Sixty pediatric patients (aged 5–10 years) with unstable radius and ulna fractures were randomized to receive either exposed intramedullary K-wires (n=30) or buried K-wires (n=30). The primary outcome was the re-fracture rate. Secondary outcomes included complication rates (such as infection), time to fracture union, and functional outcomes at 1 year using Price criteria. Follow-up was conducted at 3, 6, and 12 months. Overall, the results showed no significant difference in re-fracture rate (1 case in the exposed group, none in the buried group), complications, or functional outcomes, although operative time was shorter in the exposed group. These findings suggest that exposed K-wires are a safe, effective, and potentially more convenient alternative that avoids a second anesthesia for removal.