We retrospectively reviewed 39 distal metaphyseal radius fractures in children. This study compares the results of closed reduction with or without percutaneous pinning. Twenty-four fractures were treated by closed reduction and above-elbow cast immobilisation. Re-displacement was noted after one week in three patients, for which they were revised with reduction and pinning. Fifteen patients were initially treated by closed reduction and pinning. In these patients we saw no redisplacement after six weeks immobilisation in a forearm cast. We recommend closed reduction and pinning as a predictable and safe alternative for unstable distal metaphyseal radius fractures.