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Jimmy Garoppolo surgery could mean 5-to-6-week recovery, Dr. Nirav Pandya says

More than an hour after sustaining the thumb injury that jeopardizes the remainder of his season, quarterback Jimmy Garoppolo led the 49ers on a game-tying, fourth-quarter touchdown drive.

“It definitely does suggest that perhaps it wasn’t a very, very severe injury and the thumb wasn’t completely unstable,” UCSF orthopedic surgeon Dr. Nirav Pandya told NBC Sports Bay Area on Tuesday.

Dr. Pandya said he believes there were other factors that could have led to Garoppolo being able to finish the game Thursday night against the Tennessee Titans after sustaining a sprain to the ulnar collateral ligament of his thumb. Garoppolo reportedly also sustained a fracture or bone chip to the thumb.

The adrenaline from the game likely enabled Garoppolo to make it through, Dr. Pandya said.

“Also what happens is the finger itself can actually swell up and that will give you a sense of stability so that you’re not compromised that much,” Dr. Pandya said. “So, a lot of times, these injuries will manifest 24 to 36 hours later. The swelling goes down, and you’re able to examine it a little more.”

Garoppolo’s status for the 49ers’ Week 17 game against the Houston Texans remains in question with rookie quarterback Trey Lance emerging as the likely starter for the crucial game.

Garoppolo sustained the injury when Titans defensive lineman Denico Autry slammed him to the turf for a sack in the second quarter of the 49ers’ 20-17 loss.

“What can happen a lot of times with these ligaments is that the ligament can be stretching, and if there’s a lot of force, it can actually pull a piece of the bone off,” Dr. Pandya said. “For Jimmy moving forward, if there is damage to both of those structures [ligament and bone], that can definitely be more of a five- to six-week recovery time with the likelihood of probably needing surgery.”

Garoppolo did not take part in the 49ers’ brief practice Monday. Coach Kyle Shanahan said Garoppolo would be re-examined Wednesday.

“It didn’t feel great [Monday],” Shanahan said. “He wasn’t able to throw, and we’ll see how it is on Wednesday. Hopefully, it’ll get better.”

There are different levels to which Garoppolo can be impacted. At one end of the spectrum is surgery. Or if the damage is not as severe, he could continue to play with some degree of instability.

If Garoppolo is cleared to play, the 49ers would have to determine whether Garoppolo or a healthy Lance is the better option.

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Dr. Pandya said the track record of quarterbacks with this injury leads to concern for Garoppolo’s ability to play and function at a high level.

“The ability to grip and pinch becomes very hard,” Dr. Pandya said. “Unfortunately for a quarterback, that’s what you need to do. So, another position, maybe you could get away with taping or bracing it. But it becomes really hard, especially if there’s a lot of damage to that ligament.

“It’s hard enough being an NFL quarterback and, then, you have a thumb that doesn’t allow you to throw accurately. Even a couple milliseconds here and there throws off timing, throws accuracy off.”

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