England are sweating on the fitness of Ben Stokes after the all-rounder suffered a serious shoulder injury on the opening day of the third Test against Pakistan.

Stokes fell awkwardly on the joint while trying to cling on to a tough catch at deep backward square leg, and grimaced as he was helped off the pitch by medical staff with his right arm in a sling.

England won’t know the extent of the damage until he has undergone hospital scans on Monday morning, and the ECB were unable to say whether he had suffered a dislocation.

Ben Stokes appeared to dislocate his shoulder diving for the ball in the Test between England and Pakistan

Stokes' team-mate James Anderson (left) looks concerned as he rushes over to help his fellow bowler

The pain Stokes was in was clear for all to see as England physios help him to get to his feet

Stokes landed heavily on his shoulder after leaping through the air to try and take a catch

But despite his spectacular attempts, Stokes landing was awkward and it was where he sustained the injury

Stokes appeared in pain from the moment he landed and will have a scan on the injury on Monday

Stokes was in any case due to miss the limited-overs matches that follow the Tests here, but a serious injury would not help his chances of playing in the four-Test series against the world’s No 1-ranked side South Africa, starting in Durban on Boxing Day.

His injury may be limited to ligament damage, though dislocations can take between 12 and 16 weeks to heal.

‘We all walked into the dressing-room straightaway to try to find him,’ said Stuart Broad. ‘He’s a tough guy, so if shows pain you know it’s going to be sore. It was an amazing effort to take the catch, but the outfield was quite soft and he landed awkwardly. He’s a bit down.’

Stokes was not the only injury concern on a day when Jimmy Anderson – who moved into eighth place on the all-time Test list with 424 wickets – and Broad returned combined figures of 28.1-15-30-6 as Pakistan were bowled out for 234.

Nottinghamshire’s spin-bowling all-rounder Samit Patel underwent treatment to his left little finger only two balls into his first spell in Test cricket since his last appearance in Kolkata almost three years ago.

Patel hurt himself as he dived to his left to field off his own bowling, but recovered to take the wickets of Asad Shafiq and Wahab Riaz and looked the most dangerous of England’s trio of spinners on a pitch that turned lavishly from the start.

He had been preferred to Yorkshire seamer Liam Plunkett, despite coach Trevor Bayliss’s concern that three spinners may not necessarily do the job any better than two.

But Patel bowled 23 overs – as many as Moeen Ali and Adil Rashid combined – and removed Shafiq for just five with a beauty that turned, bounced and kissed the outside edge. Since Shafiq averaged 68 in the first two Tests from No 6, it felt like one of the moments of the day.

Patel joked recently that there were times over the last couple of years when he has wondered whether the England selectors had lost his mobile number, and he only got his chance on this tour following an injury to Surrey’s spinning all-rounder Zafar Ansari.

But, if Stokes’s contribution to this Test is indeed already over, Patel’s ability with the bat could prove crucial as England look to build a lead.

.@benstokes38 news: scans tomorrow AM on his shoulder injury to determine extent of the damage #fingerscrossed pic.twitter.com/ouTG3qwhJB — England Cricket (@englandcricket) November 1, 2015

The injury to all-rounder Stokes tarnished what was otherwise an encouraging first day for England

Stokes' shirt was used as a makeshift sling and a bad shoulder dislocation could rule him out for four months

The worst case scenario would see Stokes ruled out of the winter Test series against South Africa

England bowler Samit Patel also needed treatment for an injury to his little finger

‘Samit did really well,’ said Broad. ‘He bowled a lot of overs, showed patience, and brought stumps into play. His first wicket was a jaffa, and he’s a fantastic Test-match No 8.’

At one point Broad bowled 48 successive dot balls, the most by an England bowler in a Test for two years. ‘If you hold your length, the outfield is very slow and it’s hard to pierce the field,’ he said. ‘The mindset today was tie them down and create pressure.’