The carpal tunnel syndrome is a compressive neuropathy with high incidence rates, and its correct diagnosis, treatment and follow-up may lead to significant benefits in healthcare, social and economic terms. In this review, based on systematic review databases and guidelines, we summarise the appropriate indications for the diagnosis, treatment and follow-up, accompanied, whenever possible, by the levels of evidence and strength of recommendations.

Osteoid osteoma (OO) of the cervical spine is frequently located close to the vertebral artery, spinal cord, or nerve roots and complete surgical excision is sometimes difficult by a limited approach and more extended surgery can require spinal fusion. Percutaneous radiofrequency coagulation (PRC) has demonstrated efficacy in the treatment of OO of the pelvis and limbs however, its role in the cervical spine is still nuclear. The Authors present a series of nine cases of OO of the cervical spine, six treated with surgical excision and three with PRC. No neurological or vascular complications occurred in both series. One case of the surgical series had only partial relief of persistent pain for 1 year due to incomplete excision, but is doing well 4 years after surgery. All the other surgical cases had complete relief of symptoms immediately after surgery and are symptom-free 3-10 years later. Two cases of PRC had complete relief of symptoms 24-48 h after surgery and are symptom-free 2 and 3 years later. One case of recurrent OO after surgery and treated with PRC with a reduced dose improved only, and still requires anti-inflammatory drugs 2 years after the procedure. Our still limited experience suggests that PRC can be safely performed in local anaesthesia with the patient awake, enabling to check for signs and symptoms of possible neurological injury. PRC can substitute extensive posterior approaches and reconstructions for OO of the posterior arch and joint pillar.

Marjolin’s ulcer is a squamous cell carcinoma (SCC) arising from any site of established chronic inflammation, especially with presence of scar tissue.An emblematic case report of locally disseminated SCC arising from a chronic osteomyelitis of the left leg complicated by recurring soft tissue infections lasting since 46 years is presented and discussed according to the available international literature evidence. Concurrent diseases, supporting factors, clinical and histopathological presentation, differential diagnosis, and time and mode of management of this potentially functional- and life-threatening pathological condition are reviewed and discussed to offer a theme to daily clinical care.

Objective. The purpose of this study is to compare hospital outcomes in patients being treated with NOACs, undergoing fixation of hip fracture, compared to patients treated with clopidogrel, aspirin, or warfarin. Methods. We collected data from 370 patients who underwent hip fracture surgery. The sample was divided into 4 groups: NOACs, warfarin, clopidogrel/aspirin and not taking anticoagulation. We compared outcome measures including time to surgery, length of stay (LOS), transfusion rate, and blood loss. Results. 363 hip fractures met the inclusion criteria. The total blood loss of group 1 (NOACs) was higher compared to the other groups with an increase in the number of red blood cell (RBC) transfused units (p < 0.001). The mean total blood loss of NOACs group was higher in patients undergoing surgery after 48 hours from admission compared to before 48 hours, but not statistically significant (p < 0.483). Group 1 had a time to surgery (p < 0.0005) and LOS (p < 0.0005) greater than the other groups. Conclusions. The time of suspension of NOAC in patients with hip fracture undergoing surgery is important. Failure to understand this parameter puts the patient at risk of a longer hospital stay and greater total blood loss.