Tommy John surgery has not been ruled out for Miguel Sano, Twins general manager Terry Ryan said Tuesday.

Sano, who had received an encouraging report several weeks ago on his right (throwing) elbow, arrived in Fort Myers, Fla., late Monday night. An additional exam on Sano's strained ulnar collateral ligament will be performed, Ryan said of the power-hitting third baseman.

Asked if the Twins were confident Sano, 20, could avoid surgery on a problem that caused his Dominican Winter League season to end after two games in late October, Ryan expressed optimism but not certainty.

"That would be our hope," Ryan said. "Right now we don't think it is (going to require surgery), but I can't tell you for sure until we crank him up a little more."

Sano, outranked only by consensus minor league player of the year Byron Buxton among Twins prospects, also was plagued in July by what the Twins termed "arm fatigue." Sano still managed to bash a combined 35 home runs between Class A Fort Myers and Double-A New Britain.