Sixty-eight patients with a distal physeal injury to the tibia and/or the fibula were reviewed, with an average followup of 27 years and 4 months from the initial lesion. The average age at injury was 12 years and 6 months, whereas the average age at follow-up was 40 years. Seventeen patients had a type I Salter-Harris injury, 27 type II, 10 type III, and 14 type IV. All the patients but six were treated conservatively. According to our criteria of evaluation, 47 patients had a good result, 13 fair and eight poor. The type of Salter-Harris lesion, the amount of the initial displacement and the quality of reduction were the three main parameters which determined the end-result. Radiographic signs of osteoarthritis were present in 11.8% of our patients and all of them had presented type III or IV lesions, except for one who had a type II lesion.