Exam

Ortolani Test

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Ortolani Test, Ortolani Maneuver, Ortolani, Hip Clunk

  • See Also
  1. Galeazzi's Sign
  2. Barlow's Test
  • Indication
  1. Developmental Dysplasia of the Hip evaluation
    1. Evaluation for Congenital Hip Dislocation
  • Pathophysiology
  1. Femoral head displaced superiorly, posteriorly
  • Mechanism
  1. Attempt to relocate hip into acetabulum
  2. Examine each hip individually
  • Preparation
  1. Infant supine with diaper off
  2. Hips flexed to 90 degrees
  • Technique
  1. Infant's legs placed in frogleg position
    1. Place index and middle finger over greater trochanter
    2. Place thumb medially at inner thigh inguinal crease
  2. Attempt relocation of femoral head into acetabulum
    1. Gently abduct the hip while applying upward force
      1. Push upward with greater trochanter (away form bed)
    2. Push toward bed and laterally with thumb at knee
  3. Also assess for reduced Hip Range of Motion in abduction
    1. Abduction less than 60 degrees OR
    2. Abduction more than 20 degrees difference between sides
  • Findings
  • Signs of dislocation
  1. Hip Clunk felt on exam
    1. Occurs when femoral head relocates in acetabulum
    2. Suggests Congenital Hip Dislocation
  2. Distinguish from a hip click
    1. Benign finding
  • References
  1. Ortolani (1976) Clin Orthop Relat Res 119:6-10 [PubMed]