You are on page 1of 35


hip that can be provoked to dislocate or is subluxed or dislocated but relocatable (+ve ortolani)
Oxford handbook orthopaedics

Nenonates (should be screened clinically for instability and limitation on hip abduction ) -ORTOLANI & BARLOW TEST Infant and child

Limitation of abduction in flexion Asymmetrical gluteal creases in unilateral cases

Unilateral case Asymmerical gluteal crease Affected leg tends to be short and externally rotated Trendlenberg gait (after walking) Bilateral cases Broad perineum Waddling gait

Adolescent Adult

Discomfort after exercise (X ray may show dyplasia and possibly sublaxation ) Pain as a result of degenerative osteoarthritis (x-ray may show dysplasia &degenerative changes)

Barlow Manoeuvre: adduct hip to midline with light pressure on knee and force it posteriorly Ortolani Manoeuvre: Flex hip & knee 90, index finger on greater trochanter and gently abduct hip Barlow & Ortolani manoeuvre can be done simultaneously

Done after 2 months of age because hip doslocation has been fixed by this age Flex infant knees in supine position until heel touch buttocks +ve knees are not in the same level