Recurrent Cavus Foot in an Adolescent With Marfan Syndrome: A Case Report

Patients with Marfan syndrome typically have pes planus foot deformity, while some develop the opposite, cavus foot. Here, we describe the case of an adolescent with Marfan characteristics and a painful cavovarus foot, who underwent surgical correction but later experienced recurrent deformity and metatarsalgia. Osteotomies are the preferred treatment for cavus foot in patients aged five through skeletal maturity, providing symptom relief and preserving future definitive surgical options. In contrast, joint arthrodesis procedures are reserved for those who have reached skeletal maturity. In this case report, a 13-year-old male with Marfan syndrome underwent joint-sparing osteotomies at 12 for severe cavovarus deformity, achieving deformity correction and pain relief for two years until symptoms and deformity recurred. He was offered further corrective surgery, but his family remained hesitant. This case highlights that, while joint-sparing procedures before skeletal maturity offer temporary relief and preserve future options, recurrence is a possibility; therefore, patients and their families should be counseled accordingly.