**4. Clinical diagnosis**

If DDH is in a newborn or children, before to walk, clinical maneuvers as Ortolani, Barlow, Peter-Baden, piston, limitation of abduction can detect, only subluxation or dislocation of the hip. Dysplasia is not detected by these maneuvers.

The sound transmission tests can detect dysplasia, subluxation or dislocation [34–37].

From the neonatal stage to one year of age, at each visit to the health worker, the following clinical maneuvers should be intentionally sought according to the type of pathology.

#### **4.1 Ortolani's sign**

It is found in subluxable lax hips and is absent in teratological (**Figure 1**) [17]. Both extremities are taken, one in each hand, placing the knees between the thumb and forefinger, flexing the hips up to 90°, and resting the palm of the hand on the flexed

knee and the fingers along the femur, with the Point of the third finger on the greater trochanter, fix the opposite hip by applying slight pressure of the knee towards the table. The hip under examination is pressed vertically and gentle adduction abduction movements are made, looking for the click that occurs when the femoral head jumps over the cartilaginous labrum.
