England scrum-half Ben Youngs has been ruled out of the remainder of the NatWest 6 Nations by a ruptured knee ligament.

Eastern Daily Press: Ben Youngs leaves the pitch on a stretcher during England's win over Italy. Picture: Steven Paston/PA WireBen Youngs leaves the pitch on a stretcher during England's win over Italy. Picture: Steven Paston/PA Wire (Image: PA Wire)

Norfolk star Youngs sustained the damage to his medial collateral ligament nine minutes into Sunday's 46-15 victory over Italy in Rome and, as he is expected to be out of action for four months, he is also a major doubt for the summer tour to South Africa.

Danny Care is set to start Saturday's showdown with Wales in his absence, with Richard Wigglesworth – called up by Eddie Jones earlier yesterday – poised to deputise.

Leicester scrum-half Youngs' name was missing from the 32 summoned to England's Surrey training base yesterday and, following a scan, the extent of his injury was revealed in an RFU statement last night.

England will hope for better news from Nathan Hughes, who is to be assessed by medics to see whether he will play any role in this Six Nations.

His participation is threatened by a knee injury sustained in December, although the Fiji-born number eight was expected to be back for the latter rounds.

The absence of Billy Vunipola, who will sit out the entire Championship with his own knee problem, will mean Hughes' availability would be a substantial boost, even if Sam Simmonds demonstrated in Rome that he is an exciting alternative.

Care hopes Youngs' misfortune will enable him to become England's most capped scrum-half as a starter.

Care stepped off the bench to equal Matt Dawson's record of 77 Red Rose appearances in the number nine jersey and with Youngs stricken when his knee buckled awkwardly beneath him during a tackle, a place in the starting XV now awaits.

'You never want to see a bad injury like that and I was gutted to see Ben in so much pain,' Care said. 'First things first, he's a good mate as well as a competitor for the shirt. He's in pain and all our thoughts are with him.

'He was in the changing room after the game and was still in good spirits.

'It would be great to get into the number nine shirt for the Wales game having had 70 minutes under my belt, which is great because I love being out there with the boys.'

Wigglesworth won the last of his 27 caps during the 2015 World Cup but the 34-year-old Saracen is an outstanding game manager with a strong kicking game.