Ortolani Bump for Developmental Dysplasia of the Hip

1 in 1,000 babies is born with developmental dysplasia of the hip that can range from a shallow socket, laxity, or dislocation. Risk factors include lax ligaments, a tight intrauterine space, breech positioning prior to birth, or a family history of hip problems.

The physical exam tests to assess hip position and stability are the Ortolani test (lifting and abducting the leg with a dislocated hip commonly results in the hip clunking into place) and the Barlow test (applying posterior pressure on the flexed and adducted leg and feeling the hip slide out posteriorly).

Initial treatment is with a Pavlik harness which positions the hip with flexion and abduction, which has 90% effectiveness for hips that are shallow or loose and 60-70% effectiveness for hips that are dislocated.   

The effectiveness of Pavlik harness might improve with a foam positioning device that replicates the Ortolani test. The name for the prototype of this positioning device is the Ortolani Bump. The effectiveness of this device could be assessed with an ultrasound of the hip while in a Pavlik harness and on the Ortolani Bump.