Fabio Jakobsen is back on top with La Vuelta Stage Win

Deceuninck-Quick-Step rider Fabio Jakobsen came through a sapping uphill sprint to win stage four of the Vuelta a Espana on Tuesday

The Dutchman's career was in the balance after a horrific crash in the Tour of Poland last season.

But he took the victory -- and the green points jersey -- after powering past Arnaud Demare and Magnus Cort at the end of the 163.9 kilometre ride across largely flat terrain from El Burgo de Osma to Molina de Aragon.

"It's a dream come true. After the crash, it was a long way back," said Jakobsen.

"But I'm happy I'm here. It took a lot of time and a lot of efforts by a lot of people. This is also their victory."

Rein Taaramae crashed with 2.5 kilometres to go but was quickly back on his bike and retains the overall lead, 25 seconds ahead of Frenchman Kenny Elissonde and 30secs ahead of favourite Primoz Roglic.

The Spanish trio of Carlos Canal, Angel Madrazo and Joan Bou broke away almost immediately and built up a lead of 4min 35sec, but that was down to just one minute with 50km remaining.

They were inevitably engulfed with 14km to go, at which point the sprinters set themselves up for a tilt at the stage win.

The win marks a remarkable comeback for Jakobsen who lost all his teeth and suffered multiple head fractures when sent flying over barriers and into a traffic sign at over 80kph when barged by countryman Dylan Groenewegen during a bunch