Barlow's and Ortolani manuvers
š§ Understand the Purpose
Barlow maneuver: Provocative—tests if the hip can be dislocated.
Ortolani maneuver: Reductive—tests if a dislocated hip can be reduced.
š Hand Positioning & Technique
Barlow: With the infant supine and hips flexed to 90°, gently adduct the hip while applying posterior pressure on the knee. A palpable “clunk” suggests dislocation.
Ortolani: Abduct the hip while lifting the femoral head anteriorly with your fingers on the greater trochanter. A “clunk” indicates reduction.
Palpate with fingertips, not the palm, to detect subtle shifts.
Compare both hips one at a time and repeatedly in early neonatal visits
– Interpretation
Positive Barlow: A palpable “clunk” or sensation of the femoral head slipping out of the acetabulum indicates the hip is dislocatable—i.e., it’s unstable but still located at rest.
Negative Barlow: No movement or clunk felt—suggests the hip is stable and not prone to dislocation under stress.
Positive Ortolani: A distinct “clunk” as the femoral head reduces into the acetabulum—indicates a dislocated but reducible hip.
Negative Ortolani: No clunk—either the hip is normal, or it’s dislocated and irreducible (especially in older infants or those with soft tissue contractures).
So a positive barlow and a positive ortolani means that the femur head is dislocable and reduces back, such that there is a risk fir ddh
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