Annemiek van Vleuten (Mitchelton-Scott) was the victim of a late crash during Stage 7 of the Giro Rosa, limping over the finish line, with hospital scans later confirming the current leader of the race had fractured her wrist.
Australian Amanda Spratt was caught up in the same crash and also taken to hospital after finishing the stage, abandoning the race with a concussion and heavy bruising.
The crash came after attacks on the final climb of Stage 7 of the Giro Rosa saw a select group go clear with both Van Vleuten, Spratt and the major climbers present as they raced towards the sprint finish in Maddaloni.
The group then swelled in size as the stage looked set for a reduced bunch sprint before disaster struck when a crash took down half the bunch, with Van Vleuten, Spratt and triple stage-winner Marianne Vos (CCC-Liv) hitting the road with just over a kilometre remaining.
It appeared that Soraya Paladin moved slightly to the right after coming over a rise on the side of the road, causing a ripple effect down the peloton that eventually saw Paula Andrea Patiño (Movistar) take out the front wheel of Vos, causing her to crash and bring down a number of riders.
On the slightly uphill finishing straight, Lotte Kopecky (Lotto Soudal) came around the final corner in good position, and started her sprint very early and was a comfortable winner on the line from Elizabeth Deignan (Trek-Segfredo) and Kasia Niewiadoma (Canyon-SRAM).
Van Vleuten, Vos, and the other crashed riders finished some way behind, but received the front group's time as the crash happened within the final three kilometres. Though Van Vleuten kept her pink jersey, she was taken for hospital scans which confirmed that she had fractured her wrist.
Van Vleuten will fly back to the Netherlands immediately and have an operation on her wrist on Saturday, the same day she hoped to be standing triumphant atop the final podium of the Giro Rosa.
“I was in a good position just going safe to the finish," said van Vleuten. "It was a good day for us, I was never in trouble, we were in control, I was having fun on the bike until the last 500 metres when the girls crashed in front of me and I couldn’t avoid them.
“I felt immediately it was not good with my wrist, because I saw that my wrist was not straight, so I knew straight away that was not good. I will go home now and I will have an operation on my wrist on Saturday.
“I’m super sad it’s not possible to defend the maglia rosa, but even more, no worlds on a course that suits me. I’m disappointed that I cannot defend my world champion's jersey."
Van Vleuten held a commanding lead in the general classification, a minute and 48 seconds over second-placed Kasia Niewiadoma (Canyon-SRAM). She was considered favourite for the world championships time trial and road race to be raced in just over a week's time, but will now have to watch from the sidelines.
Australian Amanda Spratt came into the race as the co-leader with van Vleuten and was also forced to withdraw from the Giro Rosa after appearing to crash into the bollards on the pavement during the pile-up.
“Right now my biggest feeling is just disappointment," said Spratt, "not just for me but for Vleuty and the whole team. Our Giro was going perfectly, and it all fell apart in one instant.
“I think I am lucky I don’t have a broken bone but the shoulder is very painful still and with a concussion I have to take it easy now. I hope to recover as quick as possible and be back racing soon. Thanks to the team for the incredible support.”