For genu recurvatum deformity after tibial fracture, precise correction osteotomy is necessary to acquire a good clinical outcome. No report on genu recurvatum has evaluated precise preoperative planning with image-processing software for three-dimensional (3D) design and modeling. We herein report a case of osseous genu recurvatum treated by anterior opening wedge osteotomy according to precise preoperative 3D simulation. This is a useful tool for precise correction of osseous deformity.