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            [0] => Advantage of the DANA MEARS tri-radiate approach in the treatment of an inveterate fracture dislocation of the hip
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    [etablissement] => Array
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            [0] => Service de chirurgie orthopédique et traumatologique, Hôpital Ibn Jazzar Kairouan, unité chirurgicale Aghlabide
        )

    [nom] => Array
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            [0] => Mahmoudi
        )

    [prenom] => Array
        (
            [0] => Ahmed
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    [email] => Array
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            [0] => intern.mahmoudi.ahmed@gmail.com
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    [telephone] => Array
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            [0] => 52688486
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    [auteurs] => Array
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            [0] => 
 
Nom prénom: Zied Mansi
Email: doc.zm@hotmail.fr
Hôpital: Hôpital Ibn Jazzar Kairouan, unité chirurgicale Aghlabide

 
Nom prénom: Mahmoudi Ahmed
Email: intern.mahmoudi.ahmed@gmail.com
Hôpital: Hôpital Ibn Jazzar Kairouan, unité chirurgicale Aghlabide

 
Nom prénom: Taghouti Mohamed
Email: 
Hôpital: Hôpital Ibn Jazzar Kairouan, unité chirurgicale Aghlabide

 
Nom prénom: Chaabeni Ala
Email: 
Hôpital: Hôpital Ibn Jazzar Kairouan, unité chirurgicale Aghlabide

 
Nom prénom: Boughattas Anouer
Email: 
Hôpital: Hôpital Ibn Jazzar Kairouan, unité chirurgicale Aghlabide

 
Nom prénom: Rbai Hedi
Email: 
Hôpital: Hôpital Ibn Jazzar Kairouan, unité chirurgicale Aghlabide

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    [event-id] => Array
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            [0] => 3663
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            [0] => 1
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    [abstract] => Array
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            [0] => https://www.sotcot.tn/wp-content/uploads/gravity_forms/1-734bfe19ec36a1528718899bf7a2927f/2024/03/Dana-mears.docx
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    [user_email] => Array
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            [0] => intern.mahmoudi.ahmed@gmail.com
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    [specialite] => Array
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            [0] => Chirurgie orthopédique et traumatologique
        )

    [pays] => Array
        (
            [0] => Tunisie
        )

    [texte_abs] => Array
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            [0] => ABSTRACT
This study addresses the intricate challenges of treating rare cases of acetabular fractures with inveterate hip dislocation, emphasizing the need for surgical intervention to restore joint stability. The study explores the Dana Mears approach's utility in managing this complex orthopedic condition to achieve optimal outcomes.
INTRODUCTION
Inveterate hip dislocation, a rare and challenging orthopedic condition, involves persistent femoral head displacement and difficulty in joint reduction. Surgery is essential for optimal results, addressing fractures, restoring stability, and minimizing long-term consequences. The Dana Mears approach is explored for its utility in managing this complexity, particularly in cases of acetabulum fractures associated with inveterate hip dislocation.
OBSERVATION
A 38-year-old MH patient with mental retardation experienced a right hip fracture and dislocation in a road accident. After 96 days, a stage 4 inveterate hip dislocation diagnosis was confirmed. Clinical examination revealed functional impotence and characteristic limb positioning. A CT scan revealed a two-column acetabulum fracture. Opting for the Dana Mears approach, the surgical intervention achieved a Merle d'Aubigné rating of 14/18 at 6 months, demonstrating successful restoration of function and reduction of the dislocation.
DISCUSSION
In addressing complex acetabulum fractures with inveterate hip dislocation, the expanded tri-radiation approach, pioneered by Mears, emerges as a crucial surgical advancement. This method facilitates precise reduction of bone fragments and effective reintegration of the femoral head into the acetabulum. Chronic hip dislocation, often resulting from serious trauma, poses challenges such as muscle atrophy and femoral head necrosis, emphasizing the importance of early open reduction to avoid complications. While inveterate hip dislocations are rare in Western societies, they are more prevalent in East Africa, underscoring the need for prompt diagnosis. The Dana Mears approach proves valuable for complex acetabulum fractures, offering extensive access for optimal outcomes, particularly in cases involving inveterate hip dislocations and extensive fractures.

CONCLUSION  
The expanded tri-radiation approach by Dana Mears is a vital surgical option for inveterate hip fracture-dislocations, offering precise anatomical reduction, superior results, and reduced complications. Despite drawbacks, its benefits make it a viable choice, individualized based on injury severity and patient characteristics.
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