eadt \u0111\u00e1ng k\u1ec3 cho ng\u01b0\u1eddi b\u1ec7nh. Nh\u1edd kh\u1ea3 n\u0103ng ti\u1ebfp c\u1eadn v\u01b0\u1ee3t tr\u1ed9i, \u0111\u1ed9 ph\u00e2n gi\u1ea3i cao v\u00e0 kh\u1ea3 n\u0103ng th\u1ef1c hi\u1ec7n c\u00e1c kh\u1ea3o s\u00e1t \u0111\u1ed9ng, si\u00eau \u00e2m \u0111\u00e3 tr\u1edf th\u00e0nh k\u1ef9 thu\u1eadt ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh \u0111\u01b0\u1ee3c \u01b0u ti\u00ean l\u1ef1a ch\u1ecdn \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 c\u00e1c t\u00ecnh tr\u1ea1ng n\u00e0y. K\u1ef9 thu\u1eadt n\u00e0y bao qu\u00e1t m\u1ed9t lo\u1ea1t c\u00e1c b\u1ec7nh l\u00fd, bao g\u1ed3m t\u1ed5n th\u01b0\u01a1ng g\u00e2n, d\u00e2y ch\u1eb1ng v\u00e0 kh\u1edbp, c\u0169ng nh\u01b0 c\u00e1c kh\u1ed1i u v\u00e0 gi\u1ea3 u m\u00f4 m\u1ec1m, nh\u1eefng n\u1ed9i dung n\u00e0y s\u1ebd \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 chi ti\u1ebft trong ph\u1ea7n ch\u00ednh c\u1ee7a b\u00e0i vi\u1ebft. Tuy nhi\u00ean, do s\u1ef1 ph\u1ee9c t\u1ea1p v\u00e0 k\u00edch th\u01b0\u1edbc nh\u1ecf c\u1ee7a c\u00e1c c\u1ea5u tr\u00fac n\u00e0y, c\u00f9ng v\u1edbi s\u1ef1 c\u1ea7n thi\u1ebft ph\u1ea3i ch\u1ea9n \u0111o\u00e1n s\u1edbm \u0111\u1ec3 c\u00f3 th\u1ec3 can thi\u1ec7p ph\u1eabu thu\u1eadt v\u00e0 gi\u1ea3m thi\u1ec3u s\u1ef1 suy gi\u1ea3m ch\u1ee9c n\u0103ng, vi\u1ec7c n\u1eafm v\u1eefng gi\u1ea3i ph\u1eabu, k\u1ef9 thu\u1eadt th\u0103m kh\u00e1m v\u00e0 c\u00e1c b\u1ec7nh l\u00fd c\u01a1 b\u1ea3n c\u1ee7a ng\u00f3n tay l\u00e0 v\u00f4 c\u00f9ng thi\u1ebft y\u1ebfu \u0111\u1ec3 th\u1ef1c hi\u1ec7n \u0111\u00e1nh gi\u00e1 k\u1ef9 l\u01b0\u1ee1ng v\u00e0 \u0111\u1ea1t \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c. Do \u0111\u00f3, m\u1ee5c ti\u00eau ch\u00ednh c\u1ee7a b\u00e0i vi\u1ebft n\u00e0y l\u00e0 tr\u00ecnh b\u00e0y c\u00e1c n\u1ed9i dung tr\u00ean m\u1ed9t c\u00e1ch th\u1ef1c t\u1ebf v\u00e0 tr\u1ef1c quan, gi\u00fap t\u00e0i li\u1ec7u n\u00e0y h\u1eefu \u00edch kh\u00f4ng ch\u1ec9 cho c\u00e1c b\u00e1c s\u0129 ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh m\u00e0 c\u00f2n cho c\u00e1c b\u00e1c s\u0129 chuy\u00ean khoa kh\u00e1c, v\u00ec si\u00eau \u00e2m l\u00e0 ph\u01b0\u01a1ng ph\u00e1p h\u00ecnh \u1ea3nh \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ed5 bi\u1ebfn nh\u1ea5t ngo\u00e0i chuy\u00ean ng\u00e0nh ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Gi\u1edbi thi\u1ec7u<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Si\u00eau \u00e2m (US) l\u00e0 m\u1ed9t trong nh\u1eefng k\u1ef9 thu\u1eadt ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i nh\u1ea5t tr\u00ean to\u00e0n th\u1ebf gi\u1edbi. K\u1ec3 t\u1eeb ngu\u1ed3n g\u1ed1c c\u1ee7a n\u00f3, sau s\u1ef1 ph\u00e1t hi\u1ec7n ra s\u00f3ng si\u00eau \u00e2m v\u00e0o n\u0103m 1974 b\u1edfi nh\u00e0 sinh h\u1ecdc ng\u01b0\u1eddi \u00dd Lazzaro Spallanzani trong khi nghi\u00ean c\u1ee9u s\u1ef1 bay c\u1ee7a lo\u00e0i d\u01a1i, qua s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a sonar trong Chi\u1ebfn tranh Th\u1ebf gi\u1edbi th\u1ee9 hai, v\u00e0 cho \u0111\u1ebfn vi\u1ec7c \u00e1p d\u1ee5ng si\u00eau \u00e2m v\u00e0o ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh y khoa v\u00e0o cu\u1ed1i th\u1ebf k\u1ef7 20 nh\u01b0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p kh\u1ea3 thi \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb, si\u00eau \u00e2m \u0111\u00e3 tr\u1ea3i qua s\u1ef1 ti\u1ebfn h\u00f3a v\u00e0 ph\u00e1t tri\u1ec3n li\u00ean t\u1ee5c.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">B\u1eaft \u0111\u1ea7u t\u1eeb nh\u1eefng n\u0103m 1990, v\u1edbi nh\u1eefng ti\u1ebfn b\u1ed9 v\u1ec1 c\u00f4ng ngh\u1ec7, to\u00e0n b\u1ed9 quy tr\u00ecnh \u0111\u00e3 tr\u1edf n\u00ean k\u1ef9 thu\u1eadt s\u1ed1 h\u00f3a, cho ph\u00e9p hi\u1ec3n th\u1ecb h\u00ecnh \u1ea3nh tr\u00ean m\u00e0n h\u00ecnh. Sau c\u1ed9t m\u1ed1c n\u00e0y, thi\u1ebft b\u1ecb v\u00e0 \u0111\u1ea7u d\u00f2 \u0111\u00e3 \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n \u0111\u00e1ng k\u1ec3 v\u1ec1 ch\u1ea5t l\u01b0\u1ee3ng h\u00ecnh \u1ea3nh, gi\u1ea3m chi ph\u00ed v\u00e0 tr\u1edf n\u00ean d\u1ec5 d\u00e0ng thao t\u00e1c h\u01a1n nhi\u1ec1u, khi\u1ebfn si\u00eau \u00e2m tr\u1edf th\u00e0nh ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nhi\u1ec1u nh\u1ea5t ngo\u00e0i chuy\u00ean ng\u00e0nh ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh, ch\u1eb3ng h\u1ea1n nh\u01b0 trong l\u0129nh v\u1ef1c g\u00e2y t\u00ea v\u00f9ng.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Hi\u1ec7n nay, ch\u00fang ta c\u00f3 c\u00e1c \u0111\u1ea7u d\u00f2 t\u1ea7n s\u1ed1 cao cho ph\u00e9p thu \u0111\u01b0\u1ee3c th\u00f4ng tin chi ti\u1ebft h\u01a1n v\u1ec1 c\u00e1c c\u1ea5u tr\u00fac nh\u1ecf v\u00e0 n\u00f4ng, ch\u1eb3ng h\u1ea1n nh\u01b0 c\u00e1c ng\u00f3n tay.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">C\u00e1c ng\u00f3n tay l\u00e0 m\u1ed9t trong nh\u1eefng b\u1ed9 ph\u1eadn tham gia nhi\u1ec1u nh\u1ea5t c\u1ee7a c\u01a1 th\u1ec3 con ng\u01b0\u1eddi trong s\u1ef1 t\u01b0\u01a1ng t\u00e1c v\u1edbi m\u00f4i tr\u01b0\u1eddng, c\u0169ng nh\u01b0 trong vi\u1ec7c th\u1ef1c hi\u1ec7n c\u00e1c ho\u1ea1t \u0111\u1ed9ng sinh ho\u1ea1t h\u00e0ng ng\u00e0y. Do v\u1ecb tr\u00ed v\u00e0 ch\u1ee9c n\u0103ng c\u1ee7a ch\u00fang, c\u00e1c ng\u00f3n tay r\u1ea5t nh\u1ea1y c\u1ea3m v\u1edbi nhi\u1ec1u b\u1ec7nh l\u00fd kh\u00e1c nhau do c\u00e1c ho\u1ea1t \u0111\u1ed9ng gi\u1ea3i tr\u00ed v\u00e0 ngh\u1ec1 nghi\u1ec7p li\u00ean quan \u0111\u1ebfn s\u1ee9c m\u1ea1nh v\u00e0 c\u00e1c chuy\u1ec3n \u0111\u1ed9ng l\u1eb7p \u0111i l\u1eb7p l\u1ea1i, c\u0169ng nh\u01b0 c\u00e1c ch\u1ea5n th\u01b0\u01a1ng, v\u1ed1n chi\u1ebfm 28% c\u00e1c ch\u1ea5n th\u01b0\u01a1ng h\u1ec7 c\u01a1 x\u01b0\u01a1ng kh\u1edbp. Nh\u1eefng b\u1ec7nh l\u00fd n\u00e0y s\u1ebd l\u00e0m suy gi\u1ea3m ch\u1ee9c n\u0103ng \u0111\u00e1ng k\u1ec3, khi\u1ebfn vi\u1ec7c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb tr\u1edf n\u00ean r\u1ea5t quan tr\u1ecdng.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Si\u00eau \u00e2m, nh\u1edd v\u00e0o t\u00ednh s\u1eb5n c\u00f3, kh\u1ea3 n\u0103ng cung c\u1ea5p th\u00f4ng tin chi ti\u1ebft v\u00e0 kh\u1ea3 n\u0103ng th\u1ef1c hi\u1ec7n c\u00e1c kh\u1ea3o s\u00e1t \u0111\u1ed9ng, cho ph\u00e9p ch\u00fang ta x\u00fac ti\u1ebfn vi\u1ec7c ch\u1ea9n \u0111o\u00e1n c\u00e1c b\u1ec7nh l\u00fd n\u00e0y. Tuy nhi\u00ean, s\u1ef1 th\u00e0nh c\u00f4ng c\u1ee7a ch\u1ea9n \u0111o\u00e1n ph\u1ee5 thu\u1ed9c ph\u1ea7n l\u1edbn v\u00e0o kinh nghi\u1ec7m c\u1ee7a ng\u01b0\u1eddi th\u1ef1c hi\u1ec7n. Do \u0111\u00f3, m\u1ee5c \u0111\u00edch c\u1ee7a b\u00e0i vi\u1ebft n\u00e0y l\u00e0 gi\u00fap ng\u01b0\u1eddi \u0111\u1ecdc l\u00e0m quen v\u1edbi gi\u1ea3i ph\u1eabu si\u00eau \u00e2m b\u00ecnh th\u01b0\u1eddng c\u1ee7a c\u00e1c ng\u00f3n tay, \u0111\u01b0a ra m\u1ed9t s\u1ed1 m\u1eb9o \u0111\u1ec3 th\u1ef1c hi\u1ec7n si\u00eau \u00e2m v\u00e0 xem x\u00e9t c\u00e1c b\u1ec7nh l\u00fd ph\u1ed5 bi\u1ebfn nh\u1ea5t.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Tuy nhi\u00ean, c\u1ea7n l\u01b0u \u00fd r\u1eb1ng vi\u1ec7c ti\u1ebfp x\u00fac v\u1edbi si\u00eau \u00e2m t\u1ea7n s\u1ed1 cao kh\u00f4ng ph\u1ea3i l\u00e0 kh\u00f4ng c\u00f3 r\u1ee7i ro. M\u1eb7c d\u00f9 c\u00f3 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb d\u1ef1a tr\u00ean c\u00e1c hi\u1ec7u \u1ee9ng sinh h\u1ecdc m\u00e0 ch\u00fang t\u1ea1o ra tr\u00ean c\u00e1c ch\u1ec9 s\u1ed1 c\u01a1 h\u1ecdc v\u00e0 nhi\u1ec7t c\u1ee7a m\u00f4, nh\u01b0ng trong ph\u1ea1m vi t\u1ea7n s\u1ed1 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng cho m\u1ee5c \u0111\u00edch ch\u1ea9n \u0111o\u00e1n, y v\u0103n ch\u1ec9 m\u1edbi m\u00f4 t\u1ea3 c\u00e1c r\u1ee7i ro li\u00ean quan \u0111\u1ebfn vi\u1ec7c ti\u1ebfp x\u00fac trong qu\u00e1 tr\u00ecnh si\u00eau \u00e2m thai k\u1ef3 tam c\u00e1 nguy\u1ec7t th\u1ee9 nh\u1ea5t.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>K\u1ef9 thu\u1eadt si\u00eau \u00e2m<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">C\u00e1c h\u00ecnh \u1ea3nh trong b\u00e0i vi\u1ebft n\u00e0y \u0111\u01b0\u1ee3c thu th\u1eadp t\u1eeb c\u00e1c b\u1ec7nh nh\u00e2n t\u1ea1i trung t\u00e2m c\u1ee7a ch\u00fang t\u00f4i v\u00e0 nh\u1eefng ng\u01b0\u1eddi t\u00ecnh nguy\u1ec7n kh\u1ecfe m\u1ea1nh, s\u1eed d\u1ee5ng m\u00e1y si\u00eau \u00e2m cao c\u1ea5p v\u00e0 c\u00e1c \u0111\u1ea7u d\u00f2 linear t\u1ea7n s\u1ed1 cao (15\u201318 MHz), bao g\u1ed3m c\u1ea3 d\u1ea1ng linear c\u01a1 b\u1ea3n v\u00e0 \u0111\u1ea7u d\u00f2 d\u1ea1ng que (stick probes).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c b\u1ed1 tr\u00ed ng\u1ed3i \u0111\u1ed1i di\u1ec7n v\u1edbi b\u00e1c s\u0129 ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh, v\u1edbi b\u00e0n tay \u0111\u1eb7t tr\u00ean b\u00e0n kh\u00e1m \u1edf t\u01b0 th\u1ebf ph\u00f9 h\u1ee3p \u0111\u1ec3 thu \u0111\u01b0\u1ee3c h\u00ecnh \u1ea3nh c\u1ee7a v\u00f9ng quan t\u00e2m tr\u00ean c\u1ea3 hai m\u1eb7t c\u1eaft ngang v\u00e0 d\u1ecdc.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u0110i\u1ec1u quan tr\u1ecdng c\u1ea7n nh\u1edb l\u00e0 lu\u00f4n b\u00f4i m\u1ed9t l\u01b0\u1ee3ng gel d\u1ed3i d\u00e0o l\u00ean c\u00e1c c\u1ea5u tr\u00fac n\u00f4ng v\u00e0 nh\u1ecf \u0111\u1ec3 quan s\u00e1t t\u1ed1i \u01b0u.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">V\u1ec1 kh\u1ea3o s\u00e1t \u0111\u1ed9ng, c\u00e1c h\u01b0\u1edbng d\u1eabn c\u1ee5 th\u1ec3 s\u1ebd \u0111\u01b0\u1ee3c cung c\u1ea5p trong ph\u1ea7n th\u0103m kh\u00e1m b\u1ec7nh l\u00fd.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>V\u00f9ng du\u1ed7i<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Gi\u1ea3i ph\u1eabu b\u00ecnh th\u01b0\u1eddng<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">C\u01a1 ch\u1ebf du\u1ed7i c\u1ee7a c\u00e1c ng\u00f3n tay bao g\u1ed3m c\u00e1c v\u00f9ng t\u1eeb I \u0111\u1ebfn V theo ph\u00e2n lo\u1ea1i v\u00f9ng Verdan (H\u00ecnh 1, 2) v\u00e0 c\u00f3 c\u1ea5u tr\u00fac gi\u1ea3i ph\u1eabu ph\u1ee9c t\u1ea1p. Ch\u1ee9c n\u0103ng th\u00edch h\u1ee3p c\u1ee7a n\u00f3 ph\u1ee5 thu\u1ed9c v\u00e0o ho\u1ea1t \u0111\u1ed9ng ph\u1ed1i h\u1ee3p gi\u1eefa c\u00e1c c\u01a1 n\u1ed9i t\u1ea1i c\u1ee7a b\u00e0n tay (c\u01a1 gian c\u1ed1t v\u00e0 c\u01a1 giun) v\u00e0 c\u00e1c g\u00e2n du\u1ed7i.<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large is-resized\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczOLq-Fzr2Kj0zF380RCN4hQRwreCT9N54xtPjd_NHeqerGucoBwNrcwK9jnF5L9F3diaRe8dz7yphk0tNu5A3Og-XXBRwKmTJYSEdiOcVbSBUBR3ubRW7gu0wL4Ray_o2vggP66P4F716-MudisJDhZ=w538-h647-s-no-gm\" alt=\"\" style=\"aspect-ratio:0.8315449256625728;width:355px;height:auto\"\/><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\"><em>H\u00ecnh 1. S\u01a1 \u0111\u1ed3 c\u00e1c v\u00f9ng Verdan \u1edf v\u00f9ng mu b\u00e0n tay v\u00e0 c\u00e1c ng\u00f3n tay. V\u00f9ng I, c\u00e1c kh\u1edbp li\u00ean \u0111\u1ed1t xa; V\u00f9ng II, \u0111\u1ed1t gi\u1eefa; V\u00f9ng III, c\u00e1c kh\u1edbp li\u00ean \u0111\u1ed1t g\u1ea7n; V\u00f9ng IV, \u0111\u1ed1t g\u1ea7n; V\u00f9ng V, c\u00e1c kh\u1edbp b\u00e0n ng\u00f3n; V\u00f9ng VI, v\u00f9ng mu x\u01b0\u01a1ng b\u00e0n tay; V\u00f9ng VII, m\u1ea1c gi\u1eef g\u00e2n du\u1ed7i; V\u00f9ng VIII\/IX, ch\u1ed7 n\u1ed1i g\u00e2n &#8211; c\u01a1 v\u00e0 c\u00e1c m\u1eb7t ph\u1eb3ng c\u01a1.