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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.
The main reason people should have surgery is to relieve pain. Bunion surgery may be needed if your big toe has a painful bump or you have skin irritation on the bump due to rubbing from shoewear. You may have already tried non-operative treatments, such as splints and wider shoes, with no pain relief.