Mark Cavendish suffered a nasty bump on the head as he became caught up in a serious crash in stage four on Wednesday, and it may have seemed as though he was still feeling the effects as the stage five run into Saint Quentin was played out in almost exactly the same way.

If that got the Team Sky sprinter looking for a wee lie down then so will the sight of Andre Greipel beating him to the line once again.

The German won his second consecutive stage yesterday, thwarting Cavendish's hopes of a clinching 22nd stage win. The Lotto-Belisol rider produced another textbook ride to pip Matt Goss (Orica-GreenEdge) and Juan Jose Haedo (Saxo Bank-Tinkoff Bank) on a fast finish into Saint Quentin on stage five.

Cavendish took fourth place with the small consolation that, with points classification leader Peter Sagan (Liquigas-Cannondale) held up in yet another a crash – occurring around 3km from the line just like in stage four – he closed a few crucial points on the green jersey holder.

A four-man breakaway comprising Jan Ghyselinck (Cofidis), Pablo Urtasun (Euskaltel-Euskadi), Julien Simon (Saur-Sojasun) and Matthieu Ladagnous (FDJ-BigMat) – which had led from the first kilometre of the race – came within almost 100m of succeeding before being swept up within touching distance of the line.

After Wednesday's disastrous run into Rouen, Sky made the decision not to leave Cavendish to fend for himself, sending an eight-strong train to the front of the peloton for the first time this year. The move had the bonus of keeping their general classification contender Bradley Wiggins safe from danger.

It was a precarious waiting game on the long straight approach into Saint Quentin as Sky, BMC, Katusha and Lampre jostled for position. A nervous peloton inevitably crashed, with Tyler Farrar (Garmin-Sharp) hitting the deck, taking Sagan with him. With four crashes in the last six days, Farrar is rivalling team-mate Robbie Hunter for war wounds.

"It was a crazy day," said Greipel. "I was behind the crash with 3km to go. Greg Henderson brought me back. It was a hard sprint. I think it was the hardest sprint I have done."

Earlier, Cavendish led the bunch in the intermediate sprint following a perfect lead out from Sky team-mate Edvald Boasson Hagen. Goss was in sixth, with Mark Renshaw (Rabobank) seventh and Sagan eighth.

Sprinter Marcel Kittel (Argos-Shimano) joined the Tour's growing list of casualties, forced to abandon yesterday after 40km citing gastro-intestinal problems and an injured knee.

Yesterday's result means the general classification standings remain unchanged with Fabian Cancellara (RadioShack-Nissan-Trek) still in yellow and Wiggins second overall, still 10 seconds clear of defending Tour de France champion Cadel Evans (BMC).

Despite being waylaid by the crash, Sagan retains the green jersey, while Michael Morkov, of Saxo Bank-Tinkoff Bank – with no classified climbs in yesterday's stage –remains in the polka-dot jersey. Today's 207.5km stage from Epernay to Metz is the last one for the sprinters until next Saturday.

Today could also mark Cancellara's penultimate day in the maillot jaune. After a week on the relative flat of Belgium and northern France, tomorrow the Tour heads into the first of the medium mountain stages, finishing in La Planche des Belles Filles.