SANTA CLARA — Coach Kyle Shanahan reaffirmed what appeared to be obvious Wednesday when he said 49ers quarterback Trey Lance would be out for the season after surgery to repair a broken right fibula with ligament damage.
The good news?
It would be a big surprise Lance was unable to participate in non-contact offseason work and then be ready for training camp next July.
Although the broken bone in Lance’s leg will likely be healed before the end of the season, getting him back up to speed for a violent collision sport is another matter. That’s the opinion of Dr. David Oji of Stanford Hospital, an orthopedic surgeon and an expert in ankle injuries.
Oji doesn’t know the specifics of the Lance surgery other than the 49ers’ statement of “broken right fibula with ligament disruption,” but has experience treating and operating on patients with broken ankles.
“The fracture for these types of injuries is in about two months the fracture is fairly stable,” Oji said in a phone interview. “It’s not fully healed but there’s enough bone healing that it’s mechanically stable. And it’s the same thing with the ligaments. Typically, it’s pretty stable.”
The healing of the bone, however, is only the first step in Lance’s rehab — and not necessarily the easiest part.
“The athlete still has to build up the muscle mass and the strength and that’s where I think many people don’t realize it takes longer to heal from that sometimes than the actual break itself,” Oji said.
“For someone like you and I, in two months, we’ll probably be able to ride a bike and be able to walk around comfortably. But for performing at a premiere level in the NFL, it’s going to take time.”
In Lance’s case, the two-month time frame for the bone healing would be in early November, at which point the 49ers would just past the midway point of the season.
Then comes getting the ankle ready for the rigors of the NFL, which, according to Oji, could take longer than two months.
Given that Lance is a quarterback who relies heavily on his mobility to be effective, the common sense move for the 49ers was to shut him down. With a more deliberate approach to rehabilitation, Lance would in theory be ready for off-season programs which typically begin in February.
Complications, according to Oji, are rare.
“Historically, there’s about a five to 10 percent of patients with issues with superficial infections, but generally patients do very well from this surgery,” Oji said. “It’s fairly standard surgery.”
For a recent example, Raiders quarterback Derek Carr and Tennessee quarterback Marcus Mariota broke their right fibulas in Week 16 on Christmas Eve in 2016.
Carr and Mariota both ended up going through the offseason with their respective teams, and each was ready play when the 2017 opened. In fact, they opened the season playing against each other, with the Raiders beating Tennessee Titans 26-16.
Neither showed any ill effects from the injury. Carr completed 22 of 32 passes for 262 yards and two touchdowns, while Mariota, whose playing style more closely mirrors Lance in terms of running ability, passed for 256 yards and had three rushes for 26 yards including a 10-yard touchdown run.
Lance broke his ankle with 2:33 left in the first quarter on an inside running play and had surgery on Monday.
“He’s doing as good as you can,” Shanahan said. “Trey’s been great. A number of guys, we’ve all talked to him a bunch. He’s trying to come to the game this week. I don’t think he’ll be able to, until the swelling goes down, but he’ll be back and a part of us sooner rather than later.”
Linebacker Fred Warner said Lance was “doing well, in great spirits.”
Shanahan said Monday he expects Lance to do his rehab with the club and stay connected with meetings whenever possible.
Jimmy Garoppolo, who agreed to a restructured contract on Aug. 29 to back up Lance, will take over as the starter Sunday night against the Denver Broncos.
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