Saracens number eight Billy Vunipola will miss England's fall internationals in the wake of breaking his left arm in their Champions Cup triumph over Glasgow Warriors on Sunday.
The 25-year-old needs a medical procedure and will be out of action for up to 12 weeks.
He as of late came back to activity in the wake of cracking his correct arm amid England's mid-year voyage through South Africa.
Vunipola has just begun three internationals in two years as a result of a progression of wounds.
His nonattendance leaves a gap at number eight for England mentor Eddie Jones, with Nathan Hughes confronting a suspension and Sam Simmonds additionally harmed.
Britain goes up against South Africa at Twickenham on 3 November and afterward play New Zealand, Japan, and Australia on the three ensuing Saturdays.
Britain scrum-half Danny Care told the Rugby Union Weekly digital broadcast: "It's terrible news for Saracens and England, yet primarily for Billy. You truly feel for him.
"I saw direct a week or so back, Harlequins against Saracens, he had a man-of-the-coordinate execution. He was totally splendid that day and indicated what he could do when completely fit."
Then, Vunipola's sibling Mako has a calf strain and will be observed, while Sarries second column Nick Isiekwe has a lower leg strain.