What is the proper order of steps to perform the Ortolani maneuver correctly?

The Ortolani maneuver is a clinical test used to assess for developmental dysplasia of the hip (DDH) in infants. This test specifically checks for hip dislocation or instability. To perform the maneuver correctly, it is crucial to follow a specific sequence that allows the clinician to feel for the reduction of the hip joint as it is repositioned into the acetabulum.

Beginning with flexing the knees allows the hip joint to be positioned optimally for movement. Abducting the knees (moving them away from the midline) creates a process where the femoral head is positioned towards the acetabulum, reducing any dislocated hip into place. Lastly, adducting the legs brings them back towards the midline, allowing the clinician to assess if the hip has successfully relocated.

This sequence is essential because it maximizes the chances of detecting the reduction of an unstable hip. Performing the steps in a different order, such as extending the knees or performing adduction before abduction, may compromise the maneuver's effectiveness and potentially miss a diagnosis of hip dysplasia. By adhering to the correct order of flexing, abducting, and then adducting, clinicians can accurately assess hip stability and address any potential issues early on.