A16-year-old boy sustained injury to left knee while playing. He had severe pain and swelling in the knee. He was not able to bear weight on affected limb. X-rays revealed displaced tibial spine fracture [, ]. He was treated in cast by orthopedic surgeon. Patient was not comfortable in the cast and came to us. It was a displaced fracture. We did MRI to rule out other injuries []. Patient was treated arthroscopically under spinal anesthesia in supine position. Anterolateral and anteromedial portals were used. Both the portals should be standard or slightly low as higher portal may put the scope above the fractured fragment and one may not be able to see the fracture clearly. Fractured fragment was clearly defined with the help of a shaver. It also involved significant portion of medial tibial platue [, ]. Fracture was reduced with the help of ACL zig and under C- Arm guidance, provisionally fixed with guide wire from superolateral portal taking care not to cross physis. As it was a large fragment, it did not sit completely from medial side so another wire was used from superomedial portal to fix medial side of fragment perpendicular to lateral wire, again without crossing the physis. Two 3.5 mm partially threaded cannulated screws (Zimmer) were directly used; 45mm from lateral side and 35mm from medial side []. Stability of the fragment was assessed with a probe and was found to be very stable []. Post-operatively, patient was given a knee brace []. Post-op X-rays showed proper position of both screws [, ]. He was allowed to walk full weight bearing with the knee brace and with support. Knee ROM from 0-90 was allowed for 2 weeks then 0-120 for next 2 weeks. After one month, he was allowed to walk without knee brace. At 6 months, patients was allowed to run. Now we have 8 months follow-up.