High-grade physeal fractures, such as Salter-Harris types III, IV, and V fractures, are rare pediatric injuries observed disproportionately in teenage males. Such fractures are at high risk for complications such as growth retardation and arrest, arthrofibrosis, and post-traumatic arthritis. Consultation with the orthopedic specialist is imperative to ensure appropriate imaging, management, and potential transfer to a pediatric specialty hospital. The authors present a case of a 15-year-old male who sustained a Salter-Harris IV fracture of the distal femur extending from the intercondylar notch to the metadiaphysis from a motocross accident.