A crash on the final climb of the Tour de France stage to Marseille and then a high-speed stack in the finishing straight left several riders injured, with race organisers again including a long list of names on the official medical communiqué.
Christian Vande Velde (Garmin-Sharp) and sprinter Nacer Bouhanni (FDJ.fr) seemed to be the worst injured, but AG2R's Maxime Bouet was the first to be confirmed out of the race with a fractured left distal radius.
Vande Velde went down on the final climb with 15km to go after being behind a touch of wheels from other riders in front, and had no time to react before tumbling off the road. He was examined in a hospital following the stage. The medical communiqué said he had suffered a neck injury and bruising, with a possible displacement of a screw fitted during a previous operation.
Garmin Team Doctor Prentice Steffen gave more detail later. "Christian has plates in his collarbone from previous injuries. After today's crash, an ultrasound and x-ray show a blood clot in a neck muscle (left sternocleidomastoid) and a loosened screw in his clavicle plate. From what we can tell, it is possible that the screw may have jabbed a muscle."
"Preliminary x-rays do not show a fracture but it probably flexed a bit in the crash and disrupted a screw. It's an unusual injury and we will monitor him overnight and make a determination in the morning as to whether or not he will start the stage. Christian's health is the most important thing to us, so we will evaluate him again tomorrow and determine next steps at that time."
Teammate Ryder Hesjedal was also listed in the medical communiqué, with a note saying he was involved in the finish crash and suffered a fracture of his left sixth rib. That set alarm bells ringing in the press room after the Canadian's string of unlucky crashes in the last 12 months. However, team manager Jonathan Vaughters quickly took to Twitter to reveal that the fracture occurred on stage 1.
Cyclingnews saw Hesjedal warm down after the stage and he seemed fine.
Later he said, "I have had some discomfort since the crash I was involved in during stage 1. A scan today confirmed a fracture so at least now we know what we're dealing with. A lot of times with rib injuries, fractures don't show up right away so waiting until today we were able to confirm what's going on. There's not much you can do about a fractured rib except for deal with the discomfort so that is what I've been doing and will keep doing. I just hope Christian and everyone else who crashed today is ok."
Garmin-Sharp Director Sportif Charly Wegelius said despite the injuries, spirits are still high in the Garmin-Sharp squad. "The team overall is strong and motivated and our goal is to keep lighting up the race as we roll toward Paris. There is still a lot of racing yet to come and we're proud of how the team is riding."
Bouhanni had a tough day in the saddle. He was diagnosed with a stomach problem early in the stage and then crashed hard in the finish after tangling with Matteo Trentin (Omega Pharma-Quick Step).
He was diagnosed with a back injuries, but x-rays and scan in the mobile unit at the finish ruled out fractures or anything more serious. Road rash on his left leg will make it a difficult night for the young French sprinter.
Haimar Zubeldia (RadioShack-Leopard) fractured a bone in his left hand. Both riders will decide if they can continue in the Tour de France before Thursday's sixth stage.
Fredrik Kessiakoff (Astana) also took a tumble and collected multiple cuts and bruises. He needed ice on his left wrist but the Astana team told Cyclingnews that his injuries were not a major concern.