Fifty-six patients with Salter-Harris type II physeal fractures of the distal tibia were treated with a weight-bearing long leg cast for 4 weeks. Forty patients were followed clinically and radiographically for an average of 22 months. There were no nonunions or angular deformities. There was one case of clinically insignificant premature physeal closure. Premature physeal closure results from the trauma to the physis that occurs at the time of injury and is not affected by early weight-bearing. Four weeks of immobilization in a long leg weight-bearing cast allows adequate healing and faster rehabilitation without an adverse effect on the growth of the distal tibia.