Barlow prospectively screened 9,289 consecutive neonates for hip instability using a novel two-part clinical test, aiming to define the true incidence of CDH, clarify the natural history of neonatal hip instability, and establish indications for early treatment.
When you examine a neonate, use both parts of the Barlow test: Part 1 reduces a dislocated hip (clunk of reduction), Part 2 subluxes an unstable hip posteriorly (clunk of dislocation) — missing the distinction means either over-treating lax hips that will self-resolve or under-treating true dislocations that will develop adductor contracture within weeks.
Breech presentation should heighten your suspicion and prompt careful examination, but remember that confirmed dislocation — not mere instability — requires immediate splinting.
Barlow prospectively screened 9,289 consecutive neonates for hip instability using a novel two-part clinical test, aiming to define the true incidence of CDH, clarify the natural history of neonatal hip instability, and establish indications for early treatment.
When you examine a neonate, use both parts of the Barlow test: Part 1 reduces a dislocated hip (clunk of reduction), Part 2 subluxes an unstable hip posteriorly (clunk of dislocation) — missing the distinction means either over-treating lax hips that will self-resolve or under-treating true dislocations that will develop adductor contracture within weeks.
Breech presentation should heighten your suspicion and prompt careful examination, but remember that confirmed dislocation — not mere instability — requires immediate splinting.