Barlow maneuver

Barlow maneuver is a clinical test used in orthopedics to diagnose congenital hip dislocation (CHD) or developmental dysplasia of the hip (DDH) in infants. The test is named after the British orthopedic surgeon, Thomas Barlow, who developed the maneuver. It is commonly performed alongside the Ortolani maneuver as part of the newborn physical examination to detect hip instability or dislocation.

Procedure

The Barlow maneuver is performed with the infant in a supine position. The examiner holds the infant's knee and thigh in one hand while stabilizing the pelvis with the other hand. The thigh is then gently adducted (moved towards the midline of the body) while applying light posterior pressure on the knee, attempting to dislocate the hip posteriorly. A positive Barlow test is indicated if the hip can be felt to dislocate or subluxate under this pressure. The maneuver is then repeated on the opposite side.

Significance

A positive Barlow maneuver suggests that the infant's hip is unstable and may be dislocated or prone to dislocation. Early detection of DDH is crucial as it can lead to developmental problems with the hip joint, including limping, leg length discrepancy, and osteoarthritis in later life. If detected early, DDH can often be treated successfully with non-surgical methods such as the use of a Pavlik harness, which helps to keep the hip in the correct position as it develops.

Related Tests

The Ortolani maneuver is another test used to detect DDH. Unlike the Barlow maneuver, which tests for the possibility of dislocating a stable hip, the Ortolani maneuver checks for the ease of reducing a dislocated hip back into the socket. Both tests are essential for the early detection and treatment of DDH.

See Also

• Orthopedic surgery
• Pediatrics
• Hip dysplasia