A Salter-Harris type III fracture of the distal tibia is a significant injury because of combined physeal damage and intra-articular extension. With a displaced fracture, anatomic physeal alignment and articular congruity are critical to minimize the risk of complications, but a preoperative delay makes the treatment challenging. Herein, we present a 12-year-old boy with a delayed presentation of a similar physeal injury managed by an open approach using a transfracture reduction technique. We have observed anatomic fracture healing and a favorable outcome with no signs of physeal arrest at a 2-year follow-up.
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