Orthopedic Aspects National Marfan Foundation

Description: What are the primary orthopedic problems caused by the Marfan syndrome? Orthopedics involves the skeleton and ligaments, and the muscles that move them. Aspects of the skeleton that are unique in individuals with the Marfan syndrome are differences in the growth of bone and decreased ligamentous support. There is great variability among people who are affected with the disorder in the severity of these manifestations. In only about one-third of people with the Marfan syndrome do these orthopedic concerns become severe enough to see an orthopedic doctor. The growth differences in the bones in people with the Marfan syndrome cause affected individuals to have long, slender arms, legs, fingers and feet. They also include inward or outward growth of the breastbone (sternum). A few Marfan children develop hip sockets which become too "pushed in" or deepened with growth (protrusio acetabulae). Claw or hammer toes are another possible growth difference in people with the Marfan syndrome. Ligament relaxation occurs mainly where there is constant pressure. This shows up most often in the foot, where the arch becomes stretched out and flattened, leading to flat feet (pes planus). It may also occur in the spine, where a side curvature (scoliosis) or a forward curvature (kyphosis) may develop. Dislocation of the major joints, such as the shoulders, knees and hips, however, are not much more common in people with the Marfan syndrome than in the general public. Some people with the Marfan syndrome have aches and pains in the back, arms, legs or feet. These can be partially prevented by keeping in good physical condition with regular exercise (four or five times per week) that does not stress the aorta, applying ice or heat, stretching or taking a mild analgesic (such as Tylenol®) in accordance with a doctor’s recommendation. What is scoliosis and how is it diagnosed? Scoliosis is a spinal curvature in which the vertebrae twist, usually into an S-shape or spiral shape. It is caused by the abnormally loose ligaments of the spine and the rapid growth of the child with the Marfan syndrome. Scoliosis can affect any part of the spine, and it may be mild or severe. About 50 percent of people with the Marfan syndrome develop scoliosis, although only about one-third of those with scoliosis need treatment. (more)