In this study, a midshaft forearm fracture pattern that places the ulnar nerve at risk in the pediatric population was described. In addition, the injury pattern and treatment methods were described through analysis of 7 pediatric patients (5 male and 2 female) with mean age of 8.7 years (range, 3–14) who sustained a significantly displaced closed, or grade I open, middle to distal one-third both-bone forearm fracture with subsequent ulnar nerve dysfunction. As per observations, the ulnar nerve lies in a precarious position in the middle to distal one-third forearm and is bound by anatomic constraints that place the nerve at risk of injury. A treatment algorithm comprising conservative treatment, acute exploration, early exploration (≤3 months), and late exploration (>3 months) was offered.

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