Even if surgery is recommended by your doctor, it is always your choice whether or not to have this surgery. But, it is important to understand the possible results of that decision.
Should you choose not to have the surgery and have your fracture treated with a cast, you must realize that the results are not as predictable. It is often impossible to line up the bone fragments perfectly without surgery. Studies have shown that bones that are out of place at a distance of the thickness of a dime or penny can lead to poor results. Arthritis eventually occurs in greater than 90 in 100 of these cases.
Furthermore, for patients that have nerve damage to their feet caused by diabetes, casts can cause the skin to breakdown, which causes ulcers. The reported rate is as high as 40 out of 100 patients.
The final decision to have or not to have surgery rests with you, but all concerns relating to this decision should be discussed with your doctor at length. You and your doctor can then discuss your individual situation and come up with a treatment method that is comfortable for you.