Mikel Landa has become the latest casualty of a disastrous edition of Itzulia Basque Country, abandoning the race with a broke collarbone.
The Soudal Quick-Step rider followed his team leader Remco Evenepoel in leaving the Basque race with a fracture, with Jonas Vingegaard (Visma-Lease a Bike) and Primož Roglič (Bora-Hansgrohe) also among those forced to leave the race.
Landa crashed with 94km to go on stage five, along with his teammate Gil Gelders, who also abandoned, and the Movistar pair of Gonzalo Serrano and Pelayo Sánchez, both of whom were forced to quit as well.
"During an accident on stage 5 of Itzulia Basque Country, Soudal Quick-Step riders Mikel Landa and Gil Gelders were involved in a crash, forcing both to leave the race," a statement from Soudal Quick-Step read. "Gelders was given medical attention on the spot and was treated for abrasions.
"Mikel, runner-up at the Volta a Catalunya last month, was taken to the local hospital where X-rays revealed that he has suffered a fracture to his clavicle. He will now undergo further investigation to determine the best path for his recovery. We wish both riders well."
A horror crash at Itzulia Basque Country on Thursday saw three of the favourites for the Tour de France - Vingegaard, Roglič and Evenepoel - hit the deck.
Vingegaard was the worst affected of this trio, suffering a collapsed lung, a broken collarbone and "several" fractured ribs.
Jay Vine (UAE Team Emirates) suffered a cervical and two thoracic spine vertebral body fractures, while Steff Cras (TotalEnergies) also came away with a collapsed lung, broken ribs and a two fractured vertebrae.
The week had already seen other major withdrawals, with Tom Pidcock (Ineos Grenadiers), Ben Tulett (Visma-Lease a Bike) and David Gaudu (Groupama-FDJ) among those heading home early from the Basque Country.
It is uncertain how long everyone affected will be sidelined for, but Evenepoel said he thought his long term goals would stay the same - meaning he would still be targeting the Tour de France.
In an Instagram post on Thursday, former Vuelta a España stage winner Nicolas Roche said that cyclists should not have to "risk their life if they hope to perform".
The two-time Irish national road champion said that he has "come to fear" for his friends who are still racing, and suggested that higher speeds and better braking power is partly to blame.
Romain Grégoire of Groupama-FDJ was the winner of stage five in a reduced bunch sprint.