Surgical treatment of pediatric forearm fractures is controversial. In this retrospective study, we reviewed 24 skeletally immature radial and ulnar fractures in 24 patients treated with intramedullary Rush pins and/or Kirschner wires between 1994 and 1999. The indication for surgical intervention was unacceptable closed reduction, unstable fracture pattern, open fracture, or recurrence after nonsurgical treatment. For each patient, a sugar tong splint was used for 4 weeks, and pins were removed 8 weeks after surgery. Average length of follow-up was 32 months (range, 6-58 months). All fractures in this series healed. Average time to union was 8 weeks. There were no complications of delayed union, nonunion, infection, or neurovascular injury. All patients regained full range of motion of the injured extremity.