Since Ortolani’s and Barlow’s tests can normally no longer be performed in infants, the diagnosis of a hip disorder in this age group is based on demonstrating the presence of limited abduction.
The asymmetric gluteal fold at the height of the affected side will be more striking at this age. A difference in leg length may also be manifest.
Test For Limited Abduction
Procedure
- The child lies in supine position.
- Flex the knees maximally and flex the hips by about 90°.
- Next abduct both hips [Figure 145].
Figure 145
At the age of three months, the hips can be abducted by between 80-90°. Abduction of less than 70° should be regarded as abnormal. In the case of bilateral dislocation, the limited abduction will be symmetrical.
Galeazzi’s Test
Procedure
- The child lies in supine position, preferably on the examination table.
- Flex the knees and hips so that the feet are precisely next to each other on the examination table.
- At eye level, look from the foot end and from the sides or from the head end, to ascertain whether the knees are at the same height.
- The result is positive if there is a difference in the height of the knees, with the knee on the side of the dislocated hip being lower.
- At the age of three months, a difference in leg length may not yet be very pronounced and can therefore be missed.
- In the case of bilateral displacement, there will be no difference in leg length.