England flanker Rees ruled out of Six Nations

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And winger David Strettle looks unlikely to feature again in the tournament after Harlequins confirmed he has sustained a hairline fracture to a metatarsal in his left foot.

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Quins say Strettle will be out of action for between four to eight weeks.

Rees (pictured above) was forced off during the second half of England's shock 26-19 defeat by Wales at Twickenham on Saturday, and an MRI scan yesterday confirmed the extent of his injury.

Wasps' medical team predict that Rees will be in rehab for approximately eight weeks.

The club's director of rugby Ian McGeechan said: "This is very disappointing news, particularly bearing in mind way Tom was playing in Saturday's game and I think his departure had a significant impact on England's performance in the remainder of the game.

"Our medical and rehab team will working very hard in the coming weeks to get Tom back to full fitness as soon as possible."

Strettle was also forced off through injury on Saturday and, after seeing a specialist yesterday in the company of Harlequins physio Richard Bramford, it was confirmed he has sustained a hairline fracture to the fifth metatarsal in his left foot.

It is estimated he will be out of action for approximately four to eight weeks, although he will return to see the specialist in three weeks' time to monitor his progress.

England will also be without centre Mike Tindall (bruised liver) and flanker Lewis Moody (Achilles) out of Sunday's game against Italy in Rome

Tindall remains under observation in a London hospital and is unlikely to play any further part in this season's Six Nations.