Motohiko Oyama

Jichi Medical University, Tochigi, Tochigi-ken, Japan

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Publications (3)0.54 Total impact

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    ABSTRACT: We present here a case wherein the patient developed an unsuspected pseudoaneurysm (also called a false aneurysm) secondary We present here a case wherein the patient developed an unsuspected pseudoaneurysm (also called a false aneurysm) secondary to a low-energy proximal humeral fracture. Massive hemorrhaging from the pseudoaneurysm occurred around 4months from the to a low-energy proximal humeral fracture. Massive hemorrhaging from the pseudoaneurysm occurred around 4months from the initial injury. Neurovascular deficit and necrosis were present upon examination and the limb was unsalvageable. The delay initial injury. Neurovascular deficit and necrosis were present upon examination and the limb was unsalvageable. The delay in treatment resulted in a severe and irreversible neurovascular deficit. A shoulder disarticulation was performed and postoperative in treatment resulted in a severe and irreversible neurovascular deficit. A shoulder disarticulation was performed and postoperative progress was favorable. Early diagnosis and surgical intervention is critical to recovery in such cases. Common features and progress was favorable. Early diagnosis and surgical intervention is critical to recovery in such cases. Common features and challenges associated with this sort of injury are here described based on a review of past case reports and on our own case. challenges associated with this sort of injury are here described based on a review of past case reports and on our own case. Although early diagnosis is difficult, the following are some clinical features of a pseudoaneurysm secondary to a proximal Although early diagnosis is difficult, the following are some clinical features of a pseudoaneurysm secondary to a proximal humeral fracture (1) delayed presentation; (2) severe anteromedial displacement of the fracture; (3) somewhat atypical symptoms humeral fracture (1) delayed presentation; (2) severe anteromedial displacement of the fracture; (3) somewhat atypical symptoms such as a recurrence or persistence of shoulder swelling and pain. such as a recurrence or persistence of shoulder swelling and pain.
    European Journal of Orthopaedic Surgery & Traumatology 01/2010; 20(1):51-54. · 0.18 Impact Factor
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    ABSTRACT: A 72-year-old woman with a history of lower extremity weakness, pain, and sensory loss in the right thigh for the last 15months had deteriorated during a period of 6months. Magnetic resonance imaging of the lumbosacral spine revealed apparent nerve root thickening from L1 to S and spinal canal stenosis. An L1–L3 decompressive laminectomy and durotomy revealed multiple segmentally enlarged and congestive nerve roots. A 1-mm segment of nerve root was resected and submitted for pathological analysis. The pathological examination revealed hypertrophic neuropathy, with nonspecific inflammation. After steroid use, the patient’s symptoms improved. HNCE is a rare disorder that can cause pain and lower extremity weakness, sensory loss, and hyporeflexia. One possible cause is chronic inflammatory demyelinating polyneuropathy (CIDP), but the intrathecal nerve roots are enlarged only patchily and canal stenosis is also present, so the diagnosis is unclear. As this case demonstrates, surgical management and administration of steroids are an effective treatment for some HNCE. KeywordsHypertrophic neuropathy of the cauda equina (HNCE)-Sciatica-Decompressive lumbar laminectomy-Steroid
    European Journal of Orthopaedic Surgery & Traumatology 01/2010; 20(7):569-571. · 0.18 Impact Factor
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    ABSTRACT: We present two cases of pulmonary embolism (PE) without deep venous thrombosis (DVT) after spinal surgery with an anterior approach. On the seventh day after surgery, the patients’ plasma D-dimer levels were high without symptoms, so computed tomography (CT) was performed from chest to lower limb, revealing PE without lower limb DVT. After the exam, we immediately started anticoagulation therapy with heparin and warfarin. The patients were discharged with no complications. Previous reports have documented that DVT causes most cases of PE; however, our cases had no lower limb DVT. Some reports hypothesize that anterior spinal surgery might have a differential pathogenesis of PE. Simple mechanical prophylaxis for DVT may not protect these patients. On the other hand, the administration of chemical anticoagulants therapy after spinal surgery is controversial because of the risk of epidural hematoma. We should explain the risk of PE to patients undergoing spinal surgery with an anterior approach. KeywordsSpinal surgery-Pulmonary embolism-Deep venous thrombosis-Anterior approach
    European Journal of Orthopaedic Surgery & Traumatology 20(4):309-311. · 0.18 Impact Factor