<\/em><\/p>\n\n\n\n<div class=\"wp-block-media-text is-stacked-on-mobile\" style=\"grid-template-columns:35% auto\"><figure class=\"wp-block-media-text__media\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczPzzrg3wNAreK880J-LZopx4FGRahhuFGHJNkaylonn1Xsts-NAmDlFtLFdFYXdNnLCc5WZPSSuKoWlOb760122TutkYOHkN49K-yq3BER1-6_YohlvzR38VBNv0nfM1RDLun7JtjXgrasnHU8W9oyN=w303-h913-s-no-gm\" alt=\"\"\/><\/figure><div class=\"wp-block-media-text__content\">\n<p class=\"wp-block-paragraph\"><em>H\u00ecnh 2. S\u01a1 \u0111\u1ed3 b\u1ed9 m\u00e1y du\u1ed7i c\u1ee7a c\u00e1c ng\u00f3n tay. 1, g\u00e2n t\u1eadn v\u00e0 d\u00e2y ch\u1eb1ng tam gi\u00e1c (m\u00e0u h\u1ed3ng); 2, d\u1ea3i trung t\u00e2m; 3, c\u00e1c d\u1ea3i b\u00ean; 4, tr\u1ebd g\u00e2n du\u1ed7i v\u1edbi c\u00e1c <strong>s\u1ee3i ngang<\/strong> c\u1ee7a n\u00f3; 5, g\u00e2n du\u1ed7i chung.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">G\u00e2n du\u1ed7i \u0111\u01b0\u1ee3c h\u00ecnh th\u00e0nh b\u1edfi m\u1ed9t d\u1ea3i trung t\u00e2m ch\u1ea1y d\u1ecdc theo m\u1eb7t mu c\u1ee7a c\u00e1c \u0111\u1ed1t ng\u00f3n tay v\u00e0 b\u00e1m t\u1eadn \u1edf ph\u00eda xa t\u1ea1i n\u1ec1n \u0111\u1ed1t gi\u1eefa <em>(MP &#8211; Middle Phalanges)<\/em> \u0111\u1ec3 l\u00e0m du\u1ed7i kh\u1edbp li\u00ean \u0111\u1ed1t g\u1ea7n <em>(PIP &#8211; Proximal interphalangeal joint)<\/em>, nh\u01b0ng c\u1ea7n c\u00f3 c\u00e1c th\u00e0nh ph\u1ea7n kh\u00e1c \u0111\u1ec3 \u1ed5n \u0111\u1ecbnh g\u00e2n v\u00e0 \u0111\u1ea1t \u0111\u01b0\u1ee3c s\u1ef1 du\u1ed7i c\u1ee7a kh\u1edbp li\u00ean \u0111\u1ed1t xa<em> (DIP &#8211; Distal interphalangeal joint)<\/em>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">T\u1ea1i m\u1ee9c kh\u1edbp b\u00e0n ng\u00f3n <em>(MCP &#8211; Metacarpophalangeal joint)<\/em>, c\u00e1c g\u00e2n du\u1ed7i \u0111\u01b0\u1ee3c \u1ed5n \u0111\u1ecbnh b\u1edfi <strong>tr\u1ebd g\u00e2n du\u1ed7i<\/strong>, m\u1ed9t c\u1ea5u tr\u00fac m\u1edf r\u1ed9ng h\u00ecnh tam gi\u00e1c d\u1ea1ng s\u1ee3i n\u1eb1m \u1edf m\u1eb7t mu c\u1ee7a \u0111\u1ed1t g\u1ea7n (PP), nh\u1eadn c\u00e1c s\u1ee3i t\u1eeb c\u00e1c c\u01a1 n\u1ed9i t\u1ea1i v\u00e0 h\u00f2a nh\u1eadp v\u1edbi c\u00e1c g\u00e2n du\u1ed7i. Th\u00e0nh ph\u1ea7n ch\u00ednh c\u1ee7a n\u00f3 l\u00e0 <strong>c\u00e1c s\u1ee3i ngang<\/strong><sup data-fn=\"8e09d101-226a-4a67-b3d8-cc9ce94e243b\" class=\"fn\"><a href=\"#8e09d101-226a-4a67-b3d8-cc9ce94e243b\" id=\"8e09d101-226a-4a67-b3d8-cc9ce94e243b-link\">1<\/a><\/sup>, l\u00e0 c\u00e1c d\u1ea3i s\u1ee3i b\u1eaft \u0111\u1ea7u t\u1eeb <strong>t\u1ea5m gan tay<\/strong> (volar plate)<sup data-fn=\"f0ab5e2c-d79f-4a43-907f-16172d2f3e76\" class=\"fn\"><a href=\"#f0ab5e2c-d79f-4a43-907f-16172d2f3e76\" id=\"f0ab5e2c-d79f-4a43-907f-16172d2f3e76-link\">2<\/a><\/sup> v\u00e0 b\u00e1m v\u00e0o g\u00e2n du\u1ed7i.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Tr\u00ean si\u00eau \u00e2m, <strong>tr\u1ebd g\u00e2n du\u1ed7i<\/strong> bi\u1ec3u hi\u1ec7n nh\u01b0 m\u1ed9t c\u1ea5u tr\u00fac s\u1ee3i m\u1ecfng t\u0103ng \u00e2m (2 mm) bao ph\u1ee7 b\u1ec1 m\u1eb7t mu c\u1ee7a ng\u00f3n tay (10). Tr\u00ean m\u1eb7t c\u1eaft d\u1ecdc, ch\u1ec9 quan s\u00e1t th\u1ea5y m\u1ed9t d\u1ea3i t\u0103ng \u00e2m d\u1ea1ng \u0111\u01b0\u1eddng th\u1eb3ng song song v\u1edbi ng\u00f3n tay, trong khi tr\u00ean m\u1eb7t c\u1eaft ngang, c\u00f3 th\u1ec3 th\u1ea5y h\u00ecnh \u1ea3nh &#8220;chim h\u1ea3i \u00e2u&#8221; \u0111i\u1ec3n h\u00ecnh, trong \u0111\u00f3 g\u00e2n du\u1ed7i t\u1ea1o th\u00e0nh th\u00e2n c\u1ee7a chim h\u1ea3i \u00e2u v\u00e0 <strong>c\u00e1c s\u1ee3i ngang<\/strong> l\u00e0 \u0111\u00f4i c\u00e1nh, \u0111\u01b0\u1ee3c hi\u1ec3n th\u1ecb nh\u01b0 c\u00e1c ph\u1ea7n m\u1edf r\u1ed9ng d\u1eb9t t\u0103ng \u00e2m \u1edf c\u1ea3 hai b\u00ean c\u1ee7a g\u00e2n du\u1ed7i (H\u00ecnh 3).<\/p>\n<\/div><\/div>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczPUinJ5U-B2_qHgDOrXARhGIppE7dq9R6m05GqJ2X31iGhdnys6VoBzzDU22Z0K__vN5847Y_G3jLCmcns_C8hdkXiiFerZ3vJH_XqlkNdUUypzh0DIvR5IjixyYS67wyFy94v7UXsQjvgfeBZl-UWS=w1709-h585-s-no-gm\" alt=\"\"\/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><em>H\u00ecnh 3. H\u00ecnh \u1ea3nh si\u00eau \u00e2m m\u1eb7t c\u1eaft ngang c\u1ee7a gi\u1ea3i ph\u1eabu <strong>tr\u1ebd g\u00e2n du\u1ed7i<\/strong> (xem th\u00eam h\u00ecnh atlas b\u00ean d\u01b0\u1edbi). (A) Kh\u00f4ng ch\u00fa th\u00edch. (B) C\u00f3 ch\u00fa th\u00edch: m\u00e0u t\u00edm: g\u00e2n du\u1ed7i; m\u00e0u \u0111\u1ecf: c\u00e1c s\u1ee3i ngang; m\u00e0u cam: l\u1edbp m\u1ee1; m\u00e0u xanh l\u00e1: bao kh\u1edbp m\u1eb7t mu; m\u00e0u tr\u1eafng: s\u1ee5n; m\u00e0u v\u00e0ng: v\u1ecf x\u01b0\u01a1ng.<\/em><\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczNM_Ig_Id3iwZiX_wUp56IK24XHSCNWrgG3KtzSL8tMTTUFqtBrEZplC_YQDLuA3_08t-nBYo9G4Rzdc7uoFZw3h-J_sJw0WxUlI1WWj6KTO86cYPnQXstPtDdz18uKQwVx4PCPjxjxVrcorWw2EQE5=w1349-h529-s-no-gm\" alt=\"\"\/><\/figure>\n<\/div>\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczNDx7ULeo3eGfSfpa9qJ1O_68lai8Tim9swF0EdBHHACFZUdPSpmnjKaG8L3fWhM2P4vT6DEDLECA9u0pqP9bvrBMpxIiOUAOxttfRjMO3iLTo6q3DAE-Qbl0XH-R_yrHC4s9bpAHoxkfLRUnBIne1y=w960-h334-s-no-gm\" alt=\"\"\/><\/figure>\n<\/div>\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large is-resized\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczNwwSCf0DU2EepmlW_D1BoYBKWBNBFvhLPUMXHE6irEE6DFTLryGSKyX449Ukn1XKT8qZyL70D4AzwBXQru_F1jKs91NRtHkkQ4ptGfR3neG3udW6XQP2gjlmAzR5KaDF1dkGEfUKTEx0hTC-pRZJ3N=w849-h750-s-no-gm\" alt=\"\" style=\"aspect-ratio:1.1320277953253317;width:614px;height:auto\"\/><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\">\u1ede ph\u00eda xa so v\u1edbi c\u00e1c <strong>s\u1ee3i ngang<\/strong>, c\u00e1c g\u00e2n du\u1ed7i ti\u1ebfp t\u1ee5c chia th\u00e0nh ba ph\u1ea7n: <strong>d\u1ea3i trung t\u00e2m<\/strong> \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 tr\u01b0\u1edbc \u0111\u00f3 v\u00e0 hai <strong>d\u1ea3i b\u00ean<\/strong> ch\u1ee7 y\u1ebfu \u0111\u01b0\u1ee3c h\u00ecnh th\u00e0nh b\u1edfi c\u00e1c c\u01a1 n\u1ed9i t\u1ea1i c\u1ee7a b\u00e0n tay, c\u00e1c c\u01a1 n\u00e0y c\u0169ng g\u1eedi c\u00e1c s\u1ee3i \u0111\u00f3ng g\u00f3p v\u00e0o <strong>d\u1ea3i trung t\u00e2m<\/strong>. M\u1ed9t khi c\u00e1c d\u1ea3i b\u00ean nh\u1eadn s\u1ef1 \u0111\u00f3ng g\u00f3p t\u1eeb c\u00e1c c\u01a1 n\u1ed9i t\u1ea1i, ch\u00fang \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 <strong>g\u00e2n k\u1ebft h\u1ee3p<\/strong> v\u00e0 h\u1ed9i t\u1ee5 \u1edf ph\u00eda xa \u0111\u1ec3 t\u1ea1o th\u00e0nh <strong>g\u00e2n t\u1eadn<\/strong>, b\u00e1m v\u00e0o n\u1ec1n \u0111\u1ed1t xa (DP &#8211; Distal phalanx).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">D\u00e2y ch\u1eb1ng tam gi\u00e1c (triangular ligament &#8211; tr\u00ean h\u00ecnh atlas l\u00e0 &#8220;c\u00e2n tam gi\u00e1c&#8221;) n\u1eb1m gi\u1eefa c\u00e1c g\u00e2n k\u1ebft h\u1ee3p \u0111o\u1ea1n xa v\u00e0 gi\u1eef c\u00e1c c\u1ea5u tr\u00fac n\u00e0y \u1edf ph\u00eda mu so v\u1edbi tr\u1ee5c xoay c\u1ee7a kh\u1edbp li\u00ean \u0111\u1ed1t xa (DIP &#8211; <em>Distal interphalangeal joint<\/em>) .<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Tr\u00ean si\u00eau \u00e2m, <strong>d\u1ea3i trung t\u00e2m <\/strong>c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c quan s\u00e1t tr\u00ean m\u1eb7t c\u1eaft d\u1ecdc cho \u0111\u1ebfn ch\u1ed7 b\u00e1m t\u1eadn c\u1ee7a n\u00f3 t\u1ea1i n\u1ec1n \u0111\u1ed1t gi\u1eefa (<em>MP &#8211; Middle Phalanges<\/em>), v\u00e0 <strong>g\u00e2n t\u1eadn <\/strong>v\u1edbi ch\u1ed7 b\u00e1m t\u1eadn c\u1ee7a n\u00f3 t\u1ea1i \u0111\u1ed1t xa <em>(DP &#8211; Distal phalanx)<\/em> xu\u1ea5t hi\u1ec7n nh\u01b0 c\u00e1c c\u1ea5u tr\u00fac t\u0103ng \u00e2m b\u0103ng qua m\u00f4 d\u01b0\u1edbi da ph\u00eda tr\u00ean v\u1ecf x\u01b0\u01a1ng t\u0103ng \u00e2m, trong khi hai d\u1ea3i b\u00ean h\u1ea7u nh\u01b0 kh\u00f4ng nh\u00ecn th\u1ea5y \u0111\u01b0\u1ee3c (H\u00ecnh 4).<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large is-resized\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczO2MHFlIFjENiC0DHiBzBgmf_UUtkC1beCuWp_YQtsJ7ZWoSppHxDNVy8oK3M4JTooXtL9cr3HtrtmKLDAPKlQU1gJYev4yK3Nl5Gj6F8rkhYNjm7yTn01GOwmbHFNVQ8OL7bJj3TG7HcNMFZkiu28G=w1347-h777-s-no-gm\" alt=\"\" style=\"aspect-ratio:1.7336343115124153;width:688px;height:auto\"\/><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\"><em>H\u00ecnh 4. H\u00ecnh \u1ea3nh si\u00eau \u00e2m gi\u1ea3i ph\u1eabu b\u00ecnh th\u01b0\u1eddng c\u1ee7a g\u00e2n t\u1eadn. H\u00ecnh ph\u00eda tr\u00ean kh\u00f4ng ch\u00fa th\u00edch v\u00e0 h\u00ecnh ph\u00eda d\u01b0\u1edbi c\u00f3 ch\u00fa th\u00edch. (A) M\u1eb7t c\u1eaft d\u1ecdc. (B) M\u1eb7t c\u1eaft ngang. M\u00e0u xanh d\u01b0\u01a1ng: g\u00e2n du\u1ed7i; m\u00e0u v\u00e0ng: v\u1ecf x\u01b0\u01a1ng. DP, \u0111\u1ed1t xa; MP, \u0111\u1ed1t gi\u1eefa.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Cu\u1ed1i c\u00f9ng, \u1edf ph\u1ea7n t\u1eadn c\u00f9ng v\u00e0 m\u1eb7t mu c\u1ee7a c\u00e1c ng\u00f3n tay, ch\u00fang ta th\u1ea5y m\u00f3ng tay, \u0111\u01b0\u1ee3c h\u00ecnh th\u00e0nh b\u1edfi c\u00e1c \u0111\u01a1n v\u1ecb m\u00f3ng (t\u1ea5m m\u00f3ng, gi\u01b0\u1eddng m\u00f3ng v\u00e0 m\u1ea7m m\u00f3ng) v\u00e0 v\u00f9ng quanh m\u00f3ng (c\u00e1c n\u1ebfp g\u1ea5p):<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2756 <strong>T\u1ea5m m\u00f3ng (Nail plate)<\/strong> l\u00e0 m\u1ed9t c\u1ea5u tr\u00fac hai l\u1edbp bao g\u1ed3m l\u00e1 mu v\u00e0 l\u00e1 b\u1ee5ng, b\u1eaft ngu\u1ed3n t\u1eeb m\u1ed9t ph\u1ea7n ba gi\u1eefa c\u1ee7a \u0111\u1ed1t ng\u00f3n tay. C\u00e1c d\u1ea3i n\u00e0y \u0111\u01b0\u1ee3c nh\u00ecn th\u1ea5y tr\u00ean si\u00eau \u00e2m l\u00e0 hai \u0111\u01b0\u1eddng t\u0103ng \u00e2m song song c\u00e1ch nhau b\u1edfi m\u1ed9t khoang \u1ea3o gi\u1ea3m \u00e2m g\u1ecdi l\u00e0 khoang li\u00ean b\u1ea3n (interplate space). \u0110\u1ed9 d\u00e0y c\u1ee7a c\u00e1c b\u1ea3n thay \u0111\u1ed5i t\u1eeb 0,3 \u0111\u1ebfn 0,65 mm.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2756 <strong>Gi\u01b0\u1eddng m\u00f3ng (Nail bed)<\/strong> xu\u1ea5t hi\u1ec7n nh\u01b0 m\u1ed9t d\u1ea3i gi\u1ea3m \u00e2m \u0111\u1ed3ng nh\u1ea5t n\u1eb1m gi\u1eefa b\u1ea3n m\u00f3ng v\u00e0 v\u1ecf x\u01b0\u01a1ng \u0111\u1ed1t xa <em>(DP &#8211; Distal phalanx)<\/em> r\u1ea5t gi\u00e0u m\u1ea1ch m\u00e1u tr\u00ean Doppler. \u0110\u1ed9 d\u00e0y trung b\u00ecnh c\u1ee7a n\u00f3 l\u00e0 1,5 mm v\u00e0 n\u00ean \u0111\u01b0\u1ee3c \u0111o \u1edf m\u1ed9t ph\u1ea7n ba gi\u1eefa c\u1ee7a \u0111\u1ed1t ng\u00f3n.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2756 <strong>M\u1ea7m m\u00f3ng ho\u1eb7c g\u1ed1c m\u00f3ng (Nail matrix\/root)<\/strong> n\u1eb1m d\u01b0\u1edbi n\u1ebfp g\u1ea5p g\u1ea7n. N\u00f3 \u0111\u01b0\u1ee3c quan s\u00e1t nh\u01b0 m\u1ed9t c\u1ea5u tr\u00fac h\u00ecnh tam gi\u00e1c v\u1edbi b\u1edd l\u1ed3i \u1edf ph\u00eda g\u1ea7n ti\u1ebfp x\u00fac v\u1edbi gi\u01b0\u1eddng m\u00f3ng v\u00e0 t\u0103ng \u00e2m h\u01a1n so v\u1edbi gi\u01b0\u1eddng m\u00f3ng. Chi\u1ec1u d\u00e0i c\u1ee7a n\u00f3 thay \u0111\u1ed5i t\u1eeb 1 \u0111\u1ebfn 5,3 mm. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2756 <strong>C\u00e1c m\u00f4 quanh m\u00f3ng (Periungual tissues)<\/strong> \u0111\u01b0\u1ee3c chia theo v\u1ecb tr\u00ed th\u00e0nh n\u1ebfp g\u1ea5p g\u1ea7n (eponychium), n\u1ebfp g\u1ea5p b\u00ean (perionychium), ho\u1eb7c n\u1ebfp g\u1ea5p xa (hyponychium).