Best diagnostic sign in CDH
OOLANI&;STEST is used to test DDH in infants In this test the baby&;s thighs are held with the thumbs medially and the fingers resting on the greater trochanters; the hips are flexed to 90 degrees and gently abducted. In NORMAL baby, there is smooth abduction to almost 90 degrees. In CONGENITAL DISLOCATION the movement is usually impeded,but if pressue is applied to the greater trochantehere is a soft &;CLUNK&; as the dislocation reduces,and then the hip abducts fully(JERK OF ENTRY) If abduction stops halfway and there is no jerk of entry, there may be an irreducible dislocation . ref:APLEY&;S 9th edition page no.499
Oolani's test
Telescopy
Asymmetry in gluteal skin fold
Limitation of abduction of hip with thigh flexed
Pediatric orthopedics