Validity and reliability of the ortolani and barlow clinical methods in neonatal screening for the hip dislocation ; Validité et fiabilité des méthodes clinique d’Ortolani et de Barlow dans le dépistage néonatal de la luxation de hanche

Introduction: The worldwide incidence of congenital dislocation varies between “0,1 and 66 case per 1000 live birth’s. Screening for congenital dislocation, from the first days of life through to the acquisition of walking ability, is a major public health issue. To this end, neonatal screening includes Ortolani and Barlow manoeuvres to predict the presence of dislocation. Objective: The aim of this review is to investigate the validity and reliability of these manoeuvres in order to weigh up their effectiveness within the screening programme. Methodology: Seven studies were included using the Pubmed, Cochrane Library and Dita databases, as well as Google Scholar. Validity (sensitivity, specificity, positive and negative predictive value and positive and negative likelihood ratio) and reliability (inter- and intra-rater) were examined. The validity (sensitivity, specificity, positive and negative predictive value and positive and negative likelihood ratio) and reliability (inter- and intra-rater) criteria were examined. Results: Analysis of the judgement criteria of all the included studies led us to conclude that the sensitivity of the Ortolani and Barlow manoeuvres was moderately low (0.637) and that the specificity was low (0.535). The PPV (0.316) is low, but the NPV is very good (0.966), the LR + is strong (6.582) and the LR - is moderate (0.467). The reliability of the tests could not be objectively assessed due to lack of data. Discussion: In this condition, the most important assessment criterion is sensitivity, which is not high enough. Nevertheless, these tests, coupled with analysis of other risk factors (such as female gender, the presence of asymmetric folds or hip abduction limitation) increase the effectiveness of newborn screening for DDH. Conclusion: The use of Ortolani and Barlow manoeuvres remains justified, but does not in itself constitute a diagnosis of DDH. ; Introduction : l’incidence dans le monde de la luxation congénitale varie entre « 0,1 et 6,6 cas pour 1000 naissances vivantes ». Son ...