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B\u1ec7nh l\u00fd<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">T\u1ed5n th\u01b0\u01a1ng c\u00e1c g\u00e2n du\u1ed7i ph\u1ed5 bi\u1ebfn h\u01a1n so v\u1edbi g\u00e2n g\u1ea5p do v\u1ecb tr\u00ed n\u00f4ng c\u1ee7a ch\u00fang. Ch\u00fang th\u01b0\u1eddng x\u1ea3y ra do ch\u1ea5n th\u01b0\u01a1ng, d\u00f9 l\u00e0 v\u1ebft th\u01b0\u01a1ng h\u1edf hay k\u00edn, v\u00e0 \u1edf m\u1ee9c \u0111\u1ed9 th\u1ea5p h\u01a1n l\u00e0 c\u00e1c t\u1ed5n th\u01b0\u01a1ng t\u1ef1 ph\u00e1t th\u1ee9 ph\u00e1t sau c\u00e1c qu\u00e1 tr\u00ecnh vi\u00eam. \u0110\u1ee9t g\u00e2n ho\u00e0n to\u00e0n th\u01b0\u1eddng kh\u00f4ng d\u1eabn \u0111\u1ebfn s\u1ef1 co r\u00fat \u0111\u00e1ng k\u1ec3 do h\u1ec7 th\u1ed1ng b\u00e1m t\u1eadn ph\u1ee9c t\u1ea1p c\u1ee7a ch\u00fang. Ch\u00fang t\u00f4i s\u1ebd \u0111\u1ec1 c\u1eadp \u0111\u1ebfn b\u1ec7nh l\u00fd g\u00e2n du\u1ed7i t\u1eeb g\u1ea7n \u0111\u1ebfn xa v\u00e0 d\u1ef1a tr\u00ean v\u1ecb tr\u00ed c\u1ee7a ch\u00fang trong c\u00e1c v\u00f9ng Verdan.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>V\u00f9ng V: R\u00e1ch d\u1ea3i b\u00ean (Boxer\u2019s knuckle &#8211; ng\u00f3n tay quy\u1ec1n anh)<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">T\u00ecnh tr\u1ea1ng n\u00e0y x\u1ea3y ra do ch\u1ea5n th\u01b0\u01a1ng tr\u1ef1c ti\u1ebfp (v\u00f5 s\u0129 quy\u1ec1n anh) ho\u1eb7c vi ch\u1ea5n th\u01b0\u01a1ng l\u1eb7p \u0111i l\u1eb7p l\u1ea1i \u1edf kh\u1edbp b\u00e0n ng\u00f3n <em>(MCP &#8211; Metacarpophalangeal joint)<\/em>, m\u1eb7c d\u00f9 n\u00f3 c\u0169ng c\u00f3 th\u1ec3 g\u1eb7p \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb b\u1ec7nh kh\u1edbp vi\u00eam m\u00e0 kh\u00f4ng c\u00f3 ti\u1ec1n s\u1eed ch\u1ea5n th\u01b0\u01a1ng tr\u01b0\u1edbc \u0111\u00f3. Ng\u00f3n tay b\u1ecb \u1ea3nh h\u01b0\u1edfng nhi\u1ec1u nh\u1ea5t th\u01b0\u1eddng l\u00e0 ng\u00f3n 3, v\u1edbi <strong>s\u1ee3i ngang b\u00ean quay<\/strong> b\u1ecb t\u1ed5n th\u01b0\u01a1ng, d\u1eabn \u0111\u1ebfn g\u00e2n b\u1ecb tr\u1eadt v\u1ec1 ph\u00eda tr\u1ee5. Tr\u00ean si\u00eau \u00e2m, quan s\u00e1t t\u1ed1t h\u01a1n \u1edf m\u1eb7t c\u1eaft ngang, v\u00e0 kh\u1ea3o s\u00e1t \u0111\u1ed9ng l\u00e0 thi\u1ebft y\u1ebfu \u0111\u1ec3 ch\u1ee9ng minh s\u1ef1 tr\u1eadt g\u00e2n trong qu\u00e1 tr\u00ecnh g\u1ea5p &#8211; du\u1ed7i kh\u1edbp b\u00e0n ng\u00f3n <em>(MCP &#8211; Metacarpophalangeal joint)<\/em>. Ch\u00fang ta s\u1ebd quan s\u00e1t th\u1ea5y s\u1ef1 t\u0103ng k\u00edch th\u01b0\u1edbc v\u00e0 bi\u1ebfn \u0111\u1ed5i c\u1ea5u tr\u00fac \u00e2m c\u1ee7a <strong>s\u1ee3i ngang<\/strong> b\u1ecb \u1ea3nh h\u01b0\u1edfng v\u00e0 bao kh\u1edbp b\u00ean d\u01b0\u1edbi. G\u00e2n du\u1ed7i c\u00f3 th\u1ec3 tr\u00f4ng b\u00ecnh th\u01b0\u1eddng ho\u1eb7c to ra v\u1edbi s\u1ef1 m\u1ea5t \u0111i c\u1ea5u tr\u00fac s\u1ee3i n\u1ebfu c\u00f3 r\u00e1ch s\u1ee3i. T\u0103ng t\u00edn hi\u1ec7u m\u1ea1ch m\u00e1u c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c quan s\u00e1t tr\u00ean Doppler th\u1ee9 ph\u00e1t sau c\u00e1c bi\u1ebfn \u0111\u1ed5i vi\u00eam (H\u00ecnh 5).<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczMIAwYQTa8rMOmuv3Bjl8aZL0Dy6JRK-Krlo3ymHL_UFMgXIf4Or6G09ZY9PPiXJY2dq7U1Yr-eoUUCoFGdlw3MnDcJPtKFO2lHH8d4Mqb1BZHYq2hMy4MtkFYpkMCLjsEasq2kufTcixt-jY72xs6q=w960-h346-s-no-gm\" alt=\"\"\/><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\"><em>H\u00ecnh 5. Si\u00eau \u00e2m ng\u00f3n tay tr\u00ean m\u1eb7t c\u1eaft ngang t\u1ea1i m\u1ee9c c\u00e1c d\u1ea3i b\u00ean. (A) v\u1ecb tr\u00ed gi\u1ea3i ph\u1eabu c\u1ee7a g\u00e2n du\u1ed7i trong tr\u1ebd g\u00e2n du\u1ed7i (m\u0169i t\u00ean tr\u1eafng th\u1eb3ng). (B) G\u00e2n du\u1ed7i b\u1ecb tr\u1eadt v\u1ec1 ph\u00eda tr\u1ee5 (m\u0169i t\u00ean tr\u1eafng cong) li\u00ean quan \u0111\u1ebfn t\u1ed5n th\u01b0\u01a1ng boxer\u2019s knuckle.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u0110i\u1ec1u quan tr\u1ecdng c\u1ea7n nh\u1edb l\u00e0 ng\u00f3n 2 v\u00e0 ng\u00f3n 5 c\u00f3 hai g\u00e2n du\u1ed7i, v\u00ec v\u1eady ch\u00fang c\u00f3 th\u1ec3 tr\u1eadt theo c\u00e1c h\u01b0\u1edbng kh\u00e1c nhau, m\u1ed9t v\u1ec1 ph\u00eda quay v\u00e0 m\u1ed9t v\u1ec1 ph\u00eda tr\u1ee5.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>V\u00f9ng III: R\u00e1ch d\u1ea3i trung t\u00e2m g\u00e2n du\u1ed7i (Bi\u1ebfn d\u1ea1ng ng\u00f3n tay th\u1ee3 khuy\u1ebft &#8211; Boutonniere deformity)<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">R\u00e1ch d\u1ea3i trung t\u00e2m t\u1ea1i ch\u1ed7 b\u00e1m t\u1eadn \u1edf n\u1ec1n \u0111\u1ed1t gi\u1eefa (<em>MP &#8211; Middle Phalanges<\/em>) x\u1ea3y ra sau ch\u1ea5n th\u01b0\u01a1ng tr\u1ef1c ti\u1ebfp, g\u1ea5p m\u1ea1nh, ho\u1eb7c tr\u1eadt kh\u1edbp li\u00ean \u0111\u1ed1t g\u1ea7n <em>(PIP &#8211; Proximal interphalangeal joint)<\/em> ra tr\u01b0\u1edbc (v\u1ec1 ph\u00eda l\u00f2ng b\u00e0n tay). Trong giai \u0111o\u1ea1n b\u00e1n c\u1ea5p ho\u1eb7c m\u1ea1n t\u00ednh c\u1ee7a ch\u1ea5n th\u01b0\u01a1ng, v\u00ec c\u00e1c d\u1ea3i b\u00ean c\u00f2n nguy\u00ean v\u1eb9n, ch\u00fang tr\u01b0\u1ee3t v\u1ec1 ph\u00eda l\u00f2ng b\u00e0n tay so v\u1edbi tr\u1ee5c c\u1ee7a kh\u1edbp li\u00ean \u0111\u1ed1t g\u1ea7n <em>(PIP &#8211; Proximal interphalangeal joint)<\/em>, t\u1ea1o ra m\u1ed9t v\u00f2ng khuy\u00ean m\u00e0 qua \u0111\u00f3 \u0111\u1ea7u \u0111\u1ed1t gi\u1eefa di chuy\u1ec3n, g\u00e2y ra t\u00ecnh tr\u1ea1ng <strong>g\u1ea5p kh\u1edbp li\u00ean \u0111\u1ed1t g\u1ea7n <\/strong><em>(PIP &#8211; Proximal interphalangeal joint)<\/em> v\u00e0 <strong>du\u1ed7i c\u01b0\u1ee1ng b\u1ee9c kh\u1edbp li\u00ean \u0111\u1ed1t xa<\/strong> (DIP &#8211; <em>Distal interphalangeal joint<\/em>). Tr\u00ean si\u00eau \u00e2m, quan s\u00e1t t\u1ed1t h\u01a1n \u1edf m\u1eb7t c\u1eaft d\u1ecdc, v\u00e0 kh\u1ea3o s\u00e1t \u0111\u1ed9ng g\u1ea5p kh\u1edbp li\u00ean \u0111\u1ed1t g\u1ea7n <em>(PIP &#8211; Proximal interphalangeal joint)<\/em> c\u00f4 l\u1eadp v\u1edbi vi\u1ec7c kh\u00f3a kh\u1edbp li\u00ean \u0111\u1ed1t xa (DIP &#8211; <em>Distal interphalangeal joint<\/em>) l\u00e0 thi\u1ebft y\u1ebfu. Ch\u00fang ta s\u1ebd quan s\u00e1t th\u1ea5y s\u1ef1 d\u00e0y l\u00ean c\u1ee7a d\u1ea3i g\u00e2n du\u1ed7i trung t\u00e2m v\u1edbi c\u1ea5u tr\u00fac \u00e2m kh\u00f4ng \u0111\u1ed3ng nh\u1ea5t, c\u00f3 ho\u1eb7c kh\u00f4ng k\u00e8m theo bong \u0111i\u1ec3m b\u00e1m x\u01b0\u01a1ng t\u1ea1i ch\u1ed7 b\u00e1m t\u1eadn ph\u00eda xa c\u1ee7a n\u00f3, c\u00f3 th\u1ec3 ch\u1ee9ng minh s\u1ef1 m\u1ea5t li\u00ean t\u1ee5c c\u1ee7a c\u00e1c s\u1ee3i g\u00e2n trong kh\u1ea3o s\u00e1t \u0111\u1ed9ng (H\u00ecnh 6).<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large is-resized\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczODUg2inU0JVQNmoQqWp_stl4s8Gj3VUL6HWSLxtwana_rnn5JpIvvWMDDR6-G4OU3WuDG-APM55EOTXlP7VxBqETkZAyGPI7lQTaduL7cB5HYi2hTyku7L2MwJVHL98PFgekPI89uldIlV0geRGAO4=w797-h790-s-no-gm\" alt=\"\" style=\"aspect-ratio:1.0088901108972597;width:741px;height:auto\"\/><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\"><em>H\u00ecnh 6. X-quang nghi\u00eang ng\u00f3n 5 (A) v\u1edbi g\u00e3y\/bong \u0111i\u1ec3m b\u00e1m c\u1ee7a d\u1ea3i trung t\u00e2m g\u00e2n du\u1ed7i (m\u0169i t\u00ean tr\u1eafng). Si\u00eau \u00e2m ng\u00f3n tay tr\u00ean c\u00e1c m\u1eb7t c\u1eaft d\u1ecdc (B) v\u00e0 ngang (C) cho th\u1ea5y g\u00e3y\/bong \u0111i\u1ec3m b\u00e1m c\u1ee7a d\u1ea3i trung t\u00e2m g\u00e2n du\u1ed7i (m\u0169i t\u00ean tr\u1eafng).<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>V\u00f9ng I: R\u00e1ch g\u00e2n du\u1ed7i t\u1eadn (terminal extensor band rupture<\/strong>) <strong>(Ng\u00f3n tay v\u1ed3 &#8211; Mallet finger)<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">R\u00e1ch g\u00e2n t\u1eadn t\u1ea1i ch\u1ed7 b\u00e1m t\u1eadn v\u00e0o \u0111\u1ed1t xa <em>(DP &#8211; Distal phalanx)<\/em> th\u01b0\u1eddng x\u1ea3y ra nh\u1ea5t sau ch\u1ea5n th\u01b0\u01a1ng k\u00edn v\u1edbi l\u1ef1c g\u1ea5p c\u01b0\u1ee1ng b\u1ee9c kh\u1edbp li\u00ean \u0111\u1ed1t xa (DIP &#8211; <em>Distal interphalangeal joint<\/em>), c\u00f3 ho\u1eb7c kh\u00f4ng k\u00e8m theo m\u1ea3nh x\u01b0\u01a1ng bong (H\u00ecnh 7), d\u1eabn \u0111\u1ebfn bi\u1ebfn d\u1ea1ng ng\u00f3n tay v\u1ed3 do m\u1ea5t kh\u1ea3 n\u0103ng du\u1ed7i kh\u1edbp li\u00ean \u0111\u1ed1t xa (DIP &#8211; <em>Distal interphalangeal joint<\/em>).<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large is-resized\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczOwRbk6ILwCEcoYMPQMtptU0fwvwoOy6mIzfROPLHPbNbcl4Gz6exH7TX_tWGbeevisGP4XMsNiK62Bqfvn1srueEfdMIam-5rN9yhAzQb8mTbvUmuM_Wnucc7Jyjlwvh1QS5O9XfoI5cfEehPBa1Ii=w1762-h822-s-no-gm\" alt=\"\" style=\"aspect-ratio:2.1436261413931974;width:806px;height:auto\"\/><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\"><em>H\u00ecnh 7. Si\u00eau \u00e2m ng\u00f3n tay tr\u00ean m\u1eb7t c\u1eaft d\u1ecdc c\u1ee7a g\u00e2n du\u1ed7i t\u1eadn t\u1ea1i ch\u1ed7 b\u00e1m c\u1ee7a n\u00f3 v\u00e0o \u0111\u1ed1t xa. B\u00ean tr\u00e1i kh\u00f4ng ch\u00fa th\u00edch v\u00e0 b\u00ean ph\u1ea3i c\u00f3 ch\u00fa th\u00edch. (A) Si\u00eau \u00e2m b\u00ecnh th\u01b0\u1eddng v\u1edbi g\u00e2n t\u1eadn nguy\u00ean v\u1eb9n. (B) S\u1ef1 m\u1ea5t li\u00ean t\u1ee5c k\u00edn \u0111\u00e1o c\u1ee7a g\u00e2n t\u1eadn t\u1ea1i m\u1ee9c \u0111\u1ea7u \u0111\u1ed1t gi\u1eefa sau khi g\u1ea5p th\u1ee5 \u0111\u1ed9ng kh\u1edbp li\u00ean \u0111\u1ed1t xa (DIP &#8211; Distal interphalangeal joint). M\u00e0u xanh d\u01b0\u01a1ng: g\u00e2n du\u1ed7i t\u1eadn; m\u00e0u x\u00e1m: r\u00e1ch g\u00e2n; m\u00e0u v\u00e0ng: v\u1ecf x\u01b0\u01a1ng. DP, \u0111\u1ed1t xa; MP, \u0111\u1ed1t gi\u1eefa; DIP &#8211; Distal interphalangeal joint, kh\u1edbp li\u00ean \u0111\u1ed1t xa.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Tr\u00ean si\u00eau \u00e2m, quan s\u00e1t t\u1ed1t h\u01a1n \u1edf m\u1eb7t c\u1eaft d\u1ecdc v\u1edbi s\u1ef1 t\u0103ng k\u00edch th\u01b0\u1edbc v\u00e0 bi\u1ebfn \u0111\u1ed5i c\u1ea5u tr\u00fac \u00e2m c\u1ee7a g\u00e2n t\u1eadn, c\u00f3 ho\u1eb7c kh\u00f4ng k\u00e8m theo bong \u0111i\u1ec3m b\u00e1m x\u01b0\u01a1ng. Kh\u1ea3o s\u00e1t \u0111\u1ed9ng v\u1edbi g\u1ea5p &#8211; du\u1ed7i th\u1ee5 \u0111\u1ed9ng kh\u1edbp li\u00ean \u0111\u1ed1t xa (DIP &#8211; <em>Distal interphalangeal join<\/em>t) l\u00e0 thi\u1ebft y\u1ebfu \u0111\u1ec3 ch\u1ee9ng minh c\u00e1c tr\u01b0\u1eddng h\u1ee3p \u0111\u1ee9t ho\u00e0n to\u00e0n. V\u1ec1 v\u00f9ng m\u00f3ng, ch\u00fang t\u00f4i s\u1ebd th\u1ea3o lu\u1eadn b\u1ec7nh l\u00fd c\u1ee7a n\u00f3 m\u00e0 kh\u00f4ng \u0111i s\u00e2u v\u00e0o ph\u1ea7n u v\u00e0 gi\u1ea3 u.