Gary Ballance is set to visit a hand surgeon amid fears the England batsman has broken his left index finger, potentially presenting Mark Stoneman with an opportunity to make his Test debut against South Africa.
Having undergone an x-ray, Ballance is not expected to be fit for the third Test at The Oval, which starts a week on Thursday, after being struck by a Morne Morkel bouncer in the second innings at Trent Bridge, where the hosts suffered an embarrassing 340-run defeat.
Insult was added to injury for the Yorkshire batsman, who continues to struggle when representing his country in the longest format, as he fell for 27 and four respectively to Vernon Philander.
If, as expected, Ballance is ruled out, Surrey's Stoneman is likely to open alongside former captain Alastair Cook, with Keaton Jennings, who was out for a duck in the first innings and made just three in his second knock, set to drop down to number three.
Having watched South Africa level the four-match series at 1-1, England coach Trevor Bayliss said: "The last selection meeting we had before this series started, players like Stoneman and [Tom] Westley were spoken about at length. Obviously, [Haseeb] Hameed, who is a little out of form this year. So those types of guys, they are on the edge.
"Since Andrew Strauss all of those guys have been picked because they've done well in county cricket. They probably started off well and then fell away a little. So that's a concern, obviously," he added, referring to England's struggles to replace the former captain and opener.
"One of the things we've tried to do since I've come in is try to give those guys a bit longer to show what they have got. It still hasn't worked, to be honest. Keaton, for example, at the top of the order, if we're consistent with our selections, should get some more goes."