[Physical diagnosis--Ortolani's manoeuvre].

Ortolani's manoeuvre is used to detect hip instability. It is intended to be used to establish the mobility of a dislocated femoral head with respect to the acetabulum in newly-born infants. Barlow's modification attempts to dislocate a reduced but unstable hip out of the acetabulum. Ortolani's manoeuvre is a primarily tactile, proprioceptive sensation and has nothing to do with the usually inconsequential audible and palpable clicks in infant hips. It has been found that widespread use of Ortolani's manoeuvre cannot prevent all late diagnoses of hip dysplasia. This is because neonatal hip instability is only part of the total spectrum of hip dysplasia, and because the examination requires a relaxed newly-born infant and an experienced examiner. In the Dutch situation, general screening with Ortolani's manoeuvre is not advisable as this will lead to many false-positive and false-negative outcomes due to this neonatal examination being carried out by various physicians and midwives with insufficient experience. Better results may be expected from ultrasound screening at child welfare clinics. This is presently being investigated in a large population study.