Ortolani's sign

Ortolani's test is used to detect the presence of a dislocated hip in CDH. A positive Ortolani's sign indicates a hip that is dislocated but reducible.

The procedure is as follows:

• relax the child, for example examine just after a feed
• hips and knees flexed to 90 degrees
• thumbs on the inner side of the baby's knee
• index finger over the greater trochanter
• the hips are abducted through 90ø smoothly and gently
• note that there is no element of attempting to force the joint into dislocation

Ortolani's sign is the palpable sensation of the femoral head slipping into the acetabulum. Ortolani described the accompanying sound as a click; it is more often thought of as a clunk nowadays, although audibility is by no means an essential requirement. Restriction of abduction may indicate an irreducible dislocation.