Comparative Evaluation Of Treatment Recommendations For Upper And Lower Extremity Injuries: Surgery Vs. Physical Therapy

PURPOSE: Musculoskeletal injuries often require intervention for optimal healing and recovery; however, there are multiple treatment options for acute injuries. Determination of clinical management approaches involve a collection of independent factors: anatomical location, injury type, mechanism of injury, and activity level/weight bearing status. This study aims to describe the role of anatomic location in treatment recommendations for musculoskeletal injury. METHODS: A retrospective review was conducted on a sample group comprised of 455 patients presenting with acute musculoskeletal injuries affecting the extremities. Patients were evaluated by board-certified sports medicine physicians within two weeks of the initial injury without any prior evaluation. Treatment recommendations were recorded including additional imaging, oral medication, injection, rehabilitation, durable medical equipment, surgery, follow up and activity modifications. Rates of recommended treatments were analyzed to identify patterns associated with upper or lower extremity injuries. RESULTS: 455 patients (44.3% male) with an average age of 40.2 years were included in analysis accounting for 131 upper extremity injuries and 324 lower extremity injuries. Physicians were 1.51x more likely to recommend physical therapy for lower extremity injuries and 4.94x more likely to recommend surgery for upper extremity injuries. CONCLUSION: Physicians were more likely to recommend physical therapy for lower extremity injuries, whereas surgery was more commonly recommended for upper extremity injuries.