Ferretti A, De Carli A, Fontana M
First Department of Orthopaedic Surgery, University of Rome, La Sapienza, Italy.
Am J Sports Med. 1998 Nov-Dec;26(6):759-63. doi: 10.1177/03635465980260060401.
From 1985 to 1996, we observed 38 cases of isolated atrophy of the infraspinatus muscle in athletes; all were involved in volleyball at a competitive level. There were 20 men and 18 women with a mean age of 26 years (range, 15 to 27). At the time of the first examination, 35 of these athletes had no pain and were treated with exercises to strengthen the external rotators. The remaining three patients underwent surgery because of pain at the posterior aspect of the shoulder. Sixteen of the 35 players treated nonoperatively were reviewed at a mean follow-up of 5.5 years (range, 3 to 10). Thirteen were still involved in volleyball and three had retired symptom-free at the end of their careers. On physical examination, atrophy of the infraspinatus muscle was unchanged in all cases. The patients treated surgically were reviewed at a mean follow-up of 2 years. All of them were able to play volleyball at their preinjury levels, but one had pain at the anterior aspect of the shoulder after strenuous activity. Physical examination showed a notable reduction of the atrophy in one patient. Entrapment of the suprascapular nerve at the spinoglenoid notch is a usually painless syndrome that is frequently observed in volleyball players. Surgical treatment is indicated in the rare cases of painful neuropathies after careful patient selection.
1985年至1996年期间，我们观察了38例运动员冈下肌孤立性萎缩病例；所有患者均参加过竞技水平的排球运动。其中男性20例，女性18例，平均年龄26岁（范围15至27岁）。首次检查时，这些运动员中有35例无疼痛症状，接受了加强外旋肌的锻炼治疗。其余3例患者因肩部后方疼痛接受了手术治疗。对35例接受非手术治疗的运动员中的16例进行了平均5.5年（范围3至10年）的随访。13例仍从事排球运动，3例在职业生涯结束时无症状退役。体格检查发现，所有病例中冈下肌萎缩情况均无变化。对接受手术治疗的患者进行了平均2年的随访。他们所有人都能在受伤前的水平上打排球，但有1例在剧烈活动后肩部前方疼痛。体格检查显示，1例患者的萎缩情况明显减轻。肩胛上神经在肩胛冈切迹处受压是一种通常无痛的综合征，在排球运动员中经常观察到。在仔细选择患者后，罕见的疼痛性神经病变病例需要进行手术治疗。