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>V\u00f9ng g\u1ea5p<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Gi\u1ea3i ph\u1eabu b\u00ecnh th\u01b0\u1eddng<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Ph\u1ee9c h\u1ee3p g\u1ea5p bao g\u1ed3m hai g\u00e2n: g\u00e2n g\u1ea5p c\u00e1c ng\u00f3n n\u00f4ng <em>(FDS &#8211; Flexor digitorum superficialis)<\/em> v\u00e0 g\u00e2n g\u1ea5p c\u00e1c ng\u00f3n s\u00e2u <em>(FDP &#8211; Flexor digitorum profundus)<\/em>, ch\u1ea1y xuy\u00ean qua m\u1eb7t l\u00f2ng c\u00e1c ng\u00f3n tay, b\u00ean trong <strong>\u1ed1ng ng\u00f3n tay<\/strong><sup data-fn=\"20a8ea51-2320-4abb-9692-11fe3afadf57\" class=\"fn\"><a href=\"#20a8ea51-2320-4abb-9692-11fe3afadf57\" id=\"20a8ea51-2320-4abb-9692-11fe3afadf57-link\">3<\/a><\/sup>, t\u1eeb ch\u1ecfm x\u01b0\u01a1ng \u0111\u1ed1t b\u00e0n (metacarpal heads)&nbsp;\u0111\u1ebfn ch\u1ed7 b\u00e1m t\u1eadn ph\u00eda xa. \u1ede ph\u00eda g\u1ea7n so v\u1edbi \u0111\u1ed1t g\u1ea7n <em>(PP &#8211; proximal phalanx)<\/em>, c\u1ea3 hai g\u00e2n ch\u1ea1y ch\u1ed3ng l\u00ean nhau, v\u1edbi g\u00e2n g\u1ea5p c\u00e1c ng\u00f3n n\u00f4ng <em>(FDS &#8211; Flexor digitorum superficialis)<\/em> n\u1eb1m \u1edf v\u1ecb tr\u00ed n\u00f4ng h\u01a1n (v\u1ec1 ph\u00eda l\u00f2ng b\u00e0n tay h\u01a1n). Tuy nhi\u00ean, t\u1ea1i m\u1ee9c \u0111\u1ed1t g\u1ea7n <em>(PP &#8211; proximal phalanx)<\/em>, FDS chia th\u00e0nh hai g\u00e2n n\u1eb1m \u1edf hai b\u00ean c\u1ee7a FDP, l\u00fac n\u00e0y FDP n\u1eb1m \u1edf v\u1ecb tr\u00ed s\u00e2u nh\u1ea5t (v\u1ec1 ph\u00eda l\u00f2ng b\u00e0n tay) cho \u0111\u1ebfn khi b\u00e1m t\u1eadn t\u1ea1i n\u1ec1n \u0111\u1ed1t xa <em>(DP &#8211; Distal phalanx)<\/em>. Sau khi chia th\u00e0nh hai d\u1ea3i g\u00e2n, FDS h\u1ee3p l\u1ea1i \u1edf s\u00e2u so v\u1edbi FDP, t\u1ea1o th\u00e0nh m\u1ed9t r\u00f2ng r\u1ecdc, b\u00e1m v\u00e0o m\u1ed9t ph\u1ea7n ba g\u1ea7n c\u1ee7a \u0111\u1ed1t gi\u1eefa (<em>MP &#8211; Middle Phalanges<\/em>). T\u1ea1i ch\u1ed7 b\u00e1m, c\u1ea3 hai d\u1ea3i t\u1ea1o th\u00e0nh m\u1ed9t s\u1ef1 b\u1eaft ch\u00e9o c\u1ee7a c\u00e1c s\u1ee3i \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 giao thoa Camper (Camper\u2019s chiasm). \u0110\u00f4i khi, r\u1ea5t kh\u00f3 \u0111\u1ec3 quan s\u00e1t c\u00e1c g\u00e2n ri\u00eang bi\u1ec7t tr\u00ean c\u00e1c m\u1eb7t c\u1eaft d\u1ecdc v\u00e0 ngang tr\u00ean si\u00eau \u00e2m, nh\u01b0ng v\u1edbi kh\u1ea3o s\u00e1t \u0111\u1ed9ng v\u00e0 thao t\u00e1c \u0111i\u1ec1u ch\u1ec9nh \u1ea3nh gi\u1ea3 do t\u00ednh b\u1ea5t \u0111\u1eb3ng h\u01b0\u1edbng, ch\u00fang ta c\u00f3 th\u1ec3 t\u00e1ch bi\u1ec7t c\u00e1c g\u00e2n. \u0110\u1ec3 kh\u1ea3o s\u00e1t c\u00f4 l\u1eadp FDS, trong kh\u1ea3o s\u00e1t \u0111\u1ed9ng, ch\u00fang ta s\u1ebd kh\u00f3a c\u00e1c ng\u00f3n c\u00f2n l\u1ea1i \u1edf t\u01b0 th\u1ebf du\u1ed7i b\u1eb1ng tay c\u1ee7a m\u00ecnh, v\u00e0 \u0111\u1ed1i v\u1edbi FDP, ch\u00fang ta s\u1ebd ch\u1ec9 kh\u00f3a kh\u1edbp li\u00ean \u0111\u1ed1t g\u1ea7n <em>(PIP &#8211; Proximal interphalangeal joint)<\/em>. <\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large is-resized\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczPNi4WN6Qe6Z1QWYW2JqeVnXU0VjHy_hOKe1adVGZh1vtOSqw8xvqnt1dpOtSJiqqgU3rrbMXmO9-l820aa6gp3m5KBzSniqO2zso8Hd-wr8eORI2OEvYxY5fwULwHvsJu9d6wR7CGj-1yFW8kl4P8Y=w659-h806-s-no-gm\" alt=\"\" style=\"aspect-ratio:0.817632590682236;width:420px;height:auto\"\/><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\"><em>H\u00ecnh 8. S\u01a1 \u0111\u1ed3 s\u1ef1 b\u1eaft ch\u00e9o c\u1ee7a c\u00e1c g\u00e2n g\u1ea5p. M\u00e0u v\u00e0ng: g\u00e2n g\u1ea5p n\u00f4ng; m\u00e0u xanh d\u01b0\u01a1ng: g\u00e2n g\u1ea5p s\u00e2u.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Trong \u1ed1ng ng\u00f3n tay, c\u00e1c bao g\u00e2n c\u00f3 s\u1ef1 gia c\u1ed1 b\u1eb1ng s\u1ee3i g\u1ecdi l\u00e0 c\u00e1c r\u00f2ng r\u1ecdc gi\u00fap c\u1ed1 \u0111\u1ecbnh ch\u00fang v\u00e0o c\u00e1c \u0111\u1ed1t ng\u00f3n tay v\u00e0 gi\u1eef c\u00e1c g\u00e2n \u1edf v\u1ecb tr\u00ed gi\u1ea3i ph\u1eabu c\u1ee7a ch\u00fang. \u1ede c\u00e1c ng\u00f3n tay c\u00f3 ba \u0111\u1ed1t, ch\u00fang ta c\u00f3 hai lo\u1ea1i r\u00f2ng r\u1ecdc: r\u00f2ng r\u1ecdc h\u00ecnh nh\u1eabn, d\u00e0y h\u01a1n v\u00e0 kh\u1ecfe h\u01a1n (t\u1eeb g\u1ea7n \u0111\u1ebfn xa A1\u2013A5), v\u00e0 r\u00f2ng r\u1ecdc h\u00ecnh ch\u1eef th\u1eadp v\u1edbi vai tr\u00f2 c\u01a1 h\u1ecdc \u00edt h\u01a1n (t\u1eeb g\u1ea7n \u0111\u1ebfn xa C1\u2013C3) (H\u00ecnh 9). C\u00e1c r\u00f2ng r\u1ecdc A2 v\u00e0 A4 l\u00e0 quan tr\u1ecdng nh\u1ea5t. <\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large is-resized\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczOtmrVHu256pKIL1PBsxblCF25LVGMiJiMtvfy0ZIQgoyrMTH-bYAHFZzxV5Fx_m6qnE68hzl1T1_3qzAqPFICxJhIP2-k9gHCV7N21SZKQI1-j5V-ZFCN8CAlosogINp58ATKb6bQnrKq1J4sPFDi0=w1436-h793-s-no-gm\" alt=\"\" style=\"aspect-ratio:1.810893657156331;width:784px;height:auto\"\/><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\"><em>H\u00ecnh 9. S\u01a1 \u0111\u1ed3 c\u00e1c r\u00f2ng r\u1ecdc c\u1ee7a bao g\u00e2n g\u1ea5p \u1edf c\u00e1c ng\u00f3n tay ba \u0111\u1ed1t v\u1edbi g\u00f3c nh\u00ecn b\u00ean (tr\u00ean) v\u00e0 tr\u1ef1c di\u1ec7n (d\u01b0\u1edbi). R\u00f2ng r\u1ecdc h\u00ecnh nh\u1eabn (A). R\u00f2ng r\u1ecdc h\u00ecnh ch\u1eef th\u1eadp (C).<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u1ede ng\u00f3n tay c\u00e1i (ng\u00f3n 1), ch\u00fang ta c\u00f3 ba r\u00f2ng r\u1ecdc c\u1ed1 \u0111\u1ecbnh: hai r\u00f2ng r\u1ecdc h\u00ecnh nh\u1eabn (A1 v\u00e0 A2) v\u00e0 m\u1ed9t r\u00f2ng r\u1ecdc ch\u00e9o (C1), l\u00e0 ph\u1ea7n m\u1edf r\u1ed9ng c\u1ee7a c\u01a1 kh\u00e9p ng\u00f3n c\u00e1i v\u00e0 quan tr\u1ecdng nh\u1ea5t v\u1ec1 m\u1eb7t ch\u1ee9c n\u0103ng. M\u1ed9t r\u00f2ng r\u1ecdc h\u00ecnh nh\u1eabn th\u1ee9 t\u01b0 bi\u1ebfn \u0111\u1ed5i (Av) n\u1eb1m xa so v\u1edbi A1 c\u0169ng \u0111\u00e3 \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3. Tr\u00ean si\u00eau \u00e2m, c\u00e1c r\u00f2ng r\u1ecdc d\u1ec5 ti\u1ebfp c\u1eadn nh\u1ea5t l\u00e0 A1 v\u00e0 A2, \u0111\u01b0\u1ee3c quan s\u00e1t nh\u01b0 m\u1ed9t d\u1ea3i tuy\u1ebfn t\u00ednh gi\u1ea3m \u00e2m m\u1ecfng n\u1eb1m ph\u1ee7 l\u00ean c\u00e1c g\u00e2n g\u1ea5p, v\u1edbi \u0111\u01b0\u1eddng k\u00ednh <strong>kh\u00f4ng v\u01b0\u1ee3t qu\u00e1 0,62 mm<\/strong> (H\u00ecnh 10). <\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczOtHJdZillhbrvlYuz4rAdHQR_tTNmXozKaI_d_DcCJc8N3ZK6mYj5-Dnozas3rSqpm4XR1uR8yVsu2P5-gvSMZFgUMiw8cmPbcgQ_txrQVp1vsPnPoG_VlnSiF2TX-vhzUUmQnoJFrTk1RU1er7egE=w1731-h651-s-no-gm\" alt=\"\"\/><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\"><em>H\u00ecnh 10. C\u00e1c m\u1eb7t c\u1eaft si\u00eau \u00e2m ngang (A) v\u00e0 d\u1ecdc (B) c\u1ee7a ng\u00f3n tay v\u00e0 c\u00e1c s\u01a1 \u0111\u1ed3 t\u01b0\u01a1ng \u1ee9ng hi\u1ec3n th\u1ecb r\u00f2ng r\u1ecdc A1 \u1edf c\u00e1c h\u00ecnh ph\u00eda tr\u00ean (m\u0169i t\u00ean tr\u1eafng) v\u00e0 r\u00f2ng r\u1ecdc A2 \u1edf c\u00e1c h\u00ecnh ph\u00eda d\u01b0\u1edbi (\u0111\u1ea7u m\u0169i t\u00ean). M\u00e0u \u0111\u1ecf: c\u00e1c r\u00f2ng r\u1ecdc; m\u00e0u xanh d\u01b0\u01a1ng: c\u00e1c g\u00e2n g\u1ea5p.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B\u1ec7nh l\u00fd<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">C\u00e1c t\u1ed5n th\u01b0\u01a1ng g\u00e2n g\u1ea5p \u00edt g\u1eb7p h\u01a1n, v\u00e0 c\u01a1 ch\u1ebf t\u00e1c \u0111\u1ed9ng gi\u1ed1ng nh\u01b0 c\u1ee7a g\u00e2n du\u1ed7i. C\u00e1c t\u1ed5n th\u01b0\u01a1ng c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf c\u1ea3 hai g\u00e2n ho\u1eb7c ri\u00eang l\u1ebb. C\u1ea7n l\u01b0u \u00fd r\u1eb1ng trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p \u0111\u1ee9t ho\u00e0n to\u00e0n, s\u1ebd c\u00f3 s\u1ef1 co r\u00fat c\u1ee7a c\u00e1c \u0111\u1ea7u g\u00e2n, ph\u1ee5 thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 g\u1ea5p c\u1ee7a ng\u00f3n tay t\u1ea1i th\u1eddi \u0111i\u1ec3m ch\u1ea5n th\u01b0\u01a1ng. V\u00ec l\u00fd do n\u00e0y, Li\u00ean \u0111o\u00e0n Qu\u1ed1c t\u1ebf c\u00e1c Hi\u1ec7p h\u1ed9i Ph\u1eabu thu\u1eadt B\u00e0n tay (IFSSH) thi\u1ebft l\u1eadp m\u1ed9t s\u1ef1 ph\u00e2n chia \u0111\u1ecba h\u00ecnh c\u1ee7a v\u00f9ng g\u1ea5p b\u00e0n tay v\u00e0 ng\u00f3n tay (H\u00ecnh 11), \u0111\u1ec3 c\u1ea3i thi\u1ec7n vi\u1ec7c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb c\u00e1c t\u1ed5n th\u01b0\u01a1ng.<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large is-resized\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczNpUJIyQuXWg1Ot5efTRTYrV04Es_lFUNEcW3ZmVW4BlS3Sk0_CBH41tUtWAPvq1ugz6ibMhhpYgTT2UR6YR5JbhyFy83tCYqBUFFbnKlIlPuMP8tNNHDTvSdGjj7LLVObhXGTopkd2YLOWqaC7Qt1Q=w590-h849-s-no-gm\" alt=\"\" style=\"aspect-ratio:0.6949527448220391;width:400px;height:auto\"\/><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\"><em>H\u00ecnh 11. S\u01a1 \u0111\u1ed3 c\u00e1c v\u00f9ng g\u1ea5p c\u1ee7a b\u00e0n tay theo Li\u00ean \u0111o\u00e0n Qu\u1ed1c t\u1ebf c\u00e1c Hi\u1ec7p h\u1ed9i Ph\u1eabu thu\u1eadt B\u00e0n tay. V\u00f9ng I, t\u1eeb ch\u1ed7 b\u00e1m t\u1eadn c\u1ee7a g\u00e2n g\u1ea5p n\u00f4ng \u0111\u1ebfn ch\u1ed7 b\u00e1m c\u1ee7a g\u00e2n g\u1ea5p s\u00e2u; V\u00f9ng II, gi\u1eefa l\u1ed1i v\u00e0o \u1ed1ng ng\u00f3n tay v\u00e0 ch\u1ed7 b\u00e1m c\u1ee7a g\u00e2n g\u1ea5p n\u00f4ng; V\u00f9ng III, gi\u1eefa b\u1edd xa c\u1ee7a d\u00e2y ch\u1eb1ng ngang c\u1ed5 tay (m\u1ea1c gi\u1eef g\u00e2n g\u1ea5p) v\u00e0 l\u1ed1i v\u00e0o \u1ed1ng ng\u00f3n tay; V\u00f9ng IV, b\u00ean d\u01b0\u1edbi d\u00e2y ch\u1eb1ng ngang c\u1ed5 tay; V\u00f9ng V, t\u1eeb ch\u1ed7 n\u1ed1i g\u00e2n &#8211; c\u01a1 \u0111\u1ebfn l\u1ed1i v\u00e0o \u1ed1ng c\u1ed5 tay. Ch\u00fang t\u00f4i s\u1ebd \u0111\u1ec1 c\u1eadp \u0111\u1ebfn b\u1ec7nh l\u00fd g\u00e2n g\u1ea5p t\u1eeb g\u1ea7n \u0111\u1ebfn xa v\u00e0 d\u1ef1a tr\u00ean v\u1ecb tr\u00ed c\u1ee7a ch\u00fang trong c\u00e1c v\u00f9ng IFSSH (V\u00f9ng II v\u00e0 I).<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>V\u00f9ng II v\u00e0 I<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Vi\u00eam bao g\u00e2n (Tenosynovitis)<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u0110\u00e2y l\u00e0 t\u00ecnh tr\u1ea1ng vi\u00eam c\u1ee7a bao g\u00e2n v\u00e0 b\u1ea3n ch\u1ea5t c\u00f3 th\u1ec3 l\u00e0 vi\u00eam, c\u01a1 h\u1ecdc ho\u1eb7c nhi\u1ec5m tr\u00f9ng. Tr\u00ean si\u00eau \u00e2m, n\u00f3 xu\u1ea5t hi\u1ec7n nh\u01b0 m\u1ed9t vi\u1ec1n gi\u1ea3m \u00e2m xung quanh c\u00e1c g\u00e2n g\u1ea5p, c\u00f3 h\u00ecnh d\u1ea1ng chia th\u00f9y t\u01b0\u01a1ng \u1ee9ng v\u1edbi s\u1ef1 s\u1eafp x\u1ebfp c\u1ee7a c\u00e1c r\u00f2ng r\u1ecdc. Th\u00f4ng th\u01b0\u1eddng, c\u00e1c d\u1ea5u hi\u1ec7u ch\u1ed3ng l\u1ea5p nhau trong c\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c nhau, v\u00ec v\u1eady ch\u00fang n\u00ean \u0111\u01b0\u1ee3c di\u1ec5n gi\u1ea3i trong b\u1ed1i c\u1ea3nh l\u00e2m s\u00e0ng c\u1ee7a b\u1ec7nh nh\u00e2n. C\u00e1c d\u1ea5u hi\u1ec7u b\u1ed5 sung nh\u01b0 t\u0103ng sinh m\u00e0ng ho\u1ea1t d\u1ecbch (synovial proliferation), th\u00e0nh ph\u1ea7n t\u0103ng \u00e2m trong bao g\u00e2n, t\u0103ng t\u00edn hi\u1ec7u m\u1ea1ch m\u00e1u tr\u00ean Doppler, s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a d\u1ecb v\u1eadt, v\u00e0 v\u1ebft th\u01b0\u01a1ng da gi\u00fap \u0111\u01b0a ra ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c (H\u00ecnh 12). H\u00e3y nh\u1edb r\u1eb1ng c\u00e1c bao ho\u1ea1t d\u1ecbch ng\u00f3n tay c\u1ee7a ng\u00f3n 1, 2 v\u00e0 5 li\u00ean t\u1ee5c v\u1edbi bao ho\u1ea1t d\u1ecbch chung t\u1ea1i c\u1ed5 tay trong qu\u00e1 tr\u00ecnh th\u0103m kh\u00e1m. <\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large is-resized\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczON2nqcuHFKfefc6m8FHkadDjCat8N-d6rGv1PAumZMlR5Ac6QbGUciXhTPLepf69eiAbHydafWXe5lS09BILS7cuRhjwrj0G3aETlrAwA9RzfJltzh_1MlML2_mVTGdgC0hHwRyMLOuPb3Uo0-oEgI=w1737-h763-s-no-gm\" alt=\"\" style=\"aspect-ratio:2.2766141595984073;width:717px;height:auto\"\/><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\">H\u00ecnh 12. H\u00ecnh \u1ea3nh si\u00eau \u00e2m to\u00e0n c\u1ea3nh ng\u00f3n tay v\u1edbi c\u00e1c v\u00ed d\u1ee5 v\u1ec1 vi\u00eam bao g\u00e2n kh\u00f4ng ch\u00fa th\u00edch (tr\u00e1i) v\u00e0 c\u00f3 ch\u00fa th\u00edch (ph\u1ea3i). (A) Vi\u00eam bao g\u00e2n nhi\u1ec5m tr\u00f9ng sau khi b\u1ecb m\u00e8o c\u1eafn v\u1edbi s\u1ef1 t\u0103ng k\u00edch th\u01b0\u1edbc bao g\u00e2n v\u00e0 ch\u1ee9a d\u1ecbch b\u00ean trong (m\u0169i t\u00ean tr\u1eafng v\u00e0 cam). (B) Vi\u00eam bao g\u00e2n do b\u1ec7nh kh\u1edbp tinh th\u1ec3 (g\u00fat) v\u1edbi th\u00e0nh ph\u1ea7n t\u0103ng \u00e2m b\u00ean trong bao g\u00e2n cho th\u1ea5y h\u00ecnh \u1ea3nh b\u00e3o tuy\u1ebft (\u0111\u1ea7u m\u0169i t\u00ean v\u00e0 m\u00e0u cam). <em>DP &#8211; Distal phalanx<\/em>, \u0111\u1ed1t xa; <em>MP &#8211; Middle Phalanges<\/em>, \u0111\u1ed1t gi\u1eefa; <em>PP &#8211; proximal phalanx<\/em>, \u0111\u1ed1t g\u1ea7n.