Debate continues over the need for removal of internal fixation devices. Nowhere has this been more intense than in the area of forearm fractures. Although basic biologic principles would dictate that fixation interferes with bone physiology, clinical experience has taught surgeons that every reoperation has potential complications. We therefore retrospectively reviewed all patients undergoing forearm plate removal during a 5 1/2-year period. There were four subsequent refractures in 63 patients, for an incidence of 6%. Factors that appeared to influence the refracture rate were degree of initial displacement and comminution, physical characteristics of the plate, early removal, and lack of postremoval protection.