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Fractures involving the physes of the distal forearm are exceedingly common in children, representing upwards of 1/3 of all pediatric fractures. These injuries are often amenable to closed treatment, but physeal injury can lead to premature arrest and significant related long-term sequela. Common practice guidelines have not been established amongst the pediatric orthopaedic community for radiographic monitoring, need for 3-dimensional imaging, and treatment algorithms in these injuries. This review seeks to outline the literature and share the perspective and methods of a panel of leading pediatric upper extremity experts in hopes of providing a framework for better understanding these injuries and treating their growth-related sequelae.