Italy midfielder Riccardo Montolivo will miss the World Cup after breaking his left tibia in a warm-up game against Republic of Ireland.
Montolivo was forced off after a ninth-minute challenge from Alex Pearce in the match, which took place at Fulham's Craven Cottage.
The AC Milan midfielder, who played in all three of Italy's matches at the 2010 World Cup, appeared to say ''it's broken'' in the aftermath of the tackle.
Italy's team doctor Enrico Castellacci confirmed the worst, with Montolivo taken off to hospital in West London.
''Montolivo has what we suspected, a broken tibia," Castelacci said. "I haven't seen the X-ray yet to evaluate the extent of it but for a broken bone you can expect surgery.''
Italy's Montolivo out of World Cup