Acquired genu recurvatum in a skeletally immature patient treated by physeal distraction: A case report

Published: 28 October 2022
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The proximal tibia physis’ anterior growth arrest is the cause of the uncommon condition known as acquired genu recurvatum, which can also be congenital, idiopathic, or secondary to trauma, infections, cerebrovascular accidents, or neuromuscular diseases. In order to avoid the reported drawbacks that could complicate osteotomies—incomplete correction, patella infera, knee pain or stiffness, and the requirement to remove plate metalwork—physeal distraction and callotasis with external fixation has been suggested. We present the case of a 14-year-old boy who had a 5 cm difference in limb length, with the right leg being shorter, and a right knee that was 30° recurved with flexion restriction beyond 40°. The correction was made in 50 days, and the external fixator was removed in 92 days after we performed a physeal distraction with an axial EF (ST.A.R., Citieffe) through an anterior physeal osteotomy just proximal to the tuberosity in conjunction with simultaneous asymmetrical tibial and femoral contralateral epiphysiodesys. The patient returned to playing football within 8 months despite the persistence of a 3 cm leg length discrepancy and had a symmetric full range of motion of the knee without any complications or persistent pain. The correction of genu recurvatum in adolescents may be achieved safely and effectively through physeal distraction with an axial external fixator.

Johnson L, McCammon J, Cooper A. Correction of genu recurvatum deformity using a hexapod frame: a case series and review of the literature. Strategies Trauma Limb Reconstr 2021;16:116-9. DOI:

Dean RS, Graden NR, Kahat DH, et al. Treatment for symptomatic genu recurvatum. A systematic review. Orthop J Sports Med 2020;8:2325967120944113. DOI:

Olerud C, Danckwardt-Lilliestm G, Olerud S. Genu recurvatum caused by partial growth arrest of the proximal tibial physis: simultaneous correction and lengthening with physeal distraction. Arch Orthop Trauma Surg 1986;106:64-68. DOI:

Pennig D, Baranowski D. Genu recurvatum due to partial growth arrest of the proximal tibial physis: correction by callus distraction. Case report. Arch Orthop Trauma Surg 1989;108:119-21. DOI:

Dejour D, Bonin N, Locatelli E. Tibial antirecurvatum osteotomies. Oper Tech Sports Med 2000;8:67-70. DOI:

Moroni A, Pezzuto V, Pompili M, et al. Proximal osteotomy of the tibia for the treatment of genu recurvatum in adults. J Bone Jt Surg 1992;74:577–586. DOI:

De Bastiani G, Aldegheri R, Renzi Brivio L, et al. Limb lengthening by callus distraction (Callotasis). J Pediatr Orthop 1987;7:129-34. DOI:

Pierantoni, S., Corradin, M., Schiavon, R., Luppi, V., & Micaglio, A. (2022). Acquired genu recurvatum in a skeletally immature patient treated by physeal distraction: A case report. La Pediatria Medica E Chirurgica, 44(s1).


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