Which of the following is not true about the tests for hip instability in neonates?
Ans. is 'a' i.e., Ortolanis test has two parts * In the neonate following tests are used to test for hip instability:A) In Ortolani's test, the baby's thighs are held with the thumbs medially and the fingers resting on the greater trochanters; the hips are flexed to 90 degrees and gently abducted. Normally there is smooth abduction to almost 90 degrees.# In congenital dislocation the movement is usually impeded, but if pressure is applied to the greater trochanter there is a soft 'clunk' as the dislocation reduces, and then the hip abducts fully (the 'jerk of entry').# If abduction stops halfway and there is no jerk of entry, there may be an irreducible dislocation.B) Barlow's test is performed in a similar manner, but here the examiner's thumb is placed in the groin and, by grasping the upper thigh, an attempt is made to lever the femoral head in and out of the acetabulum during abduction and adduction.# If the femoral head is normally in the reduced position, but can be made to slip out of the socket and back in again, the hip is classed as 'dislocatable' (i.e. unstable).# This test is done within 2-3 days of birth.# The test has two parts :-i) Part 1 :- Infant is in supine position with hip and knee in 90deg of flexion, The hip is slowly adducted & pushed to dislocate the hip and one can hear a clunck of exit of femoral head out of the acetabulum.ii) Part 2:- Now the hip is gentely abducted and pulled to reduce the hip. This will cause clunk' indicating reduction of hip.
Ortolanis test has two parts
They are performed at 2 - 3 days of birth
In ortolanis test examiners fingers rest on the greater trochanter
In barlows test examiners thumb is placed in the groin
Congenital Dislocation of Hip (C.D.H.)