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>R\u00e1ch r\u00f2ng r\u1ecdc (Ng\u00f3n tay ng\u01b0\u1eddi leo n\u00fai &#8211; Climber\u2019s finger)<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">T\u1ed5n th\u01b0\u01a1ng c\u00e1c r\u00f2ng r\u1ecdc, c\u1ea3 do v\u1eadn \u0111\u1ed9ng qu\u00e1 m\u1ee9c v\u00e0 \u0111\u1ee9t ho\u00e0n to\u00e0n, r\u1ea5t ph\u1ed5 bi\u1ebfn trong m\u00f4n leo n\u00fai, n\u01a1i v\u1eadn \u0111\u1ed9ng vi\u00ean \u0111\u1eb7t to\u00e0n b\u1ed9 tr\u1ecdng l\u01b0\u1ee3ng l\u00ean c\u00e1c ng\u00f3n tay trong khi b\u00e1m, g\u00e2y t\u1ea3i tr\u1ecdng l\u00ean h\u1ec7 th\u1ed1ng r\u00f2ng r\u1ecdc l\u00ean \u0111\u1ebfn 700 N. Ch\u00fang c\u0169ng \u0111\u00e3 \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 trong c\u00e1c m\u00f4n th\u1ec3 thao kh\u00e1c. Ch\u00fang th\u01b0\u1eddng g\u1eb7p h\u01a1n \u1edf ng\u00f3n 2 v\u00e0 ng\u00f3n 4 v\u00e0 t\u1ea1i c\u00e1c r\u00f2ng r\u1ecdc A2 v\u00e0 A4. C\u00e1c t\u1ed5n th\u01b0\u01a1ng n\u00e0y c\u00f3 th\u1ec3 \u0111\u01a1n \u0111\u1ed9c ho\u1eb7c k\u1ebft h\u1ee3p. Trong tr\u01b0\u1eddng h\u1ee3p sau, khi r\u00e1ch ho\u00e0n to\u00e0n c\u00e1c r\u00f2ng r\u1ecdc A2, A3 v\u00e0 A4 k\u1ebft h\u1ee3p, ch\u00fang ta c\u00f3 th\u1ec3 quan s\u00e1t r\u00f5 r\u00e0ng bi\u1ebfn d\u1ea1ng d\u00e2y cung (bowstring deformity) c\u1ee7a ng\u00f3n tay khi th\u0103m kh\u00e1m l\u00e2m s\u00e0ng. Si\u00eau \u00e2m \u0111\u1ed9ng \u0111\u00e3 cho th\u1ea5y \u0111\u1ed9 nh\u1ea1y 98% v\u00e0 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u 100% trong vi\u1ec7c ph\u00e1t hi\u1ec7n t\u1ed5n th\u01b0\u01a1ng r\u00f2ng r\u1ecdc ng\u00f3n tay. H\u00ecnh \u1ea3nh ch\u1ea9n \u0111o\u00e1n l\u00e0 <strong>kho\u1ea3ng c\u00e1ch l\u1edbn h\u01a1n 1 mm gi\u1eefa g\u00e2n g\u1ea5p v\u00e0 v\u1ecf x\u01b0\u01a1ng \u0111\u1ed1t ng\u00f3n tay<\/strong>, \u0111i\u1ec1u n\u00e0y tr\u1edf n\u00ean r\u00f5 r\u00e0ng h\u01a1n trong kh\u1ea3o s\u00e1t \u0111\u1ed9ng v\u1edbi \u0111\u1ed9ng t\u00e1c g\u1ea5p \u0111\u1ed1i kh\u00e1ng, v\u00e0 c\u00e0ng nhi\u1ec1u r\u00f2ng r\u1ecdc b\u1ecb t\u1ed5n th\u01b0\u01a1ng th\u00ec d\u1ea5u hi\u1ec7u c\u00e0ng r\u00f5 r\u1ec7t. Ph\u00f9 n\u1ec1 m\u00f4 m\u1ec1m v\u00e0 t\u0103ng t\u00edn hi\u1ec7u Doppler \u1edf c\u00e1c m\u00f4 m\u1ec1m l\u00e2n c\u1eadn c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c quan s\u00e1t (H\u00ecnh 13).<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczPebAIRdfIdqiUhSnwZOGsmNxz_mwopZCudRSpL4coGizdFec6RooPKTKXHw_wpyAv5rquGohRXcENq7Grrk4w1OFCi1CiVJJdcx2ZvO_52iqp15lEEAxd0i58RdJeKFf-EdRr4hxQfJsLnRTWmH5pw=w1713-h550-s-no-gm\" alt=\"\"\/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><em>H\u00ecnh 13. M\u1eb7t c\u1eaft si\u00eau \u00e2m d\u1ecdc ng\u00f3n tay. (A) R\u00e1ch r\u00f2ng r\u1ecdc A2 v\u00e0 A3 v\u1edbi kho\u1ea3ng c\u00e1ch &gt;1 mm c\u1ee7a g\u00e2n g\u1ea5p so v\u1edbi v\u1ecf x\u01b0\u01a1ng trong khi g\u1ea5p \u0111\u1ed1i kh\u00e1ng (d\u1ea5u th\u1eadp v\u00e0ng). (B) B\u00ean l\u00e0nh \u0111\u1ed1i di\u1ec7n.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Ng\u00f3n tay l\u00f2 xo (Trigger finger)<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Ng\u00f3n tay l\u00f2 xo l\u00e0 m\u1ed9t r\u1ed1i lo\u1ea1n b\u00e0n tay ph\u1ed5 bi\u1ebfn \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 k\u1eb9t, b\u1eadt, ho\u1eb7c kh\u00f3a c\u1ee7a g\u00e2n g\u1ea5p ng\u00f3n tay b\u1ecb \u1ea3nh h\u01b0\u1edfng. Nguy c\u01a1 m\u1eafc ng\u00f3n tay l\u00f2 xo trong su\u1ed1t cu\u1ed9c \u0111\u1eddi l\u00e0 2% \u0111\u1ebfn 3%. N\u00f3 \u0111\u01b0\u1ee3c coi l\u00e0 vi\u00eam bao g\u00e2n h\u1eb9p c\u1ee7a r\u00f2ng r\u1ecdc A1, t\u1ea1o ra xung \u0111\u1ed9t kh\u00f4ng gian gi\u1eefa bao g\u00e2n v\u00e0 g\u00e2n. Xung \u0111\u1ed9t n\u00e0y g\u00e2y ma s\u00e1t v\u00e0 vi\u00eam g\u00e2n v\u00e0 r\u00f2ng r\u1ecdc cho \u0111\u1ebfn khi hi\u1ec7n t\u01b0\u1ee3ng b\u1eadt l\u00f2 xo x\u1ea3y ra v\u1edbi ti\u1ebfng k\u00eau \u0111au \u0111\u1edbn khi du\u1ed7i th\u1ee5 \u0111\u1ed9ng. Nguy\u00ean nh\u00e2n c\u1ee7a n\u00f3 c\u00f2n g\u00e2y tranh c\u00e3i v\u00e0 n\u00f3 th\u01b0\u1eddng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ng\u00f3n 1, 3 v\u00e0 4 th\u01b0\u1eddng xuy\u00ean h\u01a1n. Tr\u00ean si\u00eau \u00e2m, ch\u00fang ta quan s\u00e1t th\u1ea5y s\u1ef1 d\u00e0y l\u00ean c\u1ee7a r\u00f2ng r\u1ecdc A1 (&gt;0,62 mm), c\u00f3 ho\u1eb7c kh\u00f4ng k\u00e8m theo t\u0103ng t\u00edn hi\u1ec7u Doppler v\u00e0 t\u0103ng k\u00edch th\u01b0\u1edbc c\u1ee7a g\u00e2n l\u00e2n c\u1eadn. Ch\u00fang ta c\u0169ng c\u00f3 th\u1ec3 quan s\u00e1t s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a nang v\u00e0 d\u00e0y d\u1ea1ng n\u1ed1t c\u1ee7a bao g\u00e2n (H\u00ecnh 14). <\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczNoCfNMczYFhLymaHH0PxfuAYmGfM4RYV_iLBgs5XLe7KU5Kka608rM5saCvmE8sXPfHuyMxhsnnLINCKEP43j-a9sSeu2XKzdVa__PrTgP0QfWMigRGZmsqQ6msQM7L1EHERTfLF56L7X7k2E-YXit=w1711-h596-s-no-gm\" alt=\"\"\/><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\">H\u00ecnh 14. Si\u00eau \u00e2m ng\u00f3n tay. (A) M\u1eb7t c\u1eaft d\u1ecdc cho th\u1ea5y t\u0103ng k\u00edch th\u01b0\u1edbc c\u00e1c g\u00e2n g\u1ea5p \u1edf ph\u00eda xa so v\u1edbi r\u00f2ng r\u1ecdc (m\u0169i t\u00ean tr\u1eafng). (B) M\u1eb7t c\u1eaft ngang cho th\u1ea5y s\u1ef1 d\u00e0y l\u00ean c\u1ee7a r\u00f2ng r\u1ecdc (\u0111\u1ea7u m\u0169i t\u00ean).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>V\u00f9ng I: G\u00e2n g\u1ea5p c\u00e1c ng\u00f3n s\u00e2u \u0111o\u1ea1n xa (Jersey finger &#8211; Ng\u00f3n tay \u00e1o \u0111\u1ea5u)<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">T\u1ed5n th\u01b0\u01a1ng FDP x\u1ea3y ra trong qu\u00e1 tr\u00ecnh g\u1ea5p ch\u1ee7 \u0111\u1ed9ng ng\u00f3n tay v\u00e0 sau \u0111\u00f3 b\u1ecb du\u1ed7i qu\u00e1 m\u1ee9c th\u1ee5 \u0111\u1ed9ng \u0111\u1ed9t ng\u1ed9t. N\u00f3 th\u01b0\u1eddng x\u1ea3y ra trong c\u00e1c m\u00f4n th\u1ec3 thao va ch\u1ea1m nh\u01b0 b\u00f3ng b\u1ea7u d\u1ee5c, do \u0111\u00f3 c\u00f3 t\u00ean g\u1ecdi n\u00e0y, khi ng\u00f3n tay b\u1ecb m\u1eafc v\u00e0o \u00e1o \u0111\u1ea5u c\u1ee7a \u0111\u1ed1i th\u1ee7. N\u00f3 c\u00f3 th\u1ec3 c\u00f3 ho\u1eb7c kh\u00f4ng li\u00ean quan \u0111\u1ebfn m\u1ea3nh x\u01b0\u01a1ng b\u1ecb bong v\u00e0 co r\u00fat g\u00e2n. C\u00e1c ng\u00f3n tay b\u1ecb \u1ea3nh h\u01b0\u1edfng nhi\u1ec1u nh\u1ea5t l\u00e0 ng\u00f3n 3 v\u00e0 4. Tr\u00ean si\u00eau \u00e2m, c\u00e1c v\u1ebft <strong>r\u00e1ch b\u00e1n ph\u1ea7n cho th\u1ea5y s\u1ef1 t\u0103ng k\u00edch th\u01b0\u1edbc v\u00e0 bi\u1ebfn \u0111\u1ed5i c\u1ea5u tr\u00fac \u00e2m c\u1ee7a g\u00e2n<\/strong>, trong khi c\u00e1c v\u1ebft <strong>r\u00e1ch ho\u00e0n to\u00e0n cho th\u1ea5y s\u1ef1 b\u1ea5t th\u01b0\u1eddng c\u1ee7a v\u1ecf x\u01b0\u01a1ng v\u1edbi c\u00f3 ho\u1eb7c kh\u00f4ng c\u00f3 m\u1ea3nh bong<\/strong>, <strong>co r\u00fat g\u00e2n v\u1edbi bao g\u00e2n tr\u1ed1ng r\u1ed7ng, v\u00e0 b\u00f3ng l\u01b0ng r\u00f5 r\u1ec7t t\u1ea1i m\u1ecfm c\u1ee5t g\u00e2n<\/strong> (11) (H\u00ecnh 15). <\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczMoA3dQvyODQfuEptQf2rVAYYJjAemWGYGyS_8WgwPK3_GC-L2RVf8U5OxTgze7jeWqq-J-0VjttOsfG8J8VZHXvcBoJFQGwU0Pq-PPkBA6wkFnZWX8w7ae2UE49wweRImAGMoOSJVehQjocLxx7gyR=w1467-h855-s-no-gm\" alt=\"\"\/><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\"><em>H\u00ecnh 15. Si\u00eau \u00e2m ng\u00f3n tay. (A) C\u00e1c m\u1eb7t c\u1eaft d\u1ecdc cho th\u1ea5y s\u1ef1 v\u1eafng m\u1eb7t c\u1ee7a g\u00e2n s\u00e2u \u1edf v\u00f9ng xa c\u1ee7a ng\u00f3n tay (m\u0169i t\u00ean tr\u1eafng) trong h\u00ecnh tr\u00ean v\u00e0 b\u00ean l\u00e0nh \u0111\u1ed1i di\u1ec7n trong h\u00ecnh d\u01b0\u1edbi. (B) M\u1ed9t tr\u01b0\u1eddng h\u1ee3p kh\u00e1c c\u1ee7a jersey finger tr\u00ean m\u1eb7t c\u1eaft ngang cho th\u1ea5y g\u00e2n \u1edf v\u1ecb tr\u00ed c\u1ee7a n\u00f3 trong h\u00ecnh tr\u00ean v\u00e0 s\u1ef1 v\u1eafng m\u1eb7t c\u1ee7a g\u00e2n s\u00e2u trong h\u00ecnh d\u01b0\u1edbi (\u0111\u1ea7u m\u0169i t\u00ean). US, si\u00eau \u00e2m.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Kh\u1edbp<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Gi\u1ea3i ph\u1eabu b\u00ecnh th\u01b0\u1eddng<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">C\u00e1c kh\u1edbp b\u00e0n ng\u00f3n <em>(MCP &#8211; Metacarpophalangeal joint)<\/em> v\u00e0 li\u00ean \u0111\u1ed1t g\u1ea7n <em>(PIP &#8211; Proximal interphalangeal joint)<\/em> l\u00e0 kh\u1edbp \u0111\u1ed9ng ki\u1ec3u b\u1ea3n l\u1ec1 v\u1edbi kh\u1ea3 n\u0103ng g\u1ea5p v\u00e0 du\u1ed7i, \u0111\u01b0\u1ee3c \u1ed5n \u0111\u1ecbnh b\u1edfi t\u1ea5m gan tay <em>(volar plate)<\/em> v\u00e0 c\u00e1c d\u00e2y ch\u1eb1ng b\u00ean <em>(collateral ligaments &#8211; CL)<\/em>. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">C\u00f3 hai lo\u1ea1i CL: CL ch\u00ednh v\u00e0 CL ph\u1ee5. CL ch\u00ednh c\u0103ng khi g\u1ea5p, ng\u0103n ng\u1eeba s\u1ef1 l\u1ec7ch v\u1ec1 ph\u00eda quay v\u00e0 tr\u1ee5 t\u1ea1i kh\u1edbp. C\u00e1c CL ph\u1ee5 c\u00f3 ch\u1ed7 b\u00e1m \u1edf ph\u00eda l\u00f2ng b\u00e0n tay n\u01a1i ch\u00fang h\u00f2a nh\u1eadp v\u1edbi t\u1ea5m gan tay v\u00e0 c\u0103ng khi du\u1ed7i. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">C\u00e1c CL c\u1ee7a kh\u1edbp li\u00ean \u0111\u1ed1t g\u1ea7n <em>(PIP &#8211; Proximal interphalangeal joint)<\/em> c\u00f3 th\u1ec3 ti\u1ebfp c\u1eadn \u0111\u01b0\u1ee3c b\u1eb1ng si\u00eau \u00e2m v\u00e0 \u0111\u01b0\u1ee3c kh\u1ea3o s\u00e1t t\u1ed1t nh\u1ea5t tr\u00ean m\u1eb7t c\u1eaft d\u1ecdc, xu\u1ea5t hi\u1ec7n nh\u01b0 m\u1ed9t d\u1ea3i tuy\u1ebfn t\u00ednh gi\u1ea3m \u00e2m b\u0103ng qua kh\u1edbp. Vi\u1ec7c th\u0103m kh\u00e1m c\u00e1c d\u00e2y ch\u1eb1ng kh\u1edbp b\u00e0n ng\u00f3n <em>(MCP &#8211; Metacarpophalangeal joint)<\/em> b\u1ecb gi\u1edbi h\u1ea1n \u1edf m\u1eb7t c\u1eaft ngang, ngo\u1ea1i tr\u1eeb ng\u00f3n 1, d\u00e2y ch\u1eb1ng b\u00ean quay c\u1ee7a ng\u00f3n 2, v\u00e0 d\u00e2y ch\u1eb1ng b\u00ean tr\u1ee5 c\u1ee7a ng\u00f3n 5. