Y HOC VIET NAM THANG 10 - 5 0 2/2010
BONG MANH SUN - Xl/ONG CLIA CHOM XLTONG DUI BUOC OINH Giur BANG XUONG TL/ THAN:
NHAN MOT TRl/ONG HOP TAI BENH VIEN TINH KHANH HOA
-', fh!M
Phan HDru Chinh*, Nguyin Minh Son*
SUMMARY: ^
The peel of bone-catilage fragment from the femur head is rarely seen. If ft happens, the healthy young is often met.
In april, 2006 Orthopeadic department met a case anf the patient had been fixed these bone - cartilage fragments by using tibia autograft.
After 4 years, these fragments is fix well and the function of groin joint is normal.
I.
OAT VAN OEBong manh sun xUOng ciia chdm xUOng dui It gap.
Ch& thUdng manh tren benh nhan tre khoe.
Kinh nghiem xiJ tri ban che.
Dung CU hiong phlu thuat khdng phd biln.
Lay bd cac manh sun xUdng hoac (£nh lai?
La'y bd cac manh sun xUOng lam cho dien tiep xiic chdm xUOng dui va d cd'i khdng toan dien sinb ly, gay thoai boa khdp. Cling khdp.
Ne'u dinh lai ma diing vit kim loai sau mgt thdi gian phai chiu phiu thuat la'y vit ra. Lam tdn thUdng them phan mem va bao khdp, benh nhan dau keo dai va cd the giam cd nang khdp hang va chi dUdi.
Vit sinh hgc (tif tieu) dat tien va khdng phd bie'n.
Lam sao dinh giii manh sun xUOng trong dieu kien ciia tuyen cO sd tbiSu cac vit sinh hgc ma khdng phai la'y dung cu la muc tieu bao cao.
* B$nh vi$n tinh Khanh Hda..
II. HANH CHINH
Benh nhan: NGUYEN PHU KH...
Sd nhap vien: 2006.14308 Tudi:29
Gidi: nam - Dia chi:VTnh PhUdc. Nha trang.
So' dien thoai: 058.3830615
Co che chan thUOng: Tai nan giao thdng.
XQ: 2 manh can quang ddng dam do quanh chdm xUOng diii.
CT: Bong 2 manh cua chdm xUOng diii (P) Chan doan: Bong 2 manh sun xUOng chdm xUOng diii (P).
III. KY THUAT VA KET QUA
/. Ky thudt:
- Benh nhan dUOc giai thich rd tinh
hinh benh va phUOng phap phiu thuat chng tap luyen sau phlu thuat.
- Phlu thuat nhu trUdng hOp thay khdp hang.
+ Dudng md sau ngoai.
-I- Bgc lg chdm xUOng diii.
+ Cac manh sun xUOng bong dUOc xac dinh dung vi tri ban dau.
-I- Xac dinh do dai rgng phii hdp cua chdt giu* xUOng
+ Chdt giii dugc la'y tii manh vd xUOng chay d 1/3 tren trong xUOng chay ciing ben.
-I- Lam cac chdt giu" hinh chem (tam giac).
-1- Khoan va dat cac chdt giff cac manh xUOng.
313
HOI CHAN THUONG CHJNH H I N H VIET NAM - HOI NGHI KHOA HOC TOAN QUOC LAN THlf IX
-I- Dat lai chdm xUOng diii vao d cdi.
-(- Kiem tra cac manh sun xUOng nam diing vi tri qua cac tU the ciia xUOng dui.
-I- Ddng vet md.
+ Bd bdt chau lUng chan 3 tuan.
+ Di 2 nang khdng ty chan benh 2 thang tie'p sau bd bgt.
2. Ket qua:
+ 1 thang sau md: Vet md khd, khdng ban che co dudi khdp hang, gdi.
XQ: cac manh xUOng nam diing vi tri.
-t- 3 thang sau md: Vet md lien td't, benh nhan di 2 chan cdn ngap ngffng chan T chiu lUc td't.
XQ: cac manh xUOng nam diing vi tri, da'u cai non.
+ 5 thang: benh nhan di lai binb thffdng, trd lai cdng viec cu.
XQ: cai xffdng td't, khdng cd dS'u hoai tff, lun manh xUOng.
+ 4 nam sau benh nhan lam viec nang va sinh boat binh thffdng. Seo ve't md td't.
XQ: chdm xffOng dui nhU ben lanh.
IV. BAN LUAN
/ . Dieu kien tien hanh phdu thu4t:
- Con ngffdi:
- Trang thie't bi:
- Cd sd ly luan.
2. Ly ludn: .'^''^ ;'i.i/?f*^CI ••
- Chdm xUOng dui nhff phan dau cai chay.
, - 6 cd'i nhu phan 1dm ciia cac cd'i.
- Hoat ddng khdp hang la he thd'ng dong bg, vffa khit cua 6 cdi va chdm xUOng diii.
- Khi dinh cac manh xUOng bang chdt xUOng tu than, neu ben ngoai khdp hang thi long leo, khdng vffng chac. Nhffng khivao dat cac manh sun xffOng bong nam dung vi tri trong d cd'i thi cac manh xUOng rdi dffdc thanh 6 cdi ep vffng chac vao chdm XffOng diii.
V. KET LUAN
- Bong manh sun xUOng ciia chdm xUOng dui it gap.
- Manh sun xffOng dffOc dat lai va giff bang cho't xffOng tff than hoan toan sinh ly.
- Benh nhan khdng phai chiu phlu thuat lay vit (phlu thuat nhu ban dau).
- Cac manh sun xUOng cai td't, diing vi tn, chffc nang benh nhan trd lai binh thudng.
- Cbl mdt trffdng hop dau tien tai Benh vien Khanh Hoa. Thdi gian theo ddi 4 nam ra't td't nen chung tdi xin neu phUOng phap phiu thuat nham cd the tie'n hanh cac cO s6 y te' ma khdng phu thudc vao vit sinh hgc vUa hie'm vffa dat tien.
El.fi
i,v 'intin ••'::;
314