Arm, Wrist or Hand Surgery and Alternatives: Making the Right Choice

When you have an arm, wrist or hand injury, surgery might seem like the default choice—尤其是当您想快速回到游戏时。但是，实际上还有其他非手术选择，具体取决于您的伤害和其他几个因素。

Non-surgical treatments can deliver big wins for many sports medicine injuries, while helping sidestep the possible risks of surgical treatment. However, there are some instances where an operative procedure simply delivers the biggest returns.

“我们要确保每个人都有机会进行非手术的治疗。”Neal Chen, MD, hand specialist for Mass General Brigham Sports Medicine, and chief of the Hand & Arm Center at Massachusetts General Hospital. "So we like patients to optimize their non-operative options before electing to go on a surgical path."

Choosing to pursue or forgo arm, wrist or hand surgery takes research, an open conversation with your care team, and some personal reflection. Here are some things to consider in making the decision:

手术总是必要的吗？

The short answer is no. Relieving pain and restoring function are the ultimate goals of orthopedic treatment for hand, wrist or arm injuries. If you can achieve those through moreconservative treatments, you can avoid surgery, particularly for injuries that are mild to moderate.

"Deciding on surgery has to do with more than just your injury type and its severity. Your age, activity level and athletic status factor in, too."

Corticosteroid injections can often improve functionality and relieve chronic hand pain when over-the-counter medications or physical therapy aren't enough. Conservative treatment is also the go-to for problems like golfer's elbow and tennis elbow—with the latter often resolving on its own within 12 to 18 months. And around three quarters of mallet finger cases can be treated with splints alone.

There are still some instances where surgery should be the first choice. Operative procedures often give the best results for severe sports injuries. For instance, a badly broken or crushed wrist will likely need wrist surgery to reset the bones so the injury can heal properly.

Assessing Your Options

"Deciding on surgery has to do with more than just your injury type and its severity. Your age, activity level and athletic status factor in too," Chen says.

Someone who plays basketball or tennis recreationally, for example, may be more willing to take a slow-and-steady approach with a physical therapist. But a professional or Division 1 college athlete might choose surgery if it'll help them get back in the game faster.

在彻底评估了您的伤害之后，您的运动医学护理团队可以引导您浏览不同的治疗方案。做出明智的决定，即与您的目标和期望保持一致很重要。

When talking with your surgeon, consider asking things like:

• What are the benefits of arm, wrist or hand surgery, and how long will they last? Could I need additional surgery in the future?
• What percentage of patients have success with arm, hand or wrist surgery?
• What are the alternatives to surgery, and do they offer a similar outcome?
• 手术后康复会是什么样？我什么时候可以返回正常活动？
• What happens if I don't have surgery? Will the condition get worse or could it eventually resolve?
• Will I need physical therapy after surgery?

Getting a Second Opinion for Hand Surgery

When possible, it makes sense to get your second opinion from an orthopedic specialist who has extensive experience treating your type of arm or hand injury. It's also a good idea to seek out a specialist who's part of a multidisciplinary team, like the Mass General Brigham Sports Medicine team. A collaborative approach to treatment gives you access to a range of specialists who can help fully coordinate your care, and ultimately, help you bounce back faster.

When to Choose Surgery

选择接受手术是个人选择。这通常是严重运动伤害的最佳途径，但是即使对于温和的运动，手术也可能有意义，如果更保守的治疗方法无法改善疼痛或帮助您达到功能目标。

"The surgical pathway may be more consistent in terms of getting the results you want, especially if there may be irreversible problems if we don't proceed with surgery," Chen says.

Ultimately, it's up to patients and their doctors to make the right decision for them. So do your research, get your physician's advice and think about your own values and preferences. When you add it all up, chances are, the best game plan will be clear.