The main focus of this chapter is on separation of the distal femoral epiphysis, separation of the proximal tibial epiphysis, avulsion of the tibial tuberosity, osteochondral fractures, fracture of the intercondylar eminence of the tibia and fractures of the patella. Fracture separation of the distal femoral growth plate is most often caused by indirect injury. Separation of the proximal tibial epiphysis is a relatively rare injury. Valgus, varus, extension or flexion force are a classification of proximal tibial epiphyseal injury based on the mechanism of injury. The tibial tuberosity avulsion saw in adolescent males approaching skeletal maturity and who are physically active athletes. Osteochondral fractures of the medial or lateral femoral condylar articular surfaces may be caused by a direct blow or rapid lateral subluxation or dislocation of the patella. Fractures of the patella in children are very rare. Only 1% of all fractures occur in the patella, and only 1% percent of these occur in the immature skeleton. Dislocations about the knee, ligament injuries and Osgood-Schlatter lesion are also discussed in this chapter.