England's debilitating injury list has shown no sign of shortening as the countdown continues towards this season's autumn Tests.
England boss Eddie Jones suffered another crushing injury setback on Monday after European player of the year Maro Itoje was ruled out of Twickenham appointments with South Africa, Fiji, Argentina and Australia.
Jones names his squad on Wednesday for the autumn fixtures, with 21-year-old lock Itoje set to be the most significant absentee.
Itoje's club Saracens confirmed the injury - a broken right hand - which happened during Saturday's European Champions Cup victory over the Scarlets at Allianz Park.
Saracens say he requires surgery and will be sidelined for six weeks.
In a statement released by Saracens, the club's rugby director Mark McCall said: "For any team to lose a player of the ability of Maro is a blow, and he will be missed through the autumn for both Saracens and England.
"What's now important for Maro is his recovery, and we look forward to his return later this season."
Jones has already lost the likes of Itoje's Saracens and England second-row partner George Kruis, who has an ankle injury, in addition to players such as James Haskell (foot), Anthony Watson (fractured jaw) and Jack Clifford (ankle).
Itoje helped England to the Six Nations title and Grand Slam glory last season in his debut campaign of international rugby, then started all three games when Jones' team claimed a memorable 3-0 Test series whitewash against Australia Down Under.
And he was a hugely influential figure during Saracens' march to winning the European Champions Cup and retaining the Aviva Premiership title last term.
With Itoje and Kruis out of action, it looks as if Jones will now turn to seasoned campaigners Joe Launchbury and Courtney Lawes as his second-row partnership for the Springboks clash on November 12.
Itoje had also been talked about as an openside flanker option for Jones, with Haskell and other candidates like Leicester's Mike Williams and Wasps' Sam Jones all injured.
But the Australian will have to look elsewhere as England aim to extend their nine-match unbeaten run under Jones, starting against South Africa.