How serious does my toe injury need to be in order for me to need surgery?

Some fractures, ... Some fractures, some tendon ruptures, blood vessel damage that decreases blood flow to the toe, excess foot swelling that is compressing nerves and blood vessels, enlarging infections, deep cuts, deep punctures, etc..., are some conditions that may need an orthopedic or foot surgeon to repair. An injured person can see a primary care doctor first, and then be referred to orthopedics if needed.