Patients with a fractured toe may not be placed in a cast, but the fracture must be immobilized with other fixation devices. It is not possible to do no immobilization at all, because without immobilization, there will be slight movement of the fracture site, and if other external forces are applied, the fracture site may be displaced extensively, which may result in delayed healing or even non-healing of the fracture site. In clinical practice, if the patient refuses to be put in a cast, he or she can be treated by splinting or surgery instead. A splint is a metal splint made for a finger or toe that is strong and easily shaped. The splint is used to externally fix the fracture after it has been repositioned by manipulation. If the surgeon deems it necessary, the fracture may also be repositioned by surgical incision and then fixed with a grasp on the fracture site. This type of fixation is mandatory and is not negotiable. This type of fixation does not last very long and is usually removed in less than four weeks.