Cape Town - South Africa captain Graeme Smith will be out of action for at least four months, and maybe much longer, following ankle surgery, according to a senior Cricket South Africa official.
Smith had a "highly unusual" operation 10 days ago on his troublesome left ankle, said Shuaib Manjra, head of the organisation's medical committee.
"It is too early to tell with any certainty - he had a highly unusual operation and it is difficult to predict how long it will take for the stress fracture to heal," Manjra said.
"The best-case scenario is that he returns to playing in around four months, but that could stretch to six months or even longer."
The surgery on the talus bone of his ankle included the insertion of two pins and the injection of additional bone marrow into six holes to help with the healing process.
"He had a similar operation in 2011 and we thought we had solved the problem only for it to return six months later. So we will have to wait and see how it goes this time," Manjra said.
There are concerns about the long-term prognosis for the left-handed opener. The injury flared up again in the home one-day series against Pakistan in March.
"This operation will fix the acute problem, but we must find out what is causing the stress and balance the load as best we can. Graeme is a big chap and his bones take a lot of stress. We will continue to manage his playing and physiotherapy schedule.
"He will also have a special boot custom-made in the adidas laboratory in Germany that we hope will help to take the pressure off the ankle," Manjra said.
India will tour South Africa later this year and although the match schedule has not yet been released, the first of three Test matches is likely to start on Boxing Day. There will also be seven ODIs and two T20 matches.
Smith has already been forced out of the ICC Champions Trophy in England and Wales next month, as well as South Africa's ODI tour to Sri Lanka in July.
He is also unlikely to be fit for the trip to Abu Dhabi in October and November when South Africa take on Pakistan in Test and ODI matches.