Despite the frequent exposure of the knee in children to violent trauma, the incidence of fracture of the proximal tibial epiphysis is extremely low, accounting for about 0.5 per cent of all epiphyseal injuries. This is due to its freedom from collateral ligament attachments and therefore the frequent varus and valgus stresses to the knee are transmitted not to the epiphysis but rather to the metaphysis distal to it. Closed reduction and external immobilization is adequate treatment for most type - I or 3 fractures. Patients with displaced type - III or IV fractures undergo open reduction and internal fixation when there was significant displacement of the fragments or incongruity of the joint. The authors reviewed a case of Salter-Harris type II injury of proximal tibial epiphysis which required open reduction and internal fixation because it had the insertion spread of the periosteum into the separation site.