Ten opening-wedge callotasis through the proximal tibia just below the tuberosity were performed using the Ilizarov apparatus in ten patients who had premature asymmetrical closure of the proximal tibial physis and subsequent genu recurvatum. In 4 knees, the genu recurvatum was due entirely to osseous deformity. In the remaining 6 knees, it was due to a combination of ossseous and soft-tissue (ligament and capsule) deformity. In the 6 knees that had combined deformity, the osseous deformity was predominant in all knees. The average age of the patients at surgery was 16.3 years (range, 11.0-20.5 years). Before operation, the average angle of recurvatum was 19.6 degree (range, 15-26 degree) with an average of 76.6 degrees of abnormal tilt of the tibial plateau. The average shortening of the ipsilateral limb in ten patients was 2.7 cm (range, 0.5-8.7 cm). The average duration of correction was 49 days (23-85 days), and the average fixation time was 150 days for management of genu recurvatum and associated limb-length discrepancy. In 3 patients, there were complications including patella infera, pin track infection and transient peroneal nerve palsy. After a mean follow-up of 4.2 years (range, 1.1-5.9 years), most patients had an excellent or good radiographic and functional results without any recurrence. We have found the Ilizarov method to be valid in the management of genu recurvatum with or without concomitant shortening, with relatively few complications, but full understanding of the basic principles and strict adherence to the details of the method must be carefully followed.