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u1ede ng\u00f3n 1, kh\u1edbp b\u00e0n ng\u00f3n <em>(MCP &#8211; Metacarpophalangeal joint)<\/em> \u0111\u01b0\u1ee3c gia c\u1ed1 b\u1edfi c\u00e1c CL, ph\u1ee9c h\u1ee3p t\u1ea5m gan tay\/x\u01b0\u01a1ng v\u1eebng, v\u00e0 c\u00e2n c\u01a1 kh\u00e9p ch\u1ea1y ph\u00eda tr\u00ean d\u00e2y ch\u1eb1ng b\u00ean tr\u1ee5 (UCL), c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00e2n bi\u1ec7t tr\u00ean si\u00eau \u00e2m nh\u01b0 m\u1ed9t d\u1ea3i m\u1ecfng bao ph\u1ee7 UCL. T\u1ea5m gan tay (Volar plate) l\u00e0 m\u1ed9t c\u1ea5u tr\u00fac s\u1ee5n s\u1ee3i c\u00f3 ch\u1ed7 b\u00e1m l\u1ecfng l\u1ebbo \u1edf ph\u00eda g\u1ea7n tr\u00ean ch\u1ecfm \u0111\u1ed1t g\u1ea7n (PP) v\u00e0 ch\u1ed7 b\u00e1m ch\u1eafc ch\u1eafn \u1edf ph\u00eda xa tr\u00ean n\u1ec1n \u0111\u1ed1t xa <em>(DP &#8211; Distal phalanx)<\/em>. [L\u01b0u \u00fd: trong \u0111o\u1ea1n n\u00e0y t\u00e1c gi\u1ea3 vi\u1ebft &#8220;distal insertion on the base of the DP&#8221; c\u00f3 v\u1ebb nh\u1ea7m l\u1eabn v\u1ec1 gi\u1ea3i ph\u1eabu v\u1edbi kh\u1edbp li\u00ean \u0111\u1ed1t xa (DIP &#8211; <em>Distal interphalangeal joint<\/em>) ho\u1eb7c \u0111\u1ed1t gi\u1eefa (<em>MP &#8211; Middle Phalanges<\/em>), th\u00f4ng th\u01b0\u1eddng Volar plate kh\u1edbp li\u00ean \u0111\u1ed1t g\u1ea7n <em>(PIP &#8211; Proximal interphalangeal joint)<\/em> b\u00e1m v\u00e0o n\u1ec1n \u0111\u1ed1t gi\u1eefa (<em>MP &#8211; Middle Phalanges<\/em>). Tuy nhi\u00ean t\u00f4i d\u1ecbch s\u00e1t ngh\u0129a v\u0103n b\u1ea3n g\u1ed1c l\u00e0 DP]. Tr\u00ean si\u00eau \u00e2m, n\u00f3 xu\u1ea5t hi\u1ec7n nh\u01b0 m\u1ed9t c\u1ea5u tr\u00fac h\u00ecnh tam gi\u00e1c, t\u0103ng \u00e2m n\u1eb1m gi\u1eefa kh\u1edbp v\u00e0 c\u00e1c g\u00e2n g\u1ea5p (H\u00ecnh 16). <\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczOoS9CgCjZB6cm7JUeWtGR7b65o01OSeWa7SJqgMkKnE7J5TWs9BqGTKsDZmwNm_l0ftXWBZRmGPqhHD7pdMpl_j_i8lezpHKp1kbcMWMswg_6T5nP8R_1ZV5ID2NRRCa25Cpr_6hcziKlPEmls9-_z=w1284-h847-s-no-gm\" alt=\"\"\/><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\"><em>H\u00ecnh 16. Si\u00eau \u00e2m ng\u00f3n tay tr\u00ean c\u00e1c m\u1eb7t c\u1eaft ngang (h\u00ecnh tr\u00ean) v\u00e0 d\u1ecdc (h\u00ecnh d\u01b0\u1edbi), gi\u1ea3i ph\u1eabu b\u00ecnh th\u01b0\u1eddng t\u1ea5m gan tay (m\u0169i t\u00ean tr\u1eafng). M\u00e0u xanh d\u01b0\u01a1ng: t\u1ea5m gan tay; m\u00e0u tr\u1eafng: s\u1ee5n; m\u00e0u v\u00e0ng: v\u1ecf x\u01b0\u01a1ng. US, si\u00eau \u00e2m.<\/em><\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczOFgyZb2APA-Z53bHEAUrkGn5vLFA3L5cYZz0V3qiS66eYZy0YtCRoEv8dXspTzNHEaK1rSifaqjEtFiazgebxLNvpcyrAuoBOzOgavz3Jg2voHcd-Rf2FjuUhpa2MA610Frc-uITl3rLAYj0_aA6G9=w1139-h659-s-no-gm\" alt=\"\"\/><\/figure>\n<\/div>\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczO0hswRzByxq_yNeBpt3aGGgG0XXj4jISHlDa9eiaetnLeZYZjIIDGRYDLkZ852feFx6-2TqTQyl1pvTHm37wRmZXoyGG9Pr4_hAjTWPAiUwJBc3VGLYBfqz78JerH1fR4B73XSQMtkeQcvU_oU7ncb=w1144-h256-s-no-gm\" alt=\"\"\/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B\u1ec7nh l\u00fd<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>R\u00e1ch t\u1ea5m gan tay (Volar plate)<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">T\u1ed5n th\u01b0\u01a1ng n\u00e0y ph\u1ed5 bi\u1ebfn h\u01a1n \u1edf kh\u1edbp li\u00ean \u0111\u1ed1t g\u1ea7n <em>(PIP &#8211; Proximal interphalangeal joint)<\/em> v\u00e0 x\u1ea3y ra do c\u01a1 ch\u1ebf du\u1ed7i qu\u00e1 m\u1ee9c v\u00e0\/ho\u1eb7c tr\u1eadt kh\u1edbp ra sau (v\u1ec1 ph\u00eda mu) c\u1ee7a kh\u1edbp, d\u1eabn \u0111\u1ebfn bi\u1ebfn d\u1ea1ng g\u1ea5p. Ch\u00fang c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn m\u1ea3nh x\u01b0\u01a1ng b\u1ecb bong t\u1ea1i ch\u1ed7 b\u00e1m t\u1eadn ph\u00eda xa. Tr\u00ean si\u00eau \u00e2m, n\u00f3 bi\u1ec3u hi\u1ec7n b\u1eb1ng s\u1ef1 <strong>m\u1ea5t h\u00ecnh th\u00e1i tam gi\u00e1c v\u00e0 bi\u1ebfn \u0111\u1ed5i c\u1ea5u tr\u00fac \u00e2m<\/strong> (echostructure). Th\u1ef1c hi\u1ec7n kh\u1ea3o s\u00e1t \u0111\u1ed9ng v\u1edbi du\u1ed7i qu\u00e1 m\u1ee9c th\u1ee5 \u0111\u1ed9ng kh\u1edbp li\u00ean \u0111\u1ed1t g\u1ea7n <em>(PIP &#8211; Proximal interphalangeal joint)<\/em> h\u1ed7 tr\u1ee3 ch\u1ea9n \u0111o\u00e1n c\u00e1c v\u1ebft r\u00e1ch ho\u00e0n to\u00e0n (H\u00ecnh 17). <\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczMyxQgUgSxGN8kMecFkqHb-eeQdXNGnY4oL8fAbdbkViZez2eczWFtK_Z2TLEzJ4C3bgP7NGkqY_Fdng7-SzWHlFR8V9uG0V3iZnadvwThXVjNnUCGfwQ371BBRdrhMqWTuhtYVrkj-ByQJAThaKUaM=w1717-h497-s-no-gm\" alt=\"\"\/><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\"><em>H\u00ecnh 17. Si\u00eau \u00e2m ng\u00f3n tay tr\u00ean m\u1eb7t c\u1eaft d\u1ecdc. (A) R\u00e1ch t\u1ea5m gan tay k\u00e8m bong m\u1ea3nh x\u01b0\u01a1ng t\u1ea1i ch\u1ed7 b\u00e1m t\u1eadn ph\u00eda xa (m\u0169i t\u00ean tr\u1eafng). (B) B\u00ean l\u00e0nh \u0111\u1ed1i di\u1ec7n.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D\u00e2y ch\u1eb1ng b\u00ean tr\u1ee5 (UCL) c\u1ee7a ng\u00f3n 1 (Skier\u2019s thumb\/Ranger\u2019s thumb v\u00e0 t\u1ed5n th\u01b0\u01a1ng Stener)<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">T\u1ed5n th\u01b0\u01a1ng UCL c\u1ee7a ng\u00f3n 1 x\u1ea3y ra t\u1ea1i ch\u1ed7 b\u00e1m t\u1eadn ph\u00eda xa do d\u1ea1ng qu\u00e1 m\u1ee9c k\u00e8m du\u1ed7i qu\u00e1 m\u1ee9c kh\u1edbp b\u00e0n ng\u00f3n <em>(MCP &#8211; Metacarpophalangeal joint)<\/em>. Khi g\u00e2n v\u1eabn \u1edf v\u1ecb tr\u00ed gi\u1ea3i ph\u1eabu, \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n c\u00f3 th\u1ec3 ph\u00f9 h\u1ee3p, g\u1ecdi l\u00e0 ng\u00f3n tay c\u00e1i c\u1ee7a ng\u01b0\u1eddi tr\u01b0\u1ee3t tuy\u1ebft (skier\u2019s thumb) ho\u1eb7c ng\u01b0\u1eddi b\u1ea3o v\u1ec7 r\u1eebng (ranger\u2019s thumb). Tuy nhi\u00ean, n\u1ebfu d\u00e2y ch\u1eb1ng di l\u1ec7ch v\u00e0 c\u00e2n c\u01a1 kh\u00e9p k\u1eb9t gi\u1eefa n\u00f3 v\u00e0 ch\u1ed7 b\u00e1m t\u1eadn ph\u00eda xa, \u0111\u00e2y \u0111\u01b0\u1ee3c coi l\u00e0 t\u1ed5n th\u01b0\u01a1ng Stener, c\u1ea7n \u0111i\u1ec1u tr\u1ecb ph\u1eabu thu\u1eadt. Tr\u00ean si\u00eau \u00e2m, ch\u00fang ta quan s\u00e1t th\u1ea5y c\u00e1c t\u1ed5n th\u01b0\u01a1ng b\u00e1n ph\u1ea7n ho\u1eb7c ho\u00e0n to\u00e0n kh\u00f4ng di l\u1ec7ch v\u1edbi s\u1ef1 d\u00e0y l\u00ean c\u1ee7a UCL, bi\u1ebfn \u0111\u1ed5i c\u1ea5u tr\u00fac \u00e2m, v\u00e0 t\u0103ng t\u00edn hi\u1ec7u Doppler. C\u00e1c v\u1ebft r\u00e1ch di l\u1ec7ch xu\u1ea5t hi\u1ec7n nh\u01b0 m\u1ed9t kh\u1ed1i tr\u00f2n gi\u1ea3m \u00e2m \u1edf ph\u00eda g\u1ea7n so v\u1edbi kh\u1edbp, t\u01b0\u01a1ng \u1ee9ng v\u1edbi \u0111\u1ea7u b\u1ecb di l\u1ec7ch v\u00e0 co r\u00fat c\u1ee7a UCL n\u1eb1m tr\u00ean c\u00e2n c\u01a1 kh\u00e9p, t\u1ea1o th\u00e0nh &#8220;d\u1ea5u hi\u1ec7u yo-yo&#8221;. Kh\u1ea3o s\u00e1t \u0111\u1ed9ng v\u1edbi g\u1ea5p th\u1ee5 \u0111\u1ed9ng kh\u1edbp b\u00e0n ng\u00f3n <em>(MCP &#8211; Metacarpophalangeal joint)<\/em> \u0111\u1ec3 di chuy\u1ec3n c\u00e2n c\u01a1 kh\u00e9p h\u1ed7 tr\u1ee3 ch\u1ea9n \u0111o\u00e1n (H\u00ecnh 18). <\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczOpgfmukGDi56xHb2qszCptcPhONyD13KI__S-UuhETZ4gu8l0h2T9QvXH6oQUuXKIHCNwB8d_nUR7UQSkUFaY9VfmXoV9CI2bQn5oEJ2xRSeJcS2JMmaKMNluRaPZzT1Smr36u1rF5qXCP2fCkafK7=w1711-h523-s-no-gm\" alt=\"\"\/><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\"><em>H\u00ecnh 18. Si\u00eau \u00e2m d\u1ecdc d\u00e2y ch\u1eb1ng b\u00ean tr\u1ee5 ng\u00f3n 1 v\u1edbi t\u1ed5n th\u01b0\u01a1ng Stener. (A) Kh\u00f4ng ch\u00fa th\u00edch. (B) C\u00f3 ch\u00fa th\u00edch. M\u00e0u \u0111\u1ecf: m\u1ea1c c\u01a1 kh\u00e9p; m\u00e0u xanh d\u01b0\u01a1ng: UCL b\u1ecb co r\u00fat &#8220;d\u1ea5u hi\u1ec7u yo-yo&#8221;; m\u00e0u v\u00e0ng: v\u1ecf x\u01b0\u01a1ng. PP, \u0111\u1ed1t g\u1ea7n; M, x\u01b0\u01a1ng b\u00e0n tay; UCL, d\u00e2y ch\u1eb1ng b\u00ean tr\u1ee5.<\/em><\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczP2YgCl4yzMVYKyvptnkhC5qAyBHQw5nEKGBaJNBPFsJcgGbSue0SeH22loeVXd3XPC4vlbSwPP19ajMKNvsgzW0Xm3Wf9lG-AIXqNf_V2FMZCyLyNKj05TXfJvddB50w185xT7uYXf7QSs0kv_vPAt=w400-h353-s-no-gm\" alt=\"\"\/><\/figure>\n<\/div>\n\n\n<figure class=\"wp-block-embed aligncenter is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Ultrasound of the UCL of the thumb\" width=\"640\" height=\"360\" src=\"https:\/\/www.youtube.com\/embed\/uC0o2DRgFmw?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>U v\u00e0 Gi\u1ea3 u<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Nang ho\u1ea1t d\u1ecbch (Ganglions)<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Ch\u00fang \u0111\u1ea1i di\u1ec7n cho t\u1ed5n th\u01b0\u01a1ng ph\u1ed5 bi\u1ebfn nh\u1ea5t \u1edf b\u00e0n tay v\u00e0 ng\u00f3n tay. Nang ho\u1ea1t d\u1ecbch l\u00e0 c\u00e1c t\u1ed5n th\u01b0\u01a1ng d\u1ea1ng n\u1ed1t c\u1ee9ng do ch\u1ee9a ch\u1ea5t nh\u1ea7y v\u00e0 th\u01b0\u1eddng n\u1eb1m \u1edf v\u00f9ng l\u00f2ng b\u00e0n tay c\u1ee7a c\u00e1c g\u00e2n v\u00e0 kh\u1edbp ng\u00f3n tay. Ch\u00fang ph\u1ed5 bi\u1ebfn h\u01a1n \u1edf ng\u01b0\u1eddi tr\u1ebb tu\u1ed5i v\u00e0 g\u1eb7p \u1edf n\u1eef gi\u1edbi nhi\u1ec1u g\u1ea5p ba l\u1ea7n nam gi\u1edbi. Tr\u00ean si\u00eau \u00e2m, nang ho\u1ea1t d\u1ecbch xu\u1ea5t hi\u1ec7n nh\u01b0 c\u00e1c kh\u1ed1i d\u1ea1ng n\u1ed1t ho\u1eb7c nhi\u1ec1u v\u00f2ng tr\u1ed1ng \u00e2m v\u1edbi t\u0103ng \u00e2m ph\u00eda sau v\u00e0 kh\u00f4ng c\u00f3 t\u00edn hi\u1ec7u Doppler. Ch\u00fang c\u00f3 th\u1ec3 c\u00f3 c\u00e1c v\u00e1ch m\u1ecfng v\u00e0 h\u1ed3i \u00e2m b\u00ean trong. \u0110i\u1ec1u quan tr\u1ecdng l\u00e0 c\u1ed1 g\u1eafng ch\u1ee9ng minh c\u1ed5\/s\u1ef1 th\u00f4ng th\u01b0\u01a1ng c\u1ee7a ch\u00fang v\u1edbi kh\u1edbp ho\u1eb7c bao g\u00e2n (H\u00ecnh 19). <\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large is-resized\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczMAwkbHLjgeH7dBa878hqHf7aN56ofNVgZFKk5cGanuMRljh2dkMRoE-vpxZvci40Hm5PS32DkA8CkZf57Q5ECOprsOSHXjhAoXz80D2iMsHmyE4_iOCab-K-X4f7qjBoLJudIXDJ8fUaZ3tgL7p58Q=w952-h847-s-no-gm\" alt=\"\" style=\"aspect-ratio:1.1239807652101192;width:577px;height:auto\"\/><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\"><em>H\u00ecnh 19. Si\u00eau \u00e2m ng\u00f3n tay tr\u00ean m\u1eb7t c\u1eaft d\u1ecdc. (A) Nang ho\u1ea1t d\u1ecbch \u1edf m\u1eb7t mu kh\u1edbp DIP (m\u0169i t\u00ean tr\u1eafng) th\u1ee9 ph\u00e1t sau tho\u00e1i h\u00f3a kh\u1edbp li\u00ean quan \u0111\u1ebfn gi\u01b0\u1eddng m\u00f3ng (ng\u00f4i sao tr\u1eafng). (B) Nang ho\u1ea1t d\u1ecbch bao g\u00e2n g\u1ea5p (\u0111\u1ea7u m\u0169i t\u00ean) t\u1ea1i m\u1ee9c r\u00f2ng r\u1ecdc A2. DP, \u0111\u1ed1t xa; MP, \u0111\u1ed1t gi\u1eefa; PP, \u0111\u1ed1t g\u1ea7n; US, si\u00eau \u00e2m; DIP, kh\u1edbp li\u00ean \u0111\u1ed1t xa.