Barlow vs. Ortolani

The Barlow maneuver is a test used to identify an unstable hip that can be passively dislocated. The infant is placed in a supine position with the hip flexed to 90º and in neutral rotation. The examiner adducts the hip while applying a posterior force on the knee to cause the head of the femur to dislocate posteriorly from the acetabulum. A palpable clunk may be detected as the femoral head exits the acetabulum.

The Ortolani maneuver identifies a dislocated hip that can be reduced. The infant is positioned in the same manner as for the Barlow maneuver, in a supine position with the hip flexed to 90º. From an adducted position, the hip is gently abducted while lifting or pushing the femoral trochanter anteriorly. In a positive finding, there is a palpable clunk as the hip reduces back into position. Hip examination should occur soon after birth and at every visit until the child is walking normally.