Traumatic injuries at the distal femur are of low frequency. However, due to the presence of one of the most active physis in the body, these lesions can evolve with serious alterations during the patient’s growth. For this reason, his correct identification and adequate management are relevant for the future of these patients. They are produced by high-energy accidents, so their confrontation occurs in the context of multiple trauma, with a floating knee or associated neurovascular injuries, serious situations that must be identified and corrected along with the management of the fracture. The initial radiographic study needs to be complemented with computed tomography (CT) if compromise of the articular surface, or with magnetic resonance imaging (MRI) if there are doubts of physeal involvement and ligamentous or meniscal injury. The therapeutic objective will be to recover the physeal and joint anatomy and avoid causing further damage with reduction maneuvers of the fracture or with stabilization methods. The follow-up of this injury in the pediatric population should be carried out at least least 2 years, which means that these injuries are considered differently from other common fractures in children evaluated by the orthopedic surgeon.