It’s Jimmy G time again in San Francisco. Trey Lance rushed down the middle and as he was tackled his right ankle got trapped. At first it didn’t look like much – he even tried to stand up. But then as Lance remained on the ground it was clear his right ankle/lower leg wasn’t pointing in the right direction.

By video it looks like Lance suffered an ankle fracture-dislocation. This means the ankle joint dislocates, causing a fracture to one or both of the lower leg bones. There is often associated ligament damage as well. The quicker the ankle can be reset (put back into place) the better.

Lance was carted off of the field in an air cast, indicating concern for instability (aka a severe fracture). He will be sent for x-rays and will likely head straight to the hospital. Lance is looking at season-ending surgery. His recovery time will likely be 5-6 months, but it could extend even longer if there is ligament damage that has to be repaired during surgery. If the ligament damage is minimal and can heal on its own that is better long-term.

Following surgery it’s very important to avoid infection. This complicates the recovery and compromise the health of the bone, which can have career-threatening implications. Infection is more common with an open fracture-dislocation, when the bone breaks through the skin.

Two years ago Dak Prescott suffered a similar injury. He missed the rest of the season but was back at the start of 2021 (although he battled a few other injuries, including a related calf strain).

Now the 49ers will turn back to Jimmy Garoppolo under center. That may not be the worst thing.