Abstract The epiphysis, involved in 6 to 15% of children's fractures, is responsible for bone growth. Significant disturbance occurs in only 10% of epiphyseal injuries because of relationship of usual line of fracture to germinal cells of growth plate and epiphyseal blood supply. Epiphyseal injuries are classified by radiographic appearance into 5 types, each having prognostic significance. Dislocations of major joints and disruptions of major ligaments are rare in children; if either is suspected clinically, an epiphyseal injury is likely. An accurate radiographic diagnosis can result when comparison views are obtained routinely with oblique and stress views as indicated.