MedComic

Barlow vs. Ortolani

Jorge Muniz ·
Educational medical illustration comparing the Barlow and Ortolani maneuvers for detecting developmental dysplasia of the hip (DDH) in newborns, showing hip flexion, adduction, abduction, and femoral head dislocation and reduction techniques
Illustrated guide comparing the Barlow maneuver (hip dislocation test) and the Ortolani maneuver (hip reduction test) used in newborn screening for developmental dysplasia of the hip. Proprietary medical illustration by Jorge Muniz, PA-C.

The Barlow Maneuver

The Barlow maneuver is a test used to identify an unstable hip that can be passively dislocated. The procedure involves placing the infant supine with the hip flexed to 90° in neutral rotation. The examiner adducts the hip while applying posterior force on the knee, causing the femoral head to dislocate posteriorly from the acetabulum. A palpable clunk may be detected as the femoral head exits the acetabulum.

The Ortolani Maneuver

The Ortolani maneuver identifies a dislocated hip that can be reduced. The infant is positioned supine with the hip flexed to 90°. 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.

Clinical Timing

Hip examination should occur soon after birth and at every visit until the child is walking normally.

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