The injury is a huge blow for Chelsea but has significant ramifications for England, raising the very real prospect that Wayne Bridge will become first-choice left-back for South Africa if and it remains a big if he can reconcile his differences with John Terry following Terry's affair with Vanessa Perroncel.
Cole suffered the fracture to his left ankle in the 2-1 defeat at Everton on Wednesday. The 29 year-old left Goodison Park in pain and on crutches, with his ankle badly swollen, and underwent a scan on Thursday.
The prognosis from Chelsea's medical team is three months 'approximately', which will take Cole up to mid-May, meaning he will miss the rest of the domestic season and will struggle to be in contention for England's squad, who, soon after, will depart for their altitude training in Austria.
England manager Capello will announce his provisional squad by then and, given his edict that players must be fit and playing for their clubs, it is unlikely that Cole will be given special dispensation. His World Cup, unless he makes a rapid recovery, appears to be over.
There is a cruel irony in that Cole was injured in a challenge wholly legal by Landon Donovan, who will be the United States' main player when England open their World Cup campaign in Rustenburg on June 12.
The potential loss of Cole will deeply concern Capello, who has grown to admire the left-back and regards him as one of the most important members of his squad.
Cole has to be discounted at this stage. This means Capello will have to focus more intensely on the issue of whether Bridge is able to play alongside Terry given the furore over the Chelsea captain's relationship with Perroncel, who is Bridge's former partner and mother of his child.
Bridge has indicated that he does not feel able to play alongside Terry although he has been asked, by England general manager Franco Baldini, to wait to see if he feels the same in a few weeks' time, when Capello selects his squad for the friendly against Egypt at Wembley on March 3.
The Italians hope time will heal the divide between the two players, but they will not allow any feud to derail their World Cup plans.
Bridge has been told not to be hasty because it is his World Cup as much as Terry's and, given he may now be first choice left-back, that becomes even more of a consideration.
Capello has no plans to speak to Bridge ahead of the Egypt game and maintains that he will only hold a discussion with the player over what happens and whether he can share a dressing room with Terry if he is selected. Bridge himself has only just recovered from a long knee injury lay-off and played his first game for Manchester City in almost three months last weekend.
Bridge has now spoken to Terry twice on the phone, but is still devastated by what has happened and is struggling to come to terms with events.
Terry, who was Bridge's best friend before the affair was exposed, flew to Dubai on THursday to try to patch up his marriage.
His wife, Toni, fled there with their children after the controversy over Terry's behaviour blew up.
It means the central defender will miss Chelsea's FA Cup tie against Cardiff City tomorrow, although his club maintain that he may have been rested for the match anyway. He is expected to return in time for Chelsea's Premier League match at Wolverhampton Wanderers a week tomorrow.
The injury to Cole leaves Capello short of options at left-back, especially as the other candidate he admires, Arsenal's Kieron Gibbs, is already out through injury. Although Capello tends to remain phlegmatic about injuries and absentees he will now, having taken the captaincy away from Terry, have to deal more immediately than he expected with a very thorny issue.
Meanwhile Sepp Blatter, the Fifa president, offered his own unique take on the Terry affair yesterday by claiming his off-field behaviour would have been applauded in some countries rather than causing him to be stripped of the England captaincy.
Blatter, in Vancouver for the International Olympic Committee's session, said that in 'Latin' countries such as Italy and Spain Terry's conduct would not have been considered a problem.
'Listen, this is a special approach in the Anglo-Saxon countries,' he said. 'If this happened in, let's say Latin countries, then I think it would have been applauded.'
Fabio Capello's six of the next best at left-backBy Mark Ogden
WAYNE BRIDGE: As Cole's understudy for England, and previously at Chelsea, Bridge, 29, would appear the obvious choice. But the revelations involving John Terry and Bridge's former girlfriend have clouded the picture. He is just back from a six-week knee injury lay-off and his form has been patchy for Manchester City.
STEPHEN WARNOCK: Capped just once, the Aston Villa full-back would be a gamble for Capello. Naturally left-footed and tenacious, Warnock, 28, is a defender first and foremost and he lacks the adventurous streak of Cole. His tough-tackling approach might work against him at a World Cup.
LEIGHTON BAINES: Everton manager David Moyes has claimed that a senior call-up for Baines is long overdue and his form merits some recognition. Could be caught out for pace in South Africa, but his ability from set-pieces and penalties could prove his trump card.
GARETH BARRY: With Owen Hargreaves losing his battle to be fit for South Africa, Capello would be loath to deploy his next best holding midfielder at left-back. Barry is a steady performer in that role, but his lack of pace would not help his cause. An ideal back-up at left-back, but Capello will not want Barry to be his first-choice in South Africa.
JOLEON LESCOTT: The Manchester City centre-half has played at left-back for Everton and England, but he does not relish full-back duties. He does have plenty of experience in that position, though. If he regains his form at City, he could usurp Eastlands team-mate Bridge.
JAMES MILNER: His growing maturity as a midfielder at Villa shows his value further up the field. But he has impressed when filling in at left-back and could be an emergency option.