Reliability of the Barlow and Ortolani tests for neonatal hip instability

M el-Shazly, Bernadette P. Trainor, WG Kernohan, I Turner, PE Haugh, AF Johnston, RA Mollan

Research output: Contribution to journalArticlepeer-review

25 Citations (Scopus)


Objective – To investigate if those responsible for screening for neonatal hip instability are using acceptable manual hip stress tests as described by Ortolani and Barlow.

Method – A video camera was used to record the technique of 35 personnel who were responsible for screening. They examined both a baby and a simulator. The study comprised five groups, classified by experience and practice: senior orthopaedic surgeons, senior paediatric staff, junior paediatric staff, nurses, community staff.

Results - The seven authors together with six independent expert observers viewed the video and marked the performance with the aid of a specially designed proforma. Although there was some variation between these expert observers, the results showed differences in the scores obtained by the different groups of examiners over all aspects of the test procedure.

Conclusion - Video recording for critical analysis and feedback is a useful technique in this situation. Overall, the results suggest that testing for neonatal hip instability was inadequate. A variety of hip stress manoeuvres were being performed. The ability of each subject to perform satisfactory tests seemed to depend on their experience and education. More “hands on” training and experience of testing might provide the necessary competency for screening.
Original languageEnglish
Pages (from-to)165-168
Number of pages4
JournalJournal of Medical Screening
Issue number3
Publication statusPublished (in print/issue) - 1 Jul 1994

Bibliographical note

El-Shazley led the study whilst working as a research registrar with Mollan. Kernohan and Turner provided technical support. Trainor, Haugh and Johnston provided clinical research nursing input.

Item first published online June 23, 2016


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