The neutral roll-out is perhaps the worst place to crash in a race — Italian Fabio Felline was out of Amstel Gold Race before it even started Sunday after flipping over the handlebars and fracturing his nose and skull.

Trek – Segafredo’s sprinter appeared to be reaching down to his fork with his left hand just prior to the crash.

“Fabio crashed with his face directly into the ground,” said Trek – Segafredo team physician Jens Hinder. “He sustained a broken nose and cuts to his face and the radiologists also found a fracture at the base of the skull. He needs further examination to determine if it is stable or unstable and this will determine what treatment is required for recovery. It is too early to know until he undergoes further tests.”

This comes after Felline notched podium finishes in stages at Ruta del Sol and Vuelta al Pais Vasco this spring, on the rebound from a lengthy struggle with a virus. He will miss the remainder of the Ardennes classics.