Tillaux fractures are relatively uncommon fractures of the anterolateral tibial epiphysis that are observed in adolescents during the 18-month period when the distal tibial physis has begun to fuse centrally. The case of a 16-year-old boy with a juvenile Tillaux fracture treated successfully by reduction and percutaneous fixation under arthroscopic control is presented. The procedure is technically feasible, allows accurate reconstruction of the weight bearing surface of the joint and secure internal fixation of the fracture. The authors describe the principles of the procedure and discuss its advantages compared to open surgery.