England at sixes and sevens over their nines after Care ruled out

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 from start to finish.

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. All things considered, Care was in a strong position to reclaim the No 9 shirt for the opening World Cup pool game with Argentina in Dunedin in 23 days' time. That's now for the birds.

Youngs will certainly feature when Johnson makes the final call on his 30-man party next Monday: he is back in full training and, even if he is not considered quite fit enough to face Ireland in the last warm-up game in Dublin five days later, the England medics believe he will be match-ready come the important date with the Pumas. But who will travel with him?

There had been strong indications that Johnson would take only two specialist scrum-halves rather than the usual three and fill the gap, should it need filling, with a part-timer: either Ben Foden, raised as a No 9 before successfully switching to full-back, or Riki Flutey, who made a mark in the position in his native New Zealand before moving to midfield. But Care's demise changes the selectorial landscape, and if Flutey fails to make the squad - there were surprising rumours yesterday that he might be surplus to requirements – the manager will almost certainly go for a trio of career half-backs.

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 – and England, bereft of attacking threats at centre, have come to depend on dynamic, sniping raids from their half-backs. If Johnson wants a Care clone, he has a ready-made option in the uncapped Wasps player Joe Simpson who, also, has been in the training squad all summer. Simpson is quick; if there is a faster half-back in Christendom, he is still in hiding.

Simpson is spectacularly quick; if there is a faster half-back in Christendom, he is still in hiding. But plans to blood the Sydney-born youngster in the familiar surroundings of Australia last year had to be shelved because of... you guessed it, injury.

Other possible back-ups, although they remain long shots, 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. Both turned out for the second-string Saxons in the successful Chur-chill Cup campaign two months ago.

Care, capped 27 times since the summer of 2008, sounded suitably exasperated yesterday: the 24-year-old Yorkshireman, who has been told he faces at least six weeks of incapacity, said he was "absolutely devastated". Johnson, who rarely goes overboard on the sympathy front, 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... and no one wants to see a player ruled out by injury at this stage."

If Wales have been hit hard by injury withdrawals – the hooker Matthew Rees and the wing Morgan Stoddart sit alongside Henson on the non-travelling list – England may yet catch them up.

Lewis Moody, their captain, may or may not recover from a chronic knee problem in time to start the tournament, and there are continuing concerns over the senior loose-head prop Andrew Sheridan, who has yet to show signs of life in public after weeks and months on the physiotherapy slab. Others, like the centre Shontayne Hape and the wing Chris Ashton, have played precious little rugby since the back end of last season.

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 what is certain to be 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.

Four in the frame: Which scrum-halves will go?

Ben Youngs The talk of the town last autumn, out of form after Christmas... and struggling for fitness, but medics say he will be ready.

Richard Wigglesworth He was a key contributor to his club's title-winning campaign, but is he what Martin Johnson wants?

Joe Simpson Full of pace, bursting with energy... and entirely lacking in Test experience. A bit of a Care clone, but he is a risk.

Paul Hodgson A heartbeat player who knows how to goad a pack into action, but short of Test class. He is a bit of a long shot.

Chris Hewett