Four-time Paralympic champion Alex Zanardi has undergone a third operation as he recovers from a crash during a handcycling race in Italy last month ©Getty Images

Four-time Paralympic champion Alex Zanardi has undergone a third operation as he continues his recovery from a crash during a handcycle race in his native Italy last month.

Zanardi, who won two golds in para-cycling at both the London 2012 and Rio 2016 Olympic Games, was involved in a crash while competing in a national handcycling road race in June.

A further update on Zanardi's condition was released today by the Santa Maria alle Scotte in Siena where he is being treated.

It said he had undergone a third operation, which lasted around five hours, remained in a "severe" neurological condition and was being "sedated and ventilated" in intensive care, as reported by BBC Sport.

The statement described Zanardi's cardio-respiratory and metabolic condition as "stable", but added he had suffered "complex" cranial and facial fractures.

Zanardi, who won double gold at both the London 2012 and Rio 2016 Paralympics was competing in a race in Italy when the crash happened ©Getty Images
Zanardi, who won double gold at both the London 2012 and Rio 2016 Paralympics was competing in a race in Italy when the crash happened ©Getty Images

"The operation required careful programming that made use of computerised, digital and three-dimensional technologies, made to measure for the patient," said Professor Paolo Gennaro, director of maxillofacial surgery at the hospital.

A further update will be issued on Zanardi "as soon as there are significant changes in the athlete's clinical picture."

Zanardi, 53, competed in Formula One and sportscar racing during the 1990s.

In 2001, while competing in cart racing, he suffered a life-changing accident in which he lost both his legs.

Following his accident, Zanardi was fitted with two prosthetic limbs and after competing at the World Touring Car Championship turned to Para-cycling.