Alex Smith had surgery in Birmingham, Ala. on Thursday to remove a small piece of bone from his throwing shoulder that broke just before the start of the regular season. Dr. James Andrews, who operated on Smith's separated shoulder in December, performed the latest procedure. The bone fragment was located at the tip of Smith's coracoid process, which itself is a small bone that is part of the shoulder. Andrews also removed a piece of the wire suture that was inserted during the original operation. The procedure was considered relatively minor and is not expected to affect the mechanics of Smith's right arm. Smith was placed on injured reserve in September.
According to a source with knowledge of the situation, Smith visited Andrews on Wednesday. Images taken of the shoulder showed that the fracture was not healing properly and Andrews decided to perform surgery the next day. Smith flew back to California on Friday.
Smith orginally injured the shoulder on Sept. 30, 2007 when he suffered a Grade 3 separation after being driven into the ground by Seattle defensive tackle Rocky Bernard. The hit stretched and tore the ligaments that connect the shoulder and collarbone. Smith had surgery in December to stabilize the area.
The former No. 1 overall pick in the draft nearly had returned to form when he felt a sharp pain in the shoulder at the end of practice on Sept. 5. An MRI revealed the fracture, which was in the vicinity of a wire suture Andrews had used to stabilize the shoulder. The speculation is that the suture caused tension on the bone whenever Smith threw. Part of that suture was removed Thursday. The rest had been absorbed into the scar tissue.
Smith is scheduled to earn just under $10 million in base salary next season and GM Scot McCloughan said in September that that's too big a price tag for a back-up quarterback. Things have changed since then, however. For one, Mike Nolan - with whom Smith clashed last season - is no longer the head coach. His presence in 2009 certainly would have sent Smith seeking another team next season.
Second, the player who beat out Smith for the starting job, J.T. O'Sullivan, has been demoted. O'Sullivan was the favorite of offensive coordinator Mike Martz, whose high-risk, high-reward offense doesn't seem as appealing as it did in early September. With Shaun Hill at quarterback, the 49ers are turning to a more measured approach on offense during the second half of the season.
-- Matt Barrows