La hip dysplasia it is a small malformation that bears the head of the femur, the only bone in the thigh, to come out of the cavity acetabolare, the part of the hip joint that serves to rotate the same etsta of the femur internally and thus ensure correct movement of the leg. This defect, if not treated properly, can cause sprains during growth and prevent the child from walking normally. But how is dysplasia recognized? Thanks (also) to maneuver of Ortolani...
In this article
- Ortolani maneuver: what it is
- How is the Ortolani maneuver performed?
- Positive Ortolani, Negative Ortolani: what does it mean?
Ortolani maneuver: what it is
Ortolani's maneuver represents a routine testing to be carried out in the first weeks of a newborn's life to assess the presence of hip dysplasia. It is a non-invasive, manual examination DON'T painful, which consists in practicing on the baby a delicate but decisive widening of the legs and, by exerting the right pressure on the hip, stressing the joints to find any anomalies.
Therefore, this maneuver not only helps to find bone malformations to be investigated with special ones ultrasounds, but allows you to intervene quickly, avoiding dislocations and correcting the defect before development worsens the situation.
The history of the maneuver
The Ortolani maneuver takes its name from the doctor Del Paeseno who for the 30s realized that a few manual movements could be enough to find problems in the hips. The idea came to him from the case of two twins whose mother noticed an oddity when cleaning one of her two daughters: in fact, moving her baby's legs, she felt that she was strange noise, similar to a snap.Read also: Ultrasound on the hips of the newborn: why it is done and how it works
How is the Ortolani maneuver performed?
The maneuver is quite simple, however it must be done wisely so as not to hurt the little patients.
We leave with the newborn in supine position. First the thighs are flexed at right angles to the pelvis, then the knees are taken with the palm of the hand and, placing the thumbs along the thighs and the middle fingers laterally in correspondence with the greater trochanters of the femur, the thighs are brought into a movement in sequence: flexion, abduct e external rotation. Simultaneously with the execution of this sequence, a slight pressure is also exerted on the greater trochanter in the latero-medial direction.Read also: Kristeller's maneuver: what it is, what it is for and the consequences
Positive Ortolani, Negative Ortolani: what does it mean?
Once the maneuver has been performed, the doctor communicates his diagnosis:
- Positive Ortolani: a click produced by the movement of the hip finds a problem to be ascertained with the ultrasound. In most cases, the examination certifies the incorrect position of the femur within the acetabulum.
- Negative Ortolani: the click is not felt and therefore any dysplasia is excluded. However, the absence of a trigger could hide other problems (e.g. unstable hip), therefore other tests are usually performed to avoid any possible doubts.
SOURCES: Sip; MdsManuals
- newborn 0-3 months