To assess a newborn for hip dislocation, the following physical assessment technique is used: With the infant supine, place fingers posteriorly over the greater trochanter, flex the hip 90 degrees, and abduct the thigh while pushing up with the fingers
Feel for a clunk and palpable jerk as the femur is relocated. Do the maneuver gently on an infant who is not crying. This is called:
A. Barlow's maneuver
B. Ortolani's maneuver
C. Galeazzi's maneuver
D. Hallpike maneuver
ANS: B
Table 18.2 Special Maneuvers
Barlow's Maneuver see Fig. 18.1
Dislocates a dislocatable hip posteriorly. With the infant supine, flex the hip, adduct the thigh, and feel for a palpable dislocation. As the thigh is adducted, the femoral head drops (or can be gently pushed) out of the acetabulum. Do the maneuver gently on an infant who is not crying.
Ortolani's Maneuver see Fig. 18.2
Reduces a posteriorly dislocated hip. With the infant supine, place fingers posteriorly over the greater trochanter, flex the hip 90 degrees, and abduct the thigh while pushing up with the fingers. Feel for a clunk and palpable jerk as the femur is relocated. Do the maneuver gently on an infant who is not crying.
Galeazzi's Maneuver see Fig. 18.3
Assesses knee height for equality. With the infant supine, flex the hips and knees, and place the soles of the child's feet on the table near the buttocks. Observe the knees for equal height. The sign is considered positive if the knee heights are unequal. A dislocatable hip will fall out of socket in this position and will cause the knee on the affected side to appear lower.
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