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In certain instances, a fractured pinky toe may need additional treatment. Sometimes a complex fracture can occur, and the pieces of bone do not line up, one rotates, or there is significant separation.
1 After the toe fracture heals, the person may still be left with arthritis, pain, stiffness, or even a deformity.  Sometimes, the fractured bone will not heal completely (called a nonunion), or will heal improperly (called a malunion). Rarely, surgery may be necessary to fix this problem.