SAINT-FOUR, France — Kazakh rider Alexandre Vinokourov is out of the Tour de France after being taken to a hospital with a suspected broken leg following a high-speed crash during a descent in Sunday's ninth stage. American time trial champion David Zabriskie was also forced to quit after injuring his wrist.

The 37-year-old Vinokourov's career could be over after previously saying this would be his last Tour.

Vinokourov was one of several riders caught up in the crash on a slippery road about 63 miles into the stage between Issoire and Saint-Flour in the Massif Central.

Vinokourov fell into a wooded area and landed in a ditch on the right side of the road with riders reaching speeds of more than 43 mph. He was attended to by the race doctor before several of his Astana teammates helped him back up to the road.

The 2006 Vuelta champion was then evacuated to a nearby hospital in the town of Aurillac.

Vinokourov, who was third at the 2003 Tour, served a two-year doping suspension after twice testing positive for banned blood transfusions during the 2007 race.

Omega Pharma team leader Jurgen Van Den Broeck also fell in the crash and had to pull out. Organizers said he suffered a fractured shoulder blade.

Van Den Broeck, who finished fifth last year in his second appearance on the Tour, tried to get back on his bike but quickly realized he was not able to continue racing.

Two other cyclists — Frederik Willems of Belgium and David Zabriskie of the Garmin-Cervelo team — were forced to quit after being involved in the same pile-up.

Willems, from the Omega-Pharma team, retired with a fractured collarbone, while Zabriskie injured his wrist.

Other riders involved included RadioShack leader Andreas Kloeden and British rider David Millar from the Garmin team. Both were able to return to the race.

"Millar ok, in peloton, Zab ok, maybe broken hand, but out of race," Garmin manager Jonathan Vaughters said on Twitter. "Everyone else ok."

The Tour has already lost several main contenders during a crash-marred first week, notably Bradley Wiggins, Janez Brajkovic and Chris Horner.