Ankle Fractures in the paediatric population are among the most common physeal injuries. Trauma around the ankle often results in distal tibial metaphyseal fractures in the very young child, medial and lateral malleolus fractures in middle childhood (McFarland fractures) and transitional fractures in adolescence (Tillaux and Triplane fractures). Factors affecting treatment decisions include the Salter Harris classifi cation, the age of the child and intra-articular involvement. Factors affecting management include the mechanism of injury, the position of the foot after injury and the information obtained from a CT scan. The ability to achieve satisfactory reduction determines need for open reductions and internal fi xation. Growth plate injuries can result in complications requiring further surgery.