Case: A 12-year-old boy with an isolated both bone forearm fracture was treated with closed reduction and flexible intramedullary nailing 11 days postinjury and after the loss of initial fracture alignment. On nail insertion, an intraoperative distal radial physeal fracture was encountered, thereby warranting modification in treatment.
Conclusion: Physeal injury is a rare intraoperative complication of intramedullary fixation of forearm fractures. This report provides insight regarding the management and prevention of this rare complication.