Ortolani Maneuver
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The Ortolani test is part of the
physical examination In a physical examination, medical examination, or clinical examination, a medical practitioner examines a patient for any possible medical signs or symptoms of a medical condition. It generally consists of a series of questions about the pati ...
for developmental dysplasia of the hip, along with the
Barlow maneuver The Barlow maneuver is a physical examination performed on infants to screen for developmental dysplasia of the hip. It is named for Dr. Thomas Geoffrey Barlow (September 25, 1915 – May 25, 1975), an English orthopedic surgeon, who devi ...
. Specifically, the Ortolani test is positive when a posterior
dislocation In materials science, a dislocation or Taylor's dislocation is a linear crystallographic defect or irregularity within a crystal structure that contains an abrupt change in the arrangement of atoms. The movement of dislocations allow atoms to s ...
of the hip is reducible with this maneuver. This is part of the standard infant exam performed preferably in early infancy.The Ortolani test is named after
Marino Ortolani Marino Ortolani (26 July 1904 in Altedo, Malalbergo, Province of Bologna, Italy; † 1983) was an Italian pediatrician who developed a clinical test for the recognition of hip dysplasia called the Ortolani test The Ortolani test is part of the ...
, who developed it in 1937.


Procedure

The Ortolani test is performed with the
Barlow maneuver The Barlow maneuver is a physical examination performed on infants to screen for developmental dysplasia of the hip. It is named for Dr. Thomas Geoffrey Barlow (September 25, 1915 – May 25, 1975), an English orthopedic surgeon, who devi ...
and inspection of the hip joint and legs. It relocates the dislocation of the hip joint that has just been elicited by the
Barlow maneuver The Barlow maneuver is a physical examination performed on infants to screen for developmental dysplasia of the hip. It is named for Dr. Thomas Geoffrey Barlow (September 25, 1915 – May 25, 1975), an English orthopedic surgeon, who devi ...
. The Ortolani test is performed by an examiner first flexing the hips and knees of a supine infant to 90°, then with the examiner's index fingers placing anterior pressure on the
greater trochanter The greater trochanter of the femur is a large, irregular, quadrilateral eminence and a part of the skeletal system. It is directed lateral and medially and slightly posterior. In the adult it is about 2–4 cm lower than the femoral head.Stan ...
s, gently and smoothly abducting the infant's legs using the examiner's thumbs.


Interpretation

A positive sign is a distinctive 'clunk' which can be heard and felt as the
femoral head The femoral head (femur head or head of the femur) is the highest part of the thigh bone (femur). It is supported by the femoral neck. Structure The head is globular and forms rather more than a hemisphere, is directed upward, medialward, and a l ...
relocates anteriorly into the acetabulum:


References


External links

* Congenital disorders of musculoskeletal system Hip Musculoskeletal examination Pediatrics Veterinary diagnosis {{Med-sign-stub