Monday, October 5, 2009

DDH - Clinical Examination (Tests)

Ortholani's and Barlow's tests detect DDH. You might confuse between the two tests or you may feel that both are the same. First, here is what the tests are:
  • Barlow's test: The maneuver is performed by adducting the hip while applying light pressure on the knee, directing the force posteriorly. If the hip is dislocatable, the test is considered positive. The Ortolani maneuver is then used, to confirm that the positive finding (i.e., that the hip actually dislocated).
  • Ortholoni's test: It is performed by gently abducting the infant's leg using the examiner's thumb while placing anterior pressure on the greater trochanter using the examiner's index and forefinger. A positive sign is a distinctive 'clunk' which can be heard and felt as the femoral head relocates anteriorly into the acetabulum.
Now here's how to remember the two tests:
Barlow's test - you feel the Dislocation - so Barlow's test is Bad test as you are dislocating from joint.
ORTHOlani - you try to feel the Reduction - like ORTHOpedicians reducing all fractures and dislocations.

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