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49ers’ Brock Purdy not ready to undergo elbow surgery

Brock Purdy’s pitching elbow remains inflamed, so surgery on the 49ers quarterback has been postponed from Wednesday to likely next month, a league source confirmed Tuesday night.

Dr. Keith Meister recommended delaying the procedure after investigating Purdy in the Dallas area. That came on the eve of what is still expected to be a procedure that involves inserting an internal brace to repair a torn ulnar collateral ligament, as NFL Media’s Tom Pelissero first reported.

Purdy tore the UCL in his right elbow when hit as the 49ers took possession of their NFC Championship Game loss in Philadelphia on January 29.

Some three weeks later, there is still a delay to repair Purdy’s elbow. While that may seem surprising, Purdy recently acknowledged why waiting was in his best interest, just in case the torn ligament needed to “cool down,” as Purdy told KNBR 680-AM on Feb. 9.

“They want to make sure that when they go in, they know what they’re looking at, that the ligament will start to heal on its own and just let the process go smoothly,” Purdy added, “while if you tear it go right away go in and have surgery, the ligament is all in pieces, there is a lot of inflammation and fluid in it.

“So let it cool down for a few weeks and then go in and get surgery. That’s what a lot of surgeons said is the best option, so that’s how we go about it.”

Purdy will Dr. Visiting Meister again next month, and the plan remains to continue with an internal braces repair that Purdy could have thrown in within three months of surgery and practice within six months. That timeline would put him close to the 49ers’ season opener in early September.

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Trey Lance, the 49ers’ top draft pick in 2021, is expected to serve as the 49ers’ top quarterback when they reconvene for the offseason schedule on April 17, with organized team activities beginning in mid-May. That assumes Lance’s right ankle was medically cleared, as it required a follow-up procedure on Dec. 30 to remove a stabilizing screw.

Jimmy Garoppolo becomes a free agent next month and is expected to sign elsewhere as early as March 17 when the league year begins. Coach Kyle Shanahan said last month he couldn’t envision a scenario in which Garoppolo returns, after last season was cut short by a December 4 broken foot that didn’t heal in time to be available in the playoffs or even practice.

While Purdy’s best case scenario is to return in time for the start of the season, that would mean avoiding more serious surgery, from a full reconstruction (Tommy John surgery) to a hybrid procedure.

“There is a backup plan, a hybrid surgery, which means a small part of the graft and then an internal brace, which can take between seven and nine months,” Purdy told NFL Network ahead of the Super Bowl. “But the plan right now and what all the surgeons have said is an internal brace for a six-month recovery.”

Kenta Maeda, a Minnesota Twins pitcher, underwent that hybrid surgery with Dr. Meister in September 2021, 11 days after tearing his UCL. Maeda was able to pitch bullpen sessions the following summer, but did not pitch last season, and has since started pitching again this month at the Twins’ spring training.

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Last April, Dr. Meister performed a UCL reconstruction on Oakland A’s pitcher Deolis Guerra, using a palmaris longus tendon graft. Guerra is in the camp of A, but is not throwing yet because of a strain on the crossbar.

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