Efficient synthesis of 5-(hydroxymethyl)piperazin-2-ones using automatically prepared chiral bromocarboxylic acid and Garner's aldehyde as versatile building blocks.

An efficient method for the synthesis of substituted 5-(hydroxymethyl)piperazin-2-ones was established by using an automated synthesis process. Thirteen piperazinones were synthesized from chiral α-bromocarboxylic acids and Garner's aldehyde which were prepared by using our originally developed automated synthesizer, ChemKonzert®. The automated method of synthesizing chiral α-bromocarboxylic acids was efficient and safe because the rate of the dropwise addition of the reagent can be controlled using the automated synthesizer.

A case of symptomatic tumoral calcinosis on the great toe and review of the literature.

A 67-year-old woman with no specific medical history showed a hard mass on her great toe for several years. The lesion was elastic, round, and had good mobility. An X-ray showed the lesion to be a calcified "chicken wire" lesion; CT and MRI findings indicated it as a benign subcutaneous calcified tumor.

Reconstruction of lateral ligament with arthroscopic drilling for treatment of early-stage osteoarthritis in unstable ankles.

Purpose: The purpose of this study was to investigate the clinical, radiologic, and arthroscopic results of lateral stabilization with reconstruction of the lateral ligaments and cartilage regeneration with arthroscopic drilling for the treatment of moderate osteoarthritis of the ankle with simultaneous lateral instability of the ankle (LIA).

Methods: There were 16 cases with LIA, 7 of which had stage 2 osteoarthritis of the ankle according to the radiographic classification of Takakura et al. and 9 of which had stage 3 osteoarthritis.

Retrograde drilling for osteochondral lesions of the talar dome.

Background: For the treatment of osteochondral lesions of the talar dome without detachment of the cartilage, there is little information on whether transmalleolar drilling or retrograde drilling is more effective in terms of clinical and morphologic evaluations.

Hypothesis: Retrograde drilling may be more effective than transmalleolar drilling for lesions without cartilage detachment.

Study Design: Case control study; Level of evidence, 3.

Arthroscopic assessment for intra-articular disorders in residual ankle disability after sprain.

Background: After ankle sprain, there can be many causes of disability, the origins of which cannot be determined using standard diagnostic tools.

Hypothesis: Ankle arthroscopy is a useful tool in identifying intra-articular disorders of the talocrural joint in cases of residual ankle disability after sprain.

Study Design: Cohort study (diagnosis); Level of evidence, 2.

Diagnosis and treatment of combined intra-articular disorders in acute distal fibular fractures.

Background: Some patients have residual ankle pain and disability after the treatment of an ankle fracture, despite the fracture site being well aligned. We identified intra-articular disorders in distal fibular fractures and sought to clarify the results of their operative treatment.

Methods: This is a prospective, randomized study.

Arthroscopic treatment for anterior impingement exostosis of the ankle: application of three-dimensional computed tomography.

The purpose of this study was to evaluate the operative results of excision of anterior impingement exostoses of the ankle. Preoperative three-dimensional computed tomography (3DCT) was used to make the diagnoses. The authors evaluated 16 ankles of 16 patients who underwent arthroscopic resection of the osteophytes of their anterior distal tibia or dorsal talus.

Osteochondral lesions of the talar dome associated with trauma.

Purpose: The purpose of this study was to clarify the differences in the causes of osteochondral lesions (OCL) of the ankle based on the presence of distal fibular fractures and lateral instability of the ankle.

Type Of Study: Case series.

Methods: We evaluated 92 cases of distal fibular fractures and 86 cases of lateral instability of the ankle, including 36 feet with subacute lateral instability of the ankle and 50 feet with chronic lateral instability of the ankle.

Arthroscopic drilling for chondral, subchondral, and combined chondral-subchondral lesions of the talar dome.

Purpose: We investigated the efficacy of drilling as a treatment for chondral (C), subchondral (S), and combined chondral-subchondral (CS) lesions of the talar dome associated with trauma, using magnetic resonance imaging (MRI), ankle arthroscopy, and the ankle-hindfoot scale of the American Orthopaedic Foot and Ankle Society (AOFAS score).

Type Of Study: Case series study.

Methods: Arthroscopic drilling was performed on 72 patients whose lesions were less than 7 mm in diameter.

Injury of the tibiofibular syndesmosis: value of MR imaging for diagnosis.

Purpose: To compare the use of magnetic resonance (MR) imaging with the use of arthroscopy for the diagnosis of tibiofibular syndesmotic injury.

Materials And Methods: This study involved 58 patients who had ankle sprains or distal fibular fractures and underwent surgery. All patients were examined with MR imaging for diagnosis of tibiofibular syndesmotic injury.

Symptomatic os subfibulare caused by accessory ossification: a case report.

Separated ossicles at the tip of the lateral malleolus, the condition known as os subfibulare, are sometimes a cause of ankle pain. There are two theories regarding the origin of os subfibulare. One theory proposes that it is caused by an avulsion fracture attributable to pull of the anterior talofibular ligament, whereas the other theory proposes that it is the result of an accessory ossification center.