Headache for Johnson as Care out of World Cup

World Cup warm-up matches may be necessary evils, but there are some players who will always consider them more diabolical than essential. Gavin Henson, the celebrity centre from Wales who failed to survive last weekend's much talked-about game with England in Cardiff, is certainly among them, having seen his tournament chances ruined by a busted wrist. So too, suddenly, is the fleet-footed Harlequins scrum-half Danny Care, who is out of next month's competition with a toe injury – a development that does precisely nothing for red-rose prospects of making a serious impact on proceedings.

Four years ago, England travelled to the World Cup in the throes of a scrum-half crisis. Matt Dawson and Kyran Bracken were strictly past tense, while their natural successor, Harry Ellis, was in the early stages of his long and ultimately futile battle with orthopaedic trauma – a situation that left Brian Ashton, the coach, with the unenviable task of choosing between an occasional Test player in Andy Gomarsall, a seven-a-side specialist in Peter Richards and a recent recruit from the amateur game in Shaun Perry. Gomarsall ended up the main man and played an important role in the team's unexpected advance to the final, but it was a rum do.

What price the same situation arising next month, when England pitch up in All Black country for the seventh of these global gatherings? When news broke yesterday of Care's withdrawal from the squad – during the defeat at the Millennium Stadium, in which he participated as a replacement, he mangled the big toe joint on his left foot and is in need of immediate surgery – thoughts turned immediately to alternatives. And as things stand, the alternatives are short of great.

England have Ben Youngs, of course, and if Youngs were playing the exhilarating brand of rugby he displayed during last November's international series at Twickenham, the loss of Care would be easier for Martin Johnson and his coaching staff to take. But Youngs has not been at the top of his game for months; indeed, he is not even at the bottom of his game, having spent most of the World Cup training camp recovering from a knee operation. Youngs will certainly feature when Johnson makes the final call on his 30-man party next Monday: he is back in full training and the England medics believe he will be match-ready come the important date with the Pumas.

But who will travel with him? Richard Wigglesworth, the quietly effective Saracens player who started the game at the Millennium Stadium, is now playing second fiddle to Youngs, but he is not a strike-running No 9 like Care. If Johnson wants a Care clone, he has a ready-made option in the speedy uncapped Wasps player Joe Simpson.

Other possible back-ups include Paul Hodgson of London Irish, who had a brief spell as England's No 1 choice in 2009 but has slipped down the ratings, and the new Leicester signing Micky Young.

Care, capped 27 times since the summer of 2008, who has been told he faces at least six weeks of incapacity, said he was "absolutely devastated". Johnson was equally deflated. "We are all hugely disappointed for Danny, who has worked extremely hard and has been an important member of our squad throughout the World Cup preparations. He was on course for selection," the manager said.

This latest turn of events will force Johnson to reassess his approach to selection, at precisely the moment he wanted to be sure of his own mind. And with a full-blooded encounter with the Irish still to be negotiated, there is every chance of another unwelcome medical bulletin before the players board the plane to Auckland. Or two. Or three.