This study describes five patients who had sustained a rare flexion-type fracture separation of the proximal tibial epiphysis and reviews the previous reports of this injury in the literature. The average age of our patients at injury was 15 years. All were male. The left side was involved in four patients; the right in one patient. Four of the injuries occurred during sports activities. All five of these fractures healed in satisfactory alignment after 6 weeks of immobilization without complication. We conclude that these injuries can be safely managed by closed reduction and cast immobilization in a position of full knee extension.