Introduction and purpose: Cortical strut autografts provide primary stability to resolve fractures or pseudoarthrosis associated with major bone loss, or fractures close to joint prostheses.

Materials and methods: We present 8 cases in which strut autografts were used: one pseudoarthrosis of the humerus, three periprosthetic fractures in TKR and four fractures associated with hip prosthesis surgery.

We resolved the humeral pseudoarthrosis with struts and a PCL plate plus cancellous tissue graft. For the periprosthetic fractures of the knee and hip we used revision prostheses with extension stems plus struts, held in place with cerclage wires or compression bands, with or without plates.

In all cases functional rehabilitation started early. The mean non-weight-bearing period for lower limbs was 10 weeks (8–12 months).

Results: Primary stability made it possible to begin rehabilitation early in all cases. Total consolidation of the grafts in a mean time of 5 months (4–7 months), with complete recovery of bone stock. Excellent functional outcome with full return to daily activity as before surgery.

Conclusions: The use of strut autografts associated with osteosynthesis and/or revision prosthesis implantation makes it possible to resolve cases that require a large amount of bone graft and provides sufficient primary stability for fast rehabilitation. The proper final consolidation of the grafts and complete recovery of bone stock provides stability with full guarantee of long-term success.

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.