In plain words
The Ortolani maneuver is a hands-on check of a newborn's hips. The baby lies on the back with the hips and knees bent. The clinician gently lifts and moves each leg. A hip that is not seated well in its socket can make a clicking or slipping feel. The test is part of the newborn exam. It looks for , a condition where the hip joint does not form fully. Many babies with a click have a normal hip. Follow-up with an ultrasound or X-ray is often used to confirm. Mothers may hear a click described during a pediatric visit and may be told how the next steps are planned.
The deeper version
The Ortolani maneuver, described in 1937, reduces a dislocated hip by abduction and lifting of the femoral head into the acetabulum, with a palpable or audible clunk as the head reduces. The tests for instability by adduction and posterior pressure. Both are performed in neonatal screening for developmental dysplasia of the hip, which is reported at roughly 1 to 3 per 1,000 births for clinically significant disease. The AAP clinical practice guideline (2000) emphasizes that clinical examination alone has limited sensitivity and that ultrasound is used selectively, most often for risk factors such as breech presentation and family history. Hip examination in the first weeks of life has been debated for specificity and overdiagnosis.
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Sources
- American Academy of Pediatrics — Clinical Practice Guideline: Early detection of developmental dysplasia of the hip, 2000
- Ortolani M — Un segno poco noto e sua importanza per la diagnosi precoce di prelussazione congenita dell'anca. Pediatria 1937