Naohisa Miyakoshi

Atraumatic lower leg compartment syndrome in untreated chronic myeloid leukemia: a case report

Koji Nozaka, Tsuyoshi Shirahata, Yusuke Yuasa, Shun Igarashi et autres

Abstract Background Chronic myeloid leukemia (CML) rarely presents with spontaneous soft tissue bleeding severe enough to cause compartment syndrome. In such cases, surgical decompression performed before recognition of the underlying hematologic disorder may be followed by severe postoperative hemorrhage. Case presentation A …

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Calcaneal Insufficiency Fracture: An Underrecognized Cause of Atraumatic Heel Pain in Older Adults

Koji Nozaka, Naohisa Miyakoshi

Background/Objectives: Calcaneal insufficiency fractures may be overlooked in older adults presenting with atraumatic heel-region pain because early radiographic findings can be absent or inconclusive. Evidence regarding how often these fractures are identified in routine outpatient practice remains limited. This study aimed to …

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Atraumatic subtrochanteric femoral fracture nonunion with suspected impairment of bone quality despite preserved bone mineral density: a case report

Koji Nozaka, Naohisa Miyakoshi

Fracture nonunion is a multifactorial condition involving both mechanical and biological factors. We report a case of atraumatic subtrochanteric femoral fracture nonunion in a patient with relatively preserved bone mineral density (BMD) and biochemical findings suggestive of possible impairment of bone material …

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Atrophic tibial shaft nonunion in a young elite skier possibly associated with severe vitamin D deficiency and vitamin K insufficiency successfully treated with graft-free chipping and circular external fixation: a 10-year follow-up case report

Koji Nozaka, Naohisa Miyakoshi

Long-bone nonunion is multifactorial and may involve mechanical instability, local biological compromise, and potentially modifiable metabolic abnormalities. We report a rare case of atrophic tibial shaft nonunion in a young elite skier with severe vitamin D deficiency and elevated undercarboxylated osteocalcin, treated …

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Bone-preserving ankle arthrodesis after infected pilon fracture nonunion: lessons from tapered distal docking and fibular-supported reconstruction

Koji Nozaka, Tsuyoshi Shirahata, Yusuke Yuasa, Shuntaro Harata et autres

Infected nonunion after severe pilon fracture remains a major challenge in limb reconstruction, particularly when chronic infection and repeated debridement result in severe metaphyseal bone loss and compromised distal tibial morphology. In such cases, conventional resection to create a flat arthrodesis surface …

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Mechanically stable but biologically inactive Jones fracture nonunion managed without immediate revision surgery: a case report

Koji Nozaka, Tsuyoshi Shirahata, Yusuke Yuasa, Shuntaro Harata et autres

Jones fractures are prone to delayed union and nonunion because of the vascular characteristics and mechanical loading environment of the fifth metatarsal metaphyseal–diaphyseal junction. Although nonunion is often attributed to mechanical insufficiency, host-related biological and functional factors may also be clinically relevant …

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Limb Salvage After Chronic Nonunion Following Deformity Correction in Congenital Fibular Deficiency: A Cautionary 12-Year Follow-Up Case Highlighting Biological and Mechanical Reconstructive Challenges

Koji Nozaka, Shohei Murata, Naohisa Miyakoshi

Background: Congenital fibular deficiency is a rare longitudinal deficiency of the lower extremity associated with limb-length discrepancy, ankle and foot deformity, soft-tissue imbalance, and functional impairment. Reconstruction may be challenging because bone healing, regenerate maturation, and mechanical stability can be less predictable …

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Overlapping bone transport as a bone-preserving docking strategy for a massive wedge-shaped infected tibial defect: a case report highlighting a selected reconstructive strategy

Koji Nozaka, 千田 秀一, Naohisa Miyakoshi

Large infected tibial defects remain amongst the most challenging problems in limb reconstruction, particularly when the defect is wedge-shaped rather than purely segmental. In such cases, conventional docking may require resection of irregular but viable cortex to create a flat surface, resulting …

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Biological activation of prolonged delayed fracture healing following abaloparatide under stable circular external fixation: successful limb salvage of a Gustilo type III-C pilon fracture in severe immune thrombocytopenia—a case report

Koji Nozaka, Tsuyoshi Shirahata, Yusuke Yuasa, Shuntaro Harata et autres

BACKGROUND: Delayed fracture healing may persist despite adequate mechanical stability, reflecting biological insufficiency rather than mechanical failure. Although abaloparatide has osteoanabolic effects, its role in prolonged delayed fracture healing remains unclear. CASE PRESENTATION: A 59-year-old Japanese man with severe immune thrombocytopenia (platelet …

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Successful Limb Salvage in MRSA Bacteremic Septic Charcot Midfoot Using Continuous Local Antibiotic Perfusion and Circular External Fixation: A Case Report

Koji Nozaka, Naohisa Miyakoshi

Background: Septic Charcot neuroarthropathy is a limb- and life-threatening condition characterized by the coexistence of neuropathic joint destruction and infection. In patients with severe systemic compromise, major amputation is often considered inevitable. Case Presentation: A 47-year-old man with untreated diabetes mellitus presented …

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Exercise for Osteoporosis

Michio Hongo, Yuji Kasukawa, Naohisa Miyakoshi

Association of Preoperative Inspiratory Muscle Weakness and Respiratory Sarcopenia with Postoperative Pneumonia Following Esophagectomy: A Multicenter Retrospective Cohort Study

Kazuki Okura, Tomohiro Ikeda, Hiroki Sato, Sho Katayama et autres

BACKGROUND: Esophagectomy is associated with a high rate of postoperative pneumonia, which significantly impacts patient outcomes, including survival and quality of life. While some modifiable risk factors have been identified, the specific role of preoperative respiratory muscle function remains to be fully …

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