Transitional ankle fractures are injuries to the distal tibial physis that occur in children and adolescents aged 10–17 years, in whom physeal closure has begun. During this period, the physis ossifies in a predictable order, causing fractures with special characteristics attributable to incomplete physeal closure. Most of these fractures involve the articular surface. The analysis should include its evaluation, usually with a CT-scan, to determine joint gaps or steps that would require surgical treatment.