Nakagami tangled with Marquez on the opening lap as the Repsol Honda rider battled to control bike damage sustained when he was hit from behind by Fabio Quartararo.
Tendon injuries to Nakagami’s fourth and fifth fingers required surgery in Barcelona, but the LCR Honda rider was still on track a few days later for Friday practice at his home Japanese Grand Prix.
Nakagami soldered on for 20th and last in the race before undergoing more scans and a second round of surgery in Japan.
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That ruled Nakagami out of the next three events before a return at the Valencia season finale, where he claimed 14th place followed by 19th in the post-race test.
But his injury ordeal still wasn’t over with the 30-year-old, paired alongside new team-mate Alex Rins for 2023, revealing he has now undergone a third operation:
“The surgery went well, just fixed tendon of the extensor digiti minimi. Tough winter is coming.”
Nakagami, who pulled out of the 2019 season to undergo a lengthy operation to fix ‘severe cartilage damage’ in his right shoulder, now has until the official Sepang test in February to recover.
2023 will be Nakagami’s sixth season in the premier-class, all spent at LCR Honda. The double Moto2 race winner, still seeking a debut MotoGP podium, had a best finish of seventh this season.