Aims: The purpose of this study is to evaluate the functional recovery and mortality after the sequential fracture of both hips in elderly patients. Methods: Eight hundred forty-two patients (over 64 years of age) with hip fractures (nonpathologic) consecutively admitted to our hospital between January 1, 1999, and December 31, 2001, were included in this prospective study. A total of 765 were admitted of their þrst hip fracture, and the other 77 patients had a second contralateral fracture. All patients were identiþed at the time of admission, had fracture treatment and were followed untill six months or death. Information of complications and postinjury function was collected. Differences between the two groups were explored in contingency tables. Results: Most recurrent hip fractures (90%) are the same pattern the þrst contralateral fracture was. Functional recovery, postoperative complications and the length of stay of the patients affected by recurrent fracture were similar to the ones of the patients suffering from a single fracture. Hemoglobin level at admittance was 13 g/dl (mean) for single group and 12 g/dl (mean) for recurrent group; blood transfusion was needed for 30% from the single group and 50% from the recurrent group. Six months mortality was 17% for recurrent group and 28% for single group (p=0.033). Conclusions: Our data suggest that the functional recovery in elderly patients with hip fractures is not inßuenced by a previous fracture of the contralateral hip. Lower mortality after recurrent hip fracture shows us older patients and those with more concomitant diseases died before suffering the second fracture.

Introduction and Objectives: Extraskeletal osseous sarcomas are very rare high-grade tumours. They include osteosarcoma, chondrosarcoma, and Ewing’s soft tissue sarcoma and their respective variants. We present a retrospective study of 25 cases covering the period from December 2002 to January 2003.

Materials and Methods: This study of 25 cases shows that this heterogeneous group of soft tissue sarcomas primarily affects adults (mean age 50.68; range 17 to 70 years). The thigh (36.60%) and the elbow-forearm (18.18%) are the most common locations for these tumours. In these cases, 14 chondrosarcomas, 8 osteosarcomas, and 3 Ewing’s sarcomas were diagnosed. Mean follow-up time was 48.9 months with a range of 16 to 197 months. There were 16 surgeries performed with wide or compartmental margins, while in the 5 remaining cases, amputations were performed, and one case of Ewing’s sarcoma of the pelvis was treated by means of chemotherapy and radiation therapy, as it was considered non-resectable. All cases of osteosarcoma and Ewing’s sarcoma were treated by means of pre- and postoperative chemotherapy and postoperative radiation therapy.

Results: The postoperative duration of symptoms ranged from 2 weeks to 6 years with a mean of 6 months. Local recurrence following surgery with wide or compartmental margens occurred in 8 cases, representing 35.45% (3 chondrosarcomas, 4 osteosarcomas, and 1 Ewing’s sarcoma). The total number of cases surviving without recurrence is 14 (63.6%), surviving cases with one or more recurrences is 5 (22.72%), one case is alive with metastasis (4.59%), and 3 sarcomas (2 ulcerated upon admission) had disseminated and the patients died (10.05%).

Discussion and Conclusions: All these tumours were high-grade sarcomas. The most common metastatic localizations were lungs, regional ganglia, and skeleton. The recommended treatment is surgery with wide or compartmental margins, if possible in the early stages, in conjunction with chemotherapy and radiation therapy. The worst prognosis corresponds to the osteosarcoma.