England's preparations for the Rugby World Cup have suffered a setback after Danny Care was ruled out of the tournament because of a toe injury.
The scrum-half, who has described himself as "absolutely devastated", is to have immediate surgery on his left big toe joint. Saracens' Richard Wigglesworth is set to take his place in Martin Johnson's 30-man squad for the finals in New Zealand, which begin on 9 September.
Johnson and his employers at the Rugby Football Union had said England had no fresh injury concerns after Saturday's 19-9 defeat by Wales in Cardiff, but they revealed the truth once the full extent of Care's injury became clear. The Harlequins No9 was a central figure in both England's first two warm-up games and had been a certainty to travel.
England's disappointment will be magnified by the fact Leicester's Ben Youngs has not played any competitive rugby since having an operation on his left knee in June. Wigglesworth, making a first Test start for more than three years, had to leave the field prematurely in Cardiff, after suffering a blow to the head.
If England need a scrum-half in the knock-out stages there is a slim chance that Care could yet re-enter the equation, although medical opinion suggests he will be out for a minimum of six weeks. A more likely scenario is that that Wigglesworth will travel as Youngs' understudy,, with Wasps's uncapped Joe Simpson on standby. Simpson and Care are similar in style but Wigglesworth, who can also play at fly-half, is the more experienced option.
Care's absence, even so, is likely to have tactical repercussions, particularly if Youngs takes time to rediscover his form. The England management had been relying on Care to stay fit, enabling them to use the full-back Ben Foden at scrum-half in an emergency.
"We are all hugely disappointed for Danny who has worked extremely hard and has been an important part of the squad throughout our Rugby World Cup preparations," said Johnson. "He featured in both warm-up fixtures and was on course for selection so this injury is really disappointing for him and for us as a squad."
Care, 24, is at least young enough to be involved when England host the tournament in 2015. He has been doing his best to be philosophical. On Wednesday he used Twitter to say: "Supposedly everything happens for a reason?" and to thank well-wishers for "helping me getting through this tough time".
Among those quickest to express their support was Wigglesworth, who said: "Gutted for Danny … worst timing possible. Big loss to the squad as a player and a person."
Johnson will confirm his 30-man squad on Monday, before England's final warm-up game, against Ireland in Dublin on Saturday week. The squad are due to leave for New Zealand on 29 August.
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