Hip Examination of Infant

Ortolani & Barlow Tests

<Examinations>

<Index>

 

 

 

Definition

-  Examination of the hips in infants to detect Development Dysplaisa of the Hip (DDH)

 

Features

-  Part of the routine new born examination

-  Difficult to perform >3 months

-  Ortolani & Barlow tests part of total hip examination

 

Procedure

-  Baby should be relaxed

-  Positioned supine

-  Look for symmetry in creases: adductor

-  Flex knee & hip

-  Left hand covering right leg & hip

-  Right hand covering left leg & hip

-  One side stabilises whilst other examines

-  Examining side index & middle fingers stablise & palpate greater trochanter of femur

-  Barlow = attempt to dislocate hip

-  Adduct & push posteriorly

-  Ortolani = attempt to relocate dislocated hip

-  Abduct & push on greater trochanter

-  Listening & feeling for clunk or jerk in movement

 

Interpretation

-  Fine click wo abnormal movement = normal

-  Sometimes from knee

-  Smooth subluxtion wo clunk in 1st 2-3 days of life common

-  Esp in premature infants

-  Warrants ongoing R/V

-  Clunky or jerky movements indicate dislocation/subluxation = DDH

-  Hip ultrasound at 6 weeks old (or corrected age if premature infants)

 

 

 

New Born Exam

 

 

 

References

 

Practical Paediatrics, 6th Ed, 2006 – Roberton & South