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>U x\u01a1 c\u00e2n gan tay (Palmar fibromatosis) (B\u1ec7nh Dupuytren)<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u0110\u00e2y l\u00e0 lo\u1ea1i u x\u01a1 ph\u1ed5 bi\u1ebfn nh\u1ea5t, x\u1ea3y ra \u1edf kho\u1ea3ng 1\u20132% d\u00e2n s\u1ed1 n\u00f3i chung v\u00e0 c\u00f3 th\u1ec3 b\u1ecb hai b\u00ean trong 42\u201360% c\u00e1c tr\u01b0\u1eddng h\u1ee3p. N\u00f3 ph\u1ed5 bi\u1ebfn \u1edf ng\u01b0\u1eddi cao tu\u1ed5i v\u00e0 khu tr\u00fa t\u1ea1i n\u1ec1n ng\u00f3n 4 v\u00e0 5. Khi th\u0103m kh\u00e1m l\u00e2m s\u00e0ng, n\u00f3 xu\u1ea5t hi\u1ec7n nh\u01b0 c\u00e1c n\u1ed1t d\u01b0\u1edbi da tr\u00ean b\u1ec1 m\u1eb7t l\u00f2ng b\u00e0n tay, ti\u1ebfn tri\u1ec3n ch\u1eadm th\u00e0nh c\u00e1c th\u1eebng x\u01a1 v\u00e0 g\u00e2y co k\u00e9o da v\u00e0 g\u00e2n g\u1ea5p, d\u1eabn \u0111\u1ebfn co r\u00fat g\u1ea5p ng\u00f3n tay. Tr\u00ean si\u00eau \u00e2m, u x\u01a1 gan tay xu\u1ea5t hi\u1ec7n nh\u01b0 s\u1ef1 d\u00e0y l\u00ean d\u1ea1ng n\u1ed1t gi\u1ea3m \u00e2m c\u1ee7a c\u00e2n gan tay n\u1eb1m gi\u1eefa da v\u00e0 c\u00e1c g\u00e2n g\u1ea5p (H\u00ecnh 20). Ch\u00fang th\u01b0\u1eddng kh\u00f4ng t\u0103ng sinh m\u1ea1ch \u0111\u00e1ng k\u1ec3 tr\u00ean Doppler. Kh\u1ea3o s\u00e1t \u0111\u1ed9ng cho th\u1ea5y s\u1ef1 d\u00ednh gi\u1eefa u x\u01a1 c\u00e2n gan tay v\u00e0 g\u00e2n g\u1ea5p trong c\u00e1c c\u1eed \u0111\u1ed9ng ng\u00f3n tay. <\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczORR4AG-CljeYqOmGvUEzAk1pd5R_OStw1sLOHO-gJnON0jfiTr-sEXQ0O1lPtvwlT8p5tYV6lDxZF6UW3ECWSmjoD4fUEERADiGmrRGBCUjLdDVS2k108it5Las_FZw59CitJgpuNAVQKBr-TqOdyQ=w1031-h784-s-no-gm\" alt=\"\"\/><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\"><em>H\u00ecnh 20. Si\u00eau \u00e2m ng\u00f3n tay tr\u00ean m\u1eb7t c\u1eaft d\u1ecdc. (A) H\u00ecnh \u1ea3nh to\u00e0n c\u1ea3nh cho th\u1ea5y m\u1ed9t d\u1ea3i th\u1eb3ng gi\u1ea3m \u00e2m n\u1eb1m gi\u1eefa m\u00f4 d\u01b0\u1edbi da v\u00e0 g\u00e2n g\u1ea5p li\u00ean quan \u0111\u1ebfn u x\u01a1 c\u00e2n gan tay (m\u0169i t\u00ean tr\u1eafng). (B) U x\u01a1 c\u00e2n gan tay chi ti\u1ebft h\u01a1n. <\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D\u1ecb v\u1eadt (Foreign bodies)<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">D\u1ecb v\u1eadt r\u1ea5t ph\u1ed5 bi\u1ebfn \u1edf b\u00e0n tay v\u00e0 ng\u00f3n tay, bi\u1ec3u hi\u1ec7n tr\u00ean l\u00e2m s\u00e0ng nh\u01b0 c\u00e1c kh\u1ed1i\/t\u1ed5n th\u01b0\u01a1ng d\u1ea1ng n\u1ed1t, v\u00ec ch\u00fang th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn u h\u1ea1t do ph\u1ea3n \u1ee9ng d\u1ecb v\u1eadt. Tr\u00ean si\u00eau \u00e2m, d\u1ecb v\u1eadt xu\u1ea5t hi\u1ec7n t\u0103ng \u00e2m v\u1edbi c\u00e1c h\u00ecnh d\u1ea1ng kh\u00e1c nhau v\u00e0 x\u1ea3o \u1ea3nh \u0111a \u00e2m ph\u1ea3n h\u1ed3i (reverberation artifacts) \u1edf c\u00e1c m\u1ee9c \u0111\u1ed9 kh\u00e1c nhau t\u00f9y thu\u1ed9c v\u00e0o v\u1eadt li\u1ec7u c\u1ea5u t\u1ea1o n\u00ean ch\u00fang. Ch\u00fang th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn m\u1ed9t c\u1ea5u tr\u00fac tr\u00f2n gi\u1ea3m \u00e2m quanh t\u1ed5n th\u01b0\u01a1ng v\u1edbi t\u0103ng t\u00edn hi\u1ec7u Doppler, li\u00ean quan \u0111\u1ebfn u h\u1ea1t do ph\u1ea3n \u1ee9ng d\u1ecb v\u1eadt (H\u00ecnh 21). <\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczMOtofn68swQ3HsoIvDY4Pan73VQ_c27aKb7sQM-rIktvag8CmOVcTu8ouAfNLVYtkrcEAZkf2H0xCRzigldzZr_i6MO87VM-qd2oWldwLZa1rZmF1e9cQf1EA--fOyAP41rhc4vPwQVXxeP_Si1at4=w1745-h586-s-no-gm\" alt=\"\"\/><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\"><em>H\u00ecnh 21. Si\u00eau \u00e2m ng\u00f3n 1 tay tr\u00e1i tr\u00ean m\u1eb7t c\u1eaft ngang (A) v\u00e0 d\u1ecdc (B) cho th\u1ea5y d\u1ecb v\u1eadt (m\u0169i t\u00ean tr\u1eafng) li\u00ean quan \u0111\u1ebfn vi\u1ec1n gi\u1ea3m \u00e2m xung quanh n\u00f3 li\u00ean quan \u0111\u1ebfn u h\u1ea1t do ph\u1ea3n \u1ee9ng d\u1ecb v\u1eadt. US, si\u00eau \u00e2m.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>U t\u1ebf b\u00e0o kh\u1ed5ng l\u1ed3 (Giant cell tumor)<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u0110\u00e2y l\u00e0 kh\u1ed1i u t\u00e2n sinh th\u1ef1c s\u1ef1 ph\u1ed5 bi\u1ebfn nh\u1ea5t \u1edf b\u00e0n tay v\u00e0 \u0111\u1ea1i di\u1ec7n cho s\u1ef1 m\u1edf r\u1ed9ng ngo\u00e0i kh\u1edbp c\u1ee7a vi\u00eam bao ho\u1ea1t d\u1ecbch l\u00f4ng n\u1ed1t s\u1eafc t\u1ed1. N\u00f3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn b\u1ec7nh nh\u00e2n t\u1eeb 30 \u0111\u1ebfn 50 tu\u1ed5i, h\u01a1i ph\u1ed5 bi\u1ebfn h\u01a1n \u1edf ph\u1ee5 n\u1eef. U t\u1ebf b\u00e0o kh\u1ed5ng l\u1ed3 l\u00e0 c\u00e1c kh\u1ed1i \u0111\u1eb7c ph\u00e1t tri\u1ec3n ch\u1eadm \u1edf m\u1eb7t l\u00f2ng c\u1ee7a c\u00e1c ng\u00f3n tay, g\u00e2y di l\u1ec7ch c\u00e1c c\u1ea5u tr\u00fac l\u00e2n c\u1eadn v\u00e0 g\u00e2y b\u00e0o m\u00f2n x\u01b0\u01a1ng trong 10\u201350% c\u00e1c tr\u01b0\u1eddng h\u1ee3p. Tr\u00ean si\u00eau \u00e2m, ch\u00fang xu\u1ea5t hi\u1ec7n nh\u01b0 c\u00e1c t\u1ed5n th\u01b0\u01a1ng \u0111\u1eb7c, h\u00ecnh b\u1ea7u d\u1ee5c ho\u1eb7c nhi\u1ec1u v\u00f2ng, ranh gi\u1edbi r\u00f5, gi\u1ea3m \u00e2m, n\u1eb1m trong m\u1ed1i li\u00ean h\u1ec7 m\u1eadt thi\u1ebft v\u1edbi g\u00e2n, v\u1edbi c\u00e1c m\u1ee9c \u0111\u1ed9 m\u1ea1ch m\u00e1u kh\u00e1c nhau tr\u00ean ch\u1ebf \u0111\u1ed9 Doppler (H\u00ecnh 22). <\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczNDu7N8PnUDV5LRTd7h-qsWQAa0i6IcPj1P4dm2KwAaF4kD62h1zdtlQh7vSdMdA8B0CcFhTjx3yeleg1ma7EcdP3oPaEx5SN6S5KDsWXoBnFxzh4eZY_8oJN1CDDoXMdPtk6Fbkn_oT0WIAO0bocgw=w1684-h818-s-no-gm\" alt=\"\"\/><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\"><em>H\u00ecnh 22. U t\u1ebf b\u00e0o kh\u1ed5ng l\u1ed3. (A) Si\u00eau \u00e2m m\u1eb7t c\u1eaft ngang c\u00e1c ng\u00f3n tay, kh\u00f4ng ch\u00fa th\u00edch ph\u00eda tr\u00ean v\u00e0 c\u00f3 ch\u00fa th\u00edch ph\u00eda d\u01b0\u1edbi, cho th\u1ea5y m\u1ed9t t\u1ed5n th\u01b0\u01a1ng gi\u1ea3m \u00e2m \u0111\u1eb7c kh\u00f4ng c\u00f3 d\u00f2ng ch\u1ea3y m\u1ea1ch m\u00e1u tr\u00ean ch\u1ebf \u0111\u1ed9 Doppler (m\u00e0u cam) g\u00e2y b\u00e0o m\u00f2n v\u1ecf x\u01b0\u01a1ng. (B) X-quang ng\u00f3n tay c\u00f9ng ca b\u1ec7nh nh\u01b0 A, kh\u00f4ng ch\u00fa th\u00edch b\u00ean tr\u00e1i v\u00e0 c\u00f3 ch\u00fa th\u00edch b\u00ean ph\u1ea3i, ch\u1ee9ng minh s\u1ef1 t\u0103ng m\u00f4 m\u1ec1m (m\u00e0u v\u00e0ng) v\u00e0 b\u00e0o m\u00f2n x\u01b0\u01a1ng (\u0111\u1ea7u m\u0169i t\u00ean\/m\u00e0u cam). (C) Si\u00eau \u00e2m m\u1eb7t c\u1eaft ngang c\u00e1c ng\u00f3n tay t\u1eeb m\u1ed9t ca GCT kh\u00e1c, kh\u00f4ng ch\u00fa th\u00edch ph\u00eda tr\u00ean v\u00e0 c\u00f3 ch\u00fa th\u00edch ph\u00eda d\u01b0\u1edbi, ti\u1ebft l\u1ed9 m\u1ed1i li\u00ean h\u1ec7 m\u1eadt thi\u1ebft c\u1ee7a t\u1ed5n th\u01b0\u01a1ng (m\u00e0u cam) v\u1edbi c\u00e1c g\u00e2n g\u1ea5p (m\u00e0u xanh d\u01b0\u01a1ng). GCT, u t\u1ebf b\u00e0o kh\u1ed5ng l\u1ed3.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>U cu\u1ed9n m\u1ea1ch (Glomus tumor)<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u0110\u00e2y l\u00e0 u m\u00f4 th\u1eeba (hamartoma) c\u1ee7a th\u1ec3 cu\u1ed9n m\u1ea1ch (glomus body), l\u00e0 m\u1ed9t lo\u1ea1i c\u1ea7u n\u1ed1i \u0111\u1ed9ng t\u0129nh m\u1ea1ch \u0111\u1eb7c bi\u1ec7t n\u1eb1m \u1edf l\u1edbp h\u1ea1 b\u00ec \u0111\u1ec3 \u0111i\u1ec1u nhi\u1ec7t. C\u00f3 \u0111\u1ebfn 75% u cu\u1ed9n m\u1ea1ch n\u1eb1m \u1edf b\u00e0n tay, v\u00e0 t\u1edbi 65% x\u1ea3y ra \u1edf \u0111\u1ea7u ng\u00f3n tay, ch\u1ee7 y\u1ebfu \u1edf khoang d\u01b0\u1edbi m\u00f3ng, d\u1eabn \u0111\u1ebfn bi\u1ebfn d\u1ea1ng v\u00e0 \u0111\u1ed5i m\u00e0u m\u00f3ng b\u00ean tr\u00ean. V\u1ec1 m\u1eb7t l\u00e2m s\u00e0ng, ch\u00fang bi\u1ec3u hi\u1ec7n v\u1edbi c\u01a1n \u0111au kh\u00f4ng ch\u1ecbu n\u1ed5i v\u00e0 nh\u1ea1y c\u1ea3m v\u1edbi nhi\u1ec7t \u0111\u1ed9. Tr\u00ean si\u00eau \u00e2m, ch\u00fang xu\u1ea5t hi\u1ec7n nh\u01b0 m\u1ed9t n\u1ed1t gi\u1ea3m \u00e2m nh\u1ecf ranh gi\u1edbi r\u00f5 d\u01b0\u1edbi gi\u01b0\u1eddng m\u00f3ng li\u00ean quan \u0111\u1ebfn b\u00e0o m\u00f2n x\u01b0\u01a1ng c\u1ee7a \u0111\u1ed1t xa l\u00e2n c\u1eadn v\u00e0 t\u0103ng nhi\u1ec1u t\u00edn hi\u1ec7u m\u1ea1ch m\u00e1u tr\u00ean Doppler (H\u00ecnh 23). <\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large is-resized\"><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/pw\/AP1GczPiKitcs4mDHaEfkoXFJgn2xDf7y7vw8F1Tbu3bTYwwRaSDr_A2kaQ12uuDz8GHEOJ1yTCjRDG6fG3Z_9v-5ph7J019DKy26Ir-0-FawmggVD0iY67GwY3OZMQQA3MyodVkI-tsm-UlUHiGI3pIF2a3=w1288-h832-s-no-gm\" alt=\"\" style=\"aspect-ratio:1.5481195645913726;width:704px;height:auto\"\/><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\"><em>H\u00ecnh 23. Si\u00eau \u00e2m ng\u00f3n tay t\u1ea1i ngang m\u1ee9c m\u00f3ng. (A) M\u1eb7t c\u1eaft d\u1ecdc v\u1edbi t\u1ed5n th\u01b0\u01a1ng d\u1ea1ng n\u1ed1t gi\u1ea3m \u00e2m trong gi\u01b0\u1eddng m\u00f3ng (m\u0169i t\u00ean tr\u1eafng). (B) M\u1eb7t c\u1eaft ngang c\u00f3 (tr\u00ean) v\u00e0 kh\u00f4ng c\u00f3 (d\u01b0\u1edbi) ch\u1ebf \u0111\u1ed9 Doppler cho th\u1ea5y d\u00f2ng ch\u1ea3y m\u1ea1ch m\u00e1u r\u00f5 r\u1ec7t, li\u00ean quan \u0111\u1ebfn u cu\u1ed9n m\u1ea1ch (\u0111\u1ea7u m\u0169i t\u00ean). US, si\u00eau \u00e2m.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>K\u1ebft lu\u1eadn<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">K\u1ec3 t\u1eeb khi ph\u00e1t hi\u1ec7n ra s\u00f3ng si\u00eau \u00e2m v\u00e0o n\u0103m 1974 v\u00e0 s\u1ef1 \u00e1p d\u1ee5ng sau \u0111\u00f3 nh\u01b0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb, si\u00eau \u00e2m \u0111\u00e3 tr\u1ea3i qua s\u1ef1 ti\u1ebfn h\u00f3a v\u00e0 ph\u00e1t tri\u1ec3n \u0111\u00e1ng k\u1ec3, bi\u1ebfn n\u00f3 th\u00e0nh ph\u01b0\u01a1ng ph\u00e1p h\u00ecnh \u1ea3nh \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i nh\u1ea5t c\u1ea3 trong v\u00e0 ngo\u00e0i chuy\u00ean ng\u00e0nh ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh, ch\u1eb3ng h\u1ea1n nh\u01b0 trong l\u0129nh v\u1ef1c g\u00e2y t\u00ea v\u00f9ng. Nh\u1edd s\u1ef1 ph\u00e1t tri\u1ec3n n\u00e0y, n\u00f3 n\u00ean \u0111\u01b0\u1ee3c coi l\u00e0 k\u1ef9 thu\u1eadt \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n c\u00e1c b\u1ec7nh l\u00fd \u1edf c\u00e1c c\u1ea5u tr\u00fac nh\u1ecf v\u00e0 n\u00f4ng, ch\u1eb3ng h\u1ea1n nh\u01b0 c\u00e1c ng\u00f3n tay. Tuy nhi\u00ean, \u0111i\u1ec1u quan tr\u1ecdng c\u1ea7n nh\u1edb l\u00e0 \u0111\u00e2y l\u00e0 m\u1ed9t k\u1ef9 thu\u1eadt ph\u1ee5 thu\u1ed9c v\u00e0o ng\u01b0\u1eddi th\u1ef1c hi\u1ec7n, v\u00e0 s\u1ef1 hi\u1ec3u bi\u1ebft th\u1ea5u \u0111\u00e1o v\u1ec1 gi\u1ea3i ph\u1eabu v\u00e0 k\u1ef9 thu\u1eadt th\u0103m kh\u00e1m l\u00e0 c\u1ea7n thi\u1ebft \u0111\u1ec3 c\u00f3 ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c.<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><thead><tr><td><strong>T\u1eeb <\/strong><\/td><td><strong>Phi\u00ean \u00e2m (OALD\/Medical)<\/strong><\/td><td><strong>Ngh\u0129a <\/strong><\/td><\/tr><\/thead><tbody><tr><td>operator-dependent<\/td><td>\/\u02c8\u0251\u02d0p\u0259re\u026at\u0259r d\u026a\u02c8pend\u0259nt\/<\/td><td>ph\u1ee5 thu\u1ed9c ng\u01b0\u1eddi th\u1ef1c hi\u1ec7n<\/td><\/tr><tr><td>phalanx (pl. phalanges)<\/td><td>\/\u02c8fe\u026al\u00e6\u014bks\/<\/td><td>\u0111\u1ed1t ng\u00f3n tay<\/td><\/tr><tr><td>proximal phalanx (PP)<\/td><td>\/\u02c8pr\u0251\u02d0ks\u026aml \u02c8fe\u026al\u00e6\u014bks\/<\/td><td>\u0111\u1ed1t g\u1ea7n<\/td><\/tr><tr><td>middle phalanx (MP)<\/td><td>\/\u02c8m\u026adl \u02c8fe\u026al\u00e6\u014bks\/<\/td><td>\u0111\u1ed1t gi\u1eefa<\/td><\/tr><tr><td>distal phalanx (DP)<\/td><td>\/\u02c8d\u026astl \u02c8fe\u026al\u00e6\u014bks\/<\/td><td>\u0111\u1ed1t xa<\/td><\/tr><tr><td>metacarpal<\/td><td>\/\u02ccmet\u0259\u02c8k\u0251\u02d0rpl\/<\/td><td>x\u01b0\u01a1ng b\u00e0n tay<\/td><\/tr><tr><td>metacarpophalangeal (MCP)<\/td><td>\/\u02ccmet\u0259\u02cck\u0251\u02d0rpo\u028af\u0259\u02c8l\u00e6nd\u0292i\u0259l\/<\/td><td>kh\u1edbp b\u00e0n ng\u00f3n<\/td><\/tr><tr><td>proximal interphalangeal (PIP)<\/td><td>\/\u02c8pr\u0251\u02d0ks\u026aml \u02cc\u026ant\u0259rf\u0259\u02c8l\u00e6nd\u0292i\u0259l\/<\/td><td>kh\u1edbp li\u00ean \u0111\u1ed1t g\u1ea7n<\/td><\/tr><tr><td>distal interphalangeal (DIP)<\/td><td>\/\u02c8d\u026astl \u02cc\u026ant\u0259rf\u0259\u02c8l\u00e6nd\u0292i\u0259l\/<\/td><td>kh\u1edbp li\u00ean \u0111\u1ed1t xa<\/td><\/tr><tr><td>volar plate<\/td><td>\/\u02c8vo\u028al\u0259r ple\u026at\/<\/td><td><strong>t\u1ea5m gan tay<\/strong><\/td><\/tr><tr><td>collateral ligament<\/td><td>\/k\u0259\u02c8l\u00e6t\u0259r\u0259l \u02c8l\u026a\u0261\u0259m\u0259nt\/<\/td><td>d\u00e2y ch\u1eb1ng b\u00ean<\/td><\/tr><tr><td>ulnar collateral ligament (UCL)<\/td><td>\/\u02c8\u028cln\u0259r k\u0259\u02c8l\u00e6t\u0259r\u0259l \u02c8l\u026a\u0261\u0259m\u0259nt\/<\/td><td>d\u00e2y ch\u1eb1ng b\u00ean tr\u1ee5<\/td><\/tr><tr><td>carpal annular ligament<\/td><td>\/\u02c8k\u0251\u02d0rpl \u02c8\u00e6nj\u0259l\u0259r \u02c8l\u026a\u0261\u0259m\u0259nt\/<\/td><td><strong>d\u00e2y ch\u1eb1ng ngang c\u1ed5 