Sandow M J, Ilic J
Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Wakefield Orthopaedic Clinic/SportsCare, South Australia, Australia.
J Shoulder Elbow Surg. 1998 Sep-Oct;7(5):516-21. doi: 10.1016/s1058-2746(98)90205-1.
Selective denervation of the infraspinatus muscle producing weakness and wasting has been reported in certain sports (eg, volleyball and baseball). Nerve kinking or friction caused by excessive infraspinatus motion and compression by superior or inferior transverse scapular ligament or ganglions have been proposed as possible causes. However, in extreme abduction with full external rotation of the shoulder, the medial tendinous margin between the infraspinatus and supraspinatus muscles impinges strongly against the lateral edge of scapular spine, compressing the intervening infraspinatus branch of the suprascapular nerve. Spinaglenoid notchplasty has been performed in 5 elite volleyball players with infraspinatus neuropathy, allowing recovery of shoulder function in all patients and correction of infraspinatus muscle wasting. All returned to the same or higher level of volleyball by 8 months after surgery. An alternative cause of infraspinatus compromise in volleyball players is proposed and has been treated surgically with satisfactory outcome.
据报道，在某些运动项目（如排球和棒球）中，冈下肌的选择性去神经支配会导致肌肉无力和萎缩。有人提出，冈下肌过度活动以及肩胛上横韧带或神经节的上、下压迫所引起的神经扭结或摩擦可能是其原因。然而，在肩部极度外展并完全外旋时，冈下肌和冈上肌之间的内侧腱性边缘会强烈撞击肩胛冈的外侧边缘，压迫其间的肩胛上神经冈下肌支。对5名患有冈下肌神经病变的精英排球运动员进行了肩胛下切迹成形术，所有患者的肩部功能均得以恢复，冈下肌萎缩也得到了纠正。术后8个月时，所有人都恢复到了相同或更高水平的排球运动。本文提出了排球运动员冈下肌受损的另一种原因，并已通过手术进行治疗，效果令人满意。
