Examination of the newborn includes the Ortolani and Barlow method. Hip clicks and asymmetrical folds are discussed in the older age group.
The Ortolani method is an examination method that identifies a dislocated hip that can be reduced into the socket (acetabulum). Ortolani described the feeling of reduction as a “Hip Click” but the translation from Italian was interpreted a sound instead of a sensation of the hip moving over the edge of the socket when it re-located. After the age of six weeks, this sensation is rarely detectable and should not be confused with snapping that is common and can occur in stable hips when ligaments in and around the hip create clicking noises. When the Ortolani test is positive because the hip is dislocated, treatment is recommended to keep the hip in the socket until stability has been established
The Barlow method is an examinaiton method that identifies a loose hip that can be pushed out of the socket with gentle pressure. Approximately 80% of “Barlow Positive” hips will resolve spontaneously in the first few weeks of life. Early treatment may be recommended when the hip is “dislocatable” but minor degrees of instability can be treated with multiple diapers followed by an Ultrasound Study at approximately six weeks of age.
A Chan, et.al. Acta Paediatr. 90:836, 2001; and NR Boree and Clarke JBJS 76B:525, 1994