Summary : Epiphyseal fractures around the elbow include fractures of distal humerus and proximal radial and ulnar epiphyses. Epiphyseal fractures of distal humerus include: Fractures of medial condylar epiphysis which were classified by Milch, 1964 into Milch type I and II according to the anatomic location of the fracture line and were classified by Kilfoyle, 1965 according to the stage of displacement into type I, II, and III. Fractures of lateral condylar epiphysis which were classified by Milch, 1964 into Milch type I and II according to the anatomic location of the fracture line. Fractures of medial epicondylar epiphysis which were classified by wilkins, 1991 into five types; undisplaced fractures, minimally displaced fractures, significantly displaced fractures, entrapment of fragment into the joint and fractures through the epicondylar apophysis. Fractures of lateral epicondylar epiphysis: Fractures involving proximal radial epiphysis are classified by Mason into: Type I: nondisplacd fractures and Type II: marginal fractures with displacement and Type III: comminuted fractures involving the whole head the radius. Fractures of proximal epiphysis of olecranon which are classified by Mayo into: nondisplaced (type I) and displaced (> 3 mm) fractures. Displaced fractures are then divided into srable (type II) and unstable (type III) fracture patterns. Each fracture type is then further categorized into non-comminuted (A) or comminuted (B) fractures. Diagnosis of epiphyseal injuries depends on clinical features and radiological appearance. The commonest clinical features are pain, swelling and may be deformity related to the anatomical site of the epiphysis. Also x-rays should be obtained in different views: Anteroposterior, lateral and oplique views. Arthrogram may be needed in case of suspected intra-articular epiphyseal fractures. Sonography may be helpful in cases of fractures of lower humeral epiphysis in infants where ossification centers are inapparant radiologically. The reduction of epiphyseal fractures around elbow in childrren may be closed in Salter & Harris types I and II, and may be open with internal fixation in types III & IV. The aim of treatment of these injuries is to obtain stable anatomical reduction. Complications that follow fractures of medial epicondylar epiphysis include incarceration of the medial epicondyle within the joint, ulnar nerve dysfunction, median nerve injury , non union , loss of motion , myositis ossificans , increase in the carrying angle and premature epiphyseal closure. Complications of fractures of lateral condylar epiphysis are either biologic or technical: a) Biologic complications occur as a result of the healing process even if a perfect reduction is obtained and include; lateral spur formation, true cubitus varus and valgus, fishtail deformity and delayed union ; b) Technical complications occur usually from errors in management and include: non-union with or without angulation, premature epiphyseal arrest, cubitus valgus, cubitus varus, avascular necrosis of the condylar fragment, neurolgical, complications in the form of acute nerve injuries or tardy ulnar nerve palsy, degenerative in changes in the elbow joint, limitation of motion and myositics ossificans. Complications of fractures of lower humeral epiphysis include: cubitus varus deformity, non union, avascular necrosis, loss of motion and child abuse. Complications follow fractures of proximal radial epiphysis include loss of motion, overgrowth of the radial head, premature epiphyseal closure, non union of the radial neck, avascular necrosis, increase in the carrying angle, neurological complications in the form of partial ulnar nerve and posterior interosseous nerve injury, radioulnar synostosis and myositis ossificans. Complications that follow fractures of proximal apophysis of the olecranon include overgrowth of the epiphysis and premature epiphyseal fusion. Complications of medial condylar epiphysis include: Nonunion, deformities in the form of cubitus valgus and varus and fishtail deformity, limitation of motion and ulnar neuropathy. Complications that follow fractures of lateral epicondylar epiphysis include incarceration of the fragment within the joint.