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.