Restoring Sagittal Alignment: Anterior Open-Wedge Flexion Valgus Osteotomy for Post-Traumatic Genu Recurvatum with Reversed Posterior Tibial Slope – A Rare Case Report

Introduction: Traumatic genu recurvatum is uncommon condition but functionally significant deformity of the knee, most often resulting from loss of the posterior tibial slope following proximal tibial fractures. This condition can lead to pain, instability, and limitations in daily activities. Surgical correction aims to restore both sagittal and coronal alignment to alleviate symptoms and improve function. We present a case of post-traumatic genu recurvatum secondary to a malunited bicondylar proximal tibial fracture, successfully managed with anterior open-wedge flexion valgus osteotomy. Case Report: We report the case of a 39-year-old male presenting 10 months post-injury with symptomatic genu recurvatum and instability following a malunited bicondylar proximal tibial fracture. Radiological evaluation revealed significant loss of posterior slope (−30°), varus malalignment 10°, and decreased (medial proximal tibial angle −76.9°). An anterior open-wedge flexion valgus osteotomy with tibial tubercle osteotomy was performed to restore the sagittal and coronal alignment. At 3 months, the patient achieved full functional recovery with no recurvatum or instability. Conclusion: This case highlights the importance of recognizing post-traumatic genu recurvatum, particularly when associated with proximal tibial malunion and the effectiveness of anterior slope correction osteotomy in managing post-traumatic genu recurvatum. Keywords: Genu recurvatum, flexion valgus osteotomy, post-traumatic deformity, posterior tibial slope.