Barlow's sign

Barlow's provocative test looks for a dislocatable hip in congenital dislocation of the hip - ie. a hip joint that is reduced but dislocatable.

The following sequence is followed:

• the pelvis is stabilised by one hand gripping between the sacrum and pubic symphisis
• with the thumb of the other hand along the thigh and fingers on the greater trochanter, backward pressure is applied to dislocate the hip
• if the head of the femur subluxes, force in the opposite direction or abduction should promote reduction
• the test is repeated on the other side

A positive Barlow's sign is a palpable clunk of exit with telescoping of the leg. It may prove to be positive, even if the Ortolani test is negative.