tay<\/strong><\/td><\/tr><tr><td>extensor tendon<\/td><td>\/\u026ak\u02c8stens\u0259r \u02c8tend\u0259n\/<\/td><td>g\u00e2n du\u1ed7i<\/td><\/tr><tr><td>extensor hood<\/td><td>\/\u026ak\u02c8stens\u0259r h\u028ad\/<\/td><td><strong>tr\u1ebd g\u00e2n du\u1ed7i<\/strong><\/td><\/tr><tr><td>sagittal bands<\/td><td>\/\u02c8s\u00e6d\u0292\u026atl b\u00e6ndz\/<\/td><td><strong>c\u00e1c s\u1ee3i ngang<\/strong><\/td><\/tr><tr><td>central band<\/td><td>\/\u02c8sentr\u0259l b\u00e6nd\/<\/td><td>d\u1ea3i trung t\u00e2m \/ d\u1ea3i gi\u1eefa<\/td><\/tr><tr><td>lateral band<\/td><td>\/\u02c8l\u00e6t\u0259r\u0259l b\u00e6nd\/<\/td><td>d\u1ea3i b\u00ean<\/td><\/tr><tr><td>conjoint tendon<\/td><td>\/k\u0259n\u02c8d\u0292\u0254\u026ant \u02c8tend\u0259n\/<\/td><td>g\u00e2n k\u1ebft h\u1ee3p<\/td><\/tr><tr><td>terminal tendon<\/td><td>\/\u02c8t\u025c\u02d0rm\u026anl \u02c8tend\u0259n\/<\/td><td>g\u00e2n t\u1eadn<\/td><\/tr><tr><td>triangular ligament<\/td><td>\/tra\u026a\u02c8\u00e6\u014b\u0261j\u0259l\u0259r \u02c8l\u026a\u0261\u0259m\u0259nt\/<\/td><td>d\u00e2y ch\u1eb1ng tam gi\u00e1c<\/td><\/tr><tr><td>flexor digitorum superficialis<\/td><td>\/\u02c8fleks\u0259r \u02ccd\u026ad\u0292\u026a\u02c8t\u0254\u02d0r\u0259m \u02ccsu\u02d0p\u0259r\u02ccf\u026a\u0283i\u02c8\u00e6l\u026as\/<\/td><td>g\u00e2n g\u1ea5p c\u00e1c ng\u00f3n n\u00f4ng (FDS)<\/td><\/tr><tr><td>flexor digitorum profundus<\/td><td>\/\u02c8fleks\u0259r \u02ccd\u026ad\u0292\u026a\u02c8t\u0254\u02d0r\u0259m pr\u0259\u02c8f\u028cnd\u0259s\/<\/td><td>g\u00e2n g\u1ea5p c\u00e1c ng\u00f3n s\u00e2u (FDP)<\/td><\/tr><tr><td>camper\u2019s chiasm<\/td><td>\/\u02c8k\u00e6mp\u0259rz \u02c8ka\u026a\u00e6z\u0259m\/<\/td><td>giao thoa Camper<\/td><\/tr><tr><td>digital canal<\/td><td>\/\u02c8d\u026ad\u0292\u026atl k\u0259\u02c8n\u00e6l\/<\/td><td><strong>\u1ed1ng ng\u00f3n tay<\/strong><\/td><\/tr><tr><td>annular pulley (A1-A5)<\/td><td>\/\u02c8\u00e6nj\u0259l\u0259r \u02c8p\u028ali\/<\/td><td>r\u00f2ng r\u1ecdc h\u00ecnh nh\u1eabn<\/td><\/tr><tr><td>cruciate pulley (C1-C3)<\/td><td>\/\u02c8kru\u02d0\u0283i\u0259t \u02c8p\u028ali\/<\/td><td>r\u00f2ng r\u1ecdc h\u00ecnh ch\u1eef th\u1eadp<\/td><\/tr><tr><td>nail unit<\/td><td>\/ne\u026al \u02c8ju\u02d0n\u026at\/<\/td><td>\u0111\u01a1n v\u1ecb m\u00f3ng<\/td><\/tr><tr><td>nail plate<\/td><td>\/ne\u026al ple\u026at\/<\/td><td>b\u1ea3n m\u00f3ng<\/td><\/tr><tr><td>nail bed<\/td><td>\/ne\u026al bed\/<\/td><td>gi\u01b0\u1eddng m\u00f3ng<\/td><\/tr><tr><td>nail matrix<\/td><td>\/ne\u026al \u02c8me\u026atr\u026aks\/<\/td><td>m\u1ea7m m\u00f3ng \/ gi\u01b0\u1eddng m\u00f3ng sinh tr\u01b0\u1edfng<\/td><\/tr><tr><td>periungual<\/td><td>\/\u02ccperi\u02c8\u028c\u014b\u0261w\u0259l\/<\/td><td>quanh m\u00f3ng<\/td><\/tr><tr><td>eponychium<\/td><td>\/\u02ccep\u0259\u02c8n\u026aki\u0259m\/<\/td><td>n\u1ebfp g\u1ea5p m\u00f3ng g\u1ea7n<\/td><\/tr><tr><td>hyponychium<\/td><td>\/\u02ccha\u026apo\u028a\u02c8n\u026aki\u0259m\/<\/td><td>n\u1ebfp g\u1ea5p m\u00f3ng xa<\/td><\/tr><tr><td>overuse<\/td><td>\/\u02cco\u028av\u0259r\u02c8ju\u02d0s\/<\/td><td>v\u1eadn \u0111\u1ed9ng qu\u00e1 m\u1ee9c \/ qu\u00e1 t\u1ea3i<\/td><\/tr><tr><td>avulsion<\/td><td>\/\u0259\u02c8v\u028cl\u0283n\/<\/td><td>bong \/ nh\u1ed5 b\u1eadt (x\u01b0\u01a1ng\/g\u00e2n)<\/td><\/tr><tr><td>rupture<\/td><td>\/\u02c8r\u028cpt\u0283\u0259r\/<\/td><td>\u0111\u1ee9t \/ r\u00e1ch<\/td><\/tr><tr><td>retraction<\/td><td>\/r\u026a\u02c8tr\u00e6k\u0283n\/<\/td><td>co r\u00fat<\/td><\/tr><tr><td>boxer\u2019s knuckle<\/td><td>\/\u02c8b\u0251\u02d0ks\u0259rz \u02c8n\u028ckl\/<\/td><td>t\u1ed5n th\u01b0\u01a1ng kh\u1edbp ng\u00f3n tay v\u00f5 s\u0129<\/td><\/tr><tr><td>boutonniere deformity<\/td><td>\/\u02ccbu\u02d0tn\u02c8j\u026ar d\u026a\u02c8f\u0254\u02d0rm\u0259ti\/<\/td><td>bi\u1ebfn d\u1ea1ng ng\u00f3n tay th\u1ee3 khuy\u1ebft<\/td><\/tr><tr><td>mallet finger<\/td><td>\/\u02c8m\u00e6l\u026at \u02c8f\u026a\u014b\u0261\u0259r\/<\/td><td>ng\u00f3n tay v\u1ed3 \/ ng\u00f3n tay b\u00faa<\/td><\/tr><tr><td>jersey finger<\/td><td>\/\u02c8d\u0292\u025c\u02d0rzi \u02c8f\u026a\u014b\u0261\u0259r\/<\/td><td>ng\u00f3n tay \u00e1o \u0111\u1ea5u (\u0111\u1ee9t g\u00e2n g\u1ea5p s\u00e2u)<\/td><\/tr><tr><td>climber\u2019s finger<\/td><td>\/\u02c8kla\u026am\u0259rz \u02c8f\u026a\u014b\u0261\u0259r\/<\/td><td>ng\u00f3n tay ng\u01b0\u1eddi leo n\u00fai (r\u00e1ch r\u00f2ng r\u1ecdc)<\/td><\/tr><tr><td>bowstring deformity<\/td><td>\/\u02c8bo\u028astr\u026a\u014b d\u026a\u02c8f\u0254\u02d0rm\u0259ti\/<\/td><td>bi\u1ebfn d\u1ea1ng d\u00e2y cung<\/td><\/tr><tr><td>trigger finger<\/td><td>\/\u02c8tr\u026a\u0261\u0259r \u02c8f\u026a\u014b\u0261\u0259r\/<\/td><td>ng\u00f3n tay l\u00f2 xo \/ ng\u00f3n tay c\u00f2 s\u00fang<\/td><\/tr><tr><td>skier\u2019s thumb<\/td><td>\/\u02c8ski\u02d0\u0259rz \u03b8\u028cm\/<\/td><td>ng\u00f3n c\u00e1i ng\u01b0\u1eddi tr\u01b0\u1ee3t tuy\u1ebft<\/td><\/tr><tr><td>stener lesion<\/td><td>\/\u02c8ste\u026an\u0259r \u02c8li\u02d0\u0292n\/<\/td><td>t\u1ed5n th\u01b0\u01a1ng Stener<\/td><\/tr><tr><td>yo-yo sign<\/td><td>\/\u02c8jo\u028a jo\u028a sa\u026an\/<\/td><td>d\u1ea5u hi\u1ec7u yo-yo<\/td><\/tr><tr><td>tenosynovitis<\/td><td>\/\u02ccteno\u028a\u02ccsa\u026an\u0259\u02c8va\u026at\u026as\/<\/td><td>vi\u00eam bao g\u00e2n<\/td><\/tr><tr><td>stenosing tenosynovitis<\/td><td>\/st\u026a\u02c8no\u028as\u026a\u014b &#8230;\/<\/td><td>vi\u00eam bao g\u00e2n h\u1eb9p<\/td><\/tr><tr><td>ganglion<\/td><td>\/\u02c8\u0261\u00e6\u014b\u0261li\u0259n\/<\/td><td>nang ho\u1ea1t d\u1ecbch<\/td><\/tr><tr><td>palmar fibromatosis<\/td><td>\/\u02c8p\u0251\u02d0lm\u0259r \u02ccfa\u026abro\u028am\u0259\u02c8to\u028as\u026as\/<\/td><td>u x\u01a1 l\u00f2ng b\u00e0n tay<\/td><\/tr><tr><td>dupuytren\u2019s disease<\/td><td>\/du\u02d0\u02c8pwi\u02d0tr\u0259nz d\u026a\u02c8zi\u02d0z\/<\/td><td>b\u1ec7nh Dupuytren<\/td><\/tr><tr><td>giant cell tumor<\/td><td>\/\u02c8d\u0292a\u026a\u0259nt sel \u02c8tu\u02d0m\u0259r\/<\/td><td>u t\u1ebf b\u00e0o kh\u1ed5ng l\u1ed3<\/td><\/tr><tr><td>glomus tumor<\/td><td>\/\u02c8\u0261lo\u028am\u0259s \u02c8tu\u02d0m\u0259r\/<\/td><td>u cu\u1ed9n m\u1ea1ch<\/td><\/tr><tr><td>foreign body<\/td><td>\/\u02c8f\u0254\u02d0r\u0259n \u02c8b\u0251\u02d0di\/<\/td><td>d\u1ecb v\u1eadt<\/td><\/tr><tr><td>granuloma<\/td><td>\/\u02cc\u0261r\u00e6nju\u02c8lo\u028am\u0259\/<\/td><td>u h\u1ea1t<\/td><\/tr><tr><td>hamartoma<\/td><td>\/\u02cch\u00e6m\u0251\u02d0r\u02c8to\u028am\u0259\/<\/td><td>u m\u00f4 th\u1eeba<\/td><\/tr><tr><td>hypoechoic<\/td><td>\/\u02ccha\u026apo\u028ae\u02c8ko\u028a\u026ak\/<\/td><td>gi\u1ea3m \u00e2m<\/td><\/tr><tr><td>hyperechoic<\/td><td>\/\u02ccha\u026ap\u0259re\u02c8ko\u028a\u026ak\/<\/td><td>t\u0103ng \u00e2m<\/td><\/tr><tr><td>anechoic<\/td><td>\/\u02cc\u00e6n\u0259\u02c8ko\u028a\u026ak\/<\/td><td>tr\u1ed1ng \u00e2m<\/td><\/tr><tr><td>acoustic shadowing<\/td><td>\/\u0259\u02c8ku\u02d0st\u026ak \u02c8\u0283\u00e6do\u028a\u026a\u014b\/<\/td><td>b\u00f3ng l\u01b0ng<\/td><\/tr><tr><td>acoustic enhancement<\/td><td>\/\u0259\u02c8ku\u02d0st\u026ak \u026an\u02c8h\u00e6nsm\u0259nt\/<\/td><td>t\u0103ng \u00e2m ph\u00eda sau<\/td><\/tr><tr><td>reverberation<\/td><td>\/r\u026a\u02ccv\u025c\u02d0rb\u0259\u02c8re\u026a\u0283n\/<\/td><td>\u0111a \u00e2m ph\u1ea3n h\u1ed3i<\/td><\/tr><tr><td>vascularity<\/td><td>\/\u02ccv\u00e6skj\u0259\u02c8l\u00e6r\u0259ti\/<\/td><td>t\u01b0\u1edbi m\u00e1u \/ t\u00edn hi\u1ec7u m\u1ea1ch m\u00e1u<\/td><\/tr><tr><td>infiltration<\/td><td>\/\u02cc\u026anf\u026al\u02c8tre\u026a\u0283n\/<\/td><td><strong>th\u00e2m nhi\u1ec5m<\/strong><\/td><\/tr><tr><td>fluid distension<\/td><td>\/\u02c8flu\u02d0\u026ad d\u026a\u02c8sten\u0283n\/<\/td><td><strong>t\u1ee5 d\u1ecbch<\/strong><\/td><\/tr><tr><td>intratendinous<\/td><td>\/\u02cc\u026antr\u0259\u02c8tend\u026an\u0259s\/<\/td><td><strong>trong g\u00e2n<\/strong><\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">Ch\u00fa th\u00edch<\/h3>\n\n\n<ol class=\"wp-block-footnotes\"><li id=\"8e09d101-226a-4a67-b3d8-cc9ce94e243b\">Trong t\u00e0i li\u1ec7u l\u00e0 &#8220;sagittal bands&#8221;, trong atlas c\u1ee7a Netter l\u00e0 &#8220;transverse fibers&#8221;, atlas ti\u1ebfng Vi\u1ec7t d\u1ecbch l\u00e0 &#8220;c\u00e1c s\u1ee3i ngang&#8221;. Xem h\u00ecnh atlas \u1edf tr\u00ean. <a href=\"#8e09d101-226a-4a67-b3d8-cc9ce94e243b-link\" aria-label=\"Chuy\u1ec3n \u0111\u1ebfn ph\u1ea7n tham kh\u1ea3o ch\u00fa th\u00edch cu\u1ed1i trang 1\">\u21a9\ufe0e<\/a><\/li><li id=\"f0ab5e2c-d79f-4a43-907f-16172d2f3e76\">T\u1ea5m gay tay &#8211; volar plate, c\u00f2n g\u1ecdi l\u00e0 d\u00e2y ch\u1eb1ng gan tay &#8211; Palmar ligaments, b\u1ea3n ch\u1ea5t l\u00e0 m\u00f4 s\u1ee5n s\u1ee3i, <a href=\"#f0ab5e2c-d79f-4a43-907f-16172d2f3e76-link\" aria-label=\"Chuy\u1ec3n \u0111\u1ebfn ph\u1ea7n tham kh\u1ea3o ch\u00fa th\u00edch cu\u1ed1i trang 2\">\u21a9\ufe0e<\/a><\/li><li id=\"20a8ea51-2320-4abb-9692-11fe3afadf57\">\u1ed0ng ng\u00f3n tay kh\u00e1c \u1ed1ng c\u1ed5 tay <a href=\"#20a8ea51-2320-4abb-9692-11fe3afadf57-link\" aria-label=\"Chuy\u1ec3n \u0111\u1ebfn ph\u1ea7n tham kh\u1ea3o ch\u00fa th\u00edch cu\u1ed1i trang 3\">\u21a9\ufe0e<\/a><\/li><\/ol>","protected":false},"excerpt":{"rendered":"<p>M\u1ee5c \u0111\u00edch c\u1ee7a b\u00e0i vi\u1ebft n\u00e0y l\u00e0 gi\u00fap ng\u01b0\u1eddi \u0111\u1ecdc l\u00e0m quen v\u1edbi gi\u1ea3i ph\u1eabu si\u00eau \u00e2m b\u00ecnh th\u01b0\u1eddng c\u1ee7a c\u00e1c ng\u00f3n tay, \u0111\u01b0a ra m\u1ed9t s\u1ed1 m\u1eb9o \u0111\u1ec3 th\u1ef1c hi\u1ec7n si\u00eau \u00e2m v\u00e0 xem x\u00e9t c\u00e1c b\u1ec7nh l\u00fd ph\u1ed5 bi\u1ebfn nh\u1ea5t.<\/p>\n","protected":false},"author":1,"featured_media":1289,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":"[{\"content\":\"Trong t\u00e0i li\u1ec7u l\u00e0 \\\"sagittal bands\\\", trong atlas c\u1ee7a Netter l\u00e0 \\\"transverse fibers\\\", atlas ti\u1ebfng Vi\u1ec7t d\u1ecbch l\u00e0 \\\"c\u00e1c s\u1ee3i ngang\\\". Xem h\u00ecnh atlas \u1edf tr\u00ean.\",\"id\":\"8e09d101-226a-4a67-b3d8-cc9ce94e243b\"},{\"content\":\"T\u1ea5m gay tay - volar plate, c\u00f2n g\u1ecdi l\u00e0 d\u00e2y ch\u1eb1ng gan tay - Palmar ligaments, b\u1ea3n ch\u1ea5t l\u00e0 m\u00f4 s\u1ee5n s\u1ee3i,\",\"id\":\"f0ab5e2c-d79f-4a43-907f-16172d2f3e76\"},{\"content\":\"\u1ed0ng ng\u00f3n tay kh\u00e1c \u1ed1ng c\u1ed5 tay\",\"id\":\"20a8ea51-2320-4abb-9692-11fe3afadf57\"}]"},"categories":[1,2,41,32,7,5,71],"tags":[90,93,12],"class_list":["post-1268","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-khong-phan-loai","category-doc-sach-cho-vui","category-english-corner","category-hoc-sieu-am-tu-con-so-0","category-phan-mem-cxk","category-sieu-am","category-tap-chi-bao-cao","tag-msk","tag-ngon-tay","tag-sieu-am-phan-mem"],"_links":{"self":[{"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/posts\/1268","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/comments?post=1268"}],"version-history":[{"count":16,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/posts\/1268\/revisions"}],"predecessor-version":[{"id":1291,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/posts\/1268\/revisions\/1291"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/media\/1289"}],"wp:attachment":[{"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/media?parent=1268"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/categories?post=1268"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/tags?post=1268"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}