Ortolani Subluxation Test

The clunk represents relocation of the femoral head into the acetabulum when the hip is gently abducted and directed by pressure at the greater trochanter. This finding suggests that the joint was unstable or displaced before the maneuver. Its significance is therefore mechanical: the examiner detects reduction of the joint rather than merely sensing general hip movement.

These coordinated movements create the conditions needed to assess whether the femoral head can return to the acetabulum. Flexing the infant’s hip and applying anterior pressure to the greater trochanter while abducting the joint guides the examination toward possible relocation. Careful, gentle force matters because interpretation depends on controlled movement rather than forceful manipulation.

A test result supports recognition of hip instability but does not replace a broader clinical assessment. The maneuver should be interpreted alongside other examinations and clinical findings, because its meaning depends on the overall examination context. This approach helps determine whether a suspected abnormality warrants further evaluation rather than treating one palpable or audible event as conclusive by itself.

The infant is positioned supine, with the hips flexed. The examiner then gently abducts the hip while applying anterior pressure to the greater trochanter, observing and feeling for a clunk that may indicate relocation. Because the examination depends on coordinated positioning and controlled pressure, careful technique is essential for obtaining an interpretable result.

Its primary screening value is during the newborn and infant period, when developmental dysplasia of the hip may be identified before later consequences develop. Detecting instability at this stage can support timely referral for imaging and treatment. The test therefore functions as an early clinical assessment rather than a complete evaluation performed independently of follow-up.

A finding suggestive of relocation of an unstable or dislocated hip can prompt referral for imaging and treatment assessment. Imaging provides additional evaluation after the clinical examination, while treatment decisions depend on the broader clinical findings. The practical outcome is earlier investigation of possible developmental dysplasia, which may allow care to begin before the condition is missed.