Pedrosa sustained several injuries to his left hand when he crashed heavily while leading today's extremely wet Sachsenring race.
"It's very delicate matter, because his left hand suffered the fracture of the index with a damage to his extensor tendon. Still on the left hand he also had a capsular lesion and damage to the extensor of his middle finger. He also sprained his ring finger," Dr Costa told Italia1 television.
"An important lesion was blocked and fixed here in the Clinica Mobile, and now he'll go back to Spain and if he gets operated on, then we'll have to talk about Brno (the race after Laguna Seca).
"He also sprained his right ankle, with a detachment of the peroneal malleolus, but that's a very light thing compared to this serious damage to his left hand."
Although Dr Costa did not rule out the possibility of Pedrosa racing in America, he suspected that undergoing surgery and then resting the hand prior to Brno in mid-August might be a better option.
"Risking his left hand at Laguna Seca is possible, but I think this time the doctors will try to fix in the best possible way the delicate lesions to his hand, so he should be back for the Czech Grand Prix, because there's a break in between," he said.
A statement from the Repsol Honda team said that Pedrosa had definitely fractured the top bone in the little finger on his left hand, and that it was possible that his ankle injury was also a fracture. He will see his surgeon Dr Xavier Mir in Barcelona this week.
Dr Costa added that most of the damage occurred when Pedrosa hit the kerb while sliding off the track having already fallen from his Honda, and suggested that the incident could be the cue to examine the run-off facilities at MotoGP venues.
"I think Pedrosa's hand got massacred at that point," said Dr Costa. "In the fall he had a small detachment of the peroneal malleolus. Then he might have come to me with a bruised hand, but not with all these complex lesions.
"I think that's what happened, and this must be pointed out, because when a rider slides, he must have some run-off space, and that's the most important thing. But this run-off space must allow him to slide a long way, without interrupting the course of the fall."
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