Over the weekend, one of the most promising quarterbacks of the 2021 draft class suffered a significant ankle injury, perhaps costing him the rest of the season. San Francisco 49ers quarterback Trey Lance suffered an ankle fracture and ligament damage after being tackled during a run play, and he needed to have his leg placed in an air cast before being carted off the field.
Although it’s tough to see the exact mechanism of injury from the video, you can see the play by clicking here (The NFL doesn’t allow us to embed video clips on other sites, so you have to head over to Youtube to see the injury).
Lance underwent successful surgery on Monday to address what is being described as “a fibula fracture and ligament disruption.” He later tweeted that the operation was a success.
“I truly appreciate all of the messages and prayers. Surgery was a success and I am ready to attack this rehab process. We will never understand why, but I trust that it’s all a part of His plan. I will be back better than ever. This chapter is going to make the story even greater!”
Could Trey Lance Return This Season?
The 49ers believe that Trey Lance has been lost for the season, but there is at least a very small possibility that he could return. Although information about the exact type of fracture is limited, Dr. Silverman believes that there is an outside shot that Lance could return this season if he suffered a specific type of fibula fracture. He’s projected returns from ankle fractures before, and here’s what he had to say about Lance’s injury, surgery and rehab.
“From the injury in the description, I am under the impression that Lance sustained a Weber C ankle fracture with syndesmotic disruption. This particular ankle fracture breaks the fibula (the small leg bone), relatively high in the leg and disrupts the syndesmosis ligaments, which are the ligaments that hold the fibula to the tibia and make the ankle mortise a strong stable platform on which we walk.
This fracture and ligament is best treated very carefully. The fibula commonly needs to be fixed with a plate and screws to bring the bone out to length and to recreate the perfect rotation. If not done well these injuries can have long-term significant problems. In fact, more patients develop post-traumatic ankle arthritis from this ankle fracture than many other ankle troubles.
The ligament repair is always controversial between rigid screw stabilization or flexible fixation. In my opinion, flexible fixation has more advantages when the fibular fracture is easily fixed and less advantageous when that fracture is in multiple pieces or in a harder to surgically expose location. Screws need to be removed more often than the flexible fixation. I see more nerve injuries in patients that present to our clinic and have been treated with flexible fixation.
Regardless, this fracture takes time to heal. If it is a simple fracture and bone to bone apposition is possible, I expect six weeks to heal. The ligaments take four weeks to scar into place. I know that this has been described as a season ending injury, but I believe it has the potential to be otherwise. Patients with Lance’s athletic ability often can return to training 4-6 weeks after bone healing. It’s a long season, and if the 49ers stay in playoff contention we might see Lance be able to progress to the point that he could back up Jimmy Garoppalo, as it’s likely that the 49ers would stick with Garoppalo if he’s kept them in the playoff picture. But if an injury were to befell Jimmy G late in the season, it’s possible that Lance could be in a position to return.
For obvious reasons, I am hopeful that someone with such awesome talent (and an awesome name) returns quickly. We wish him the best of luck in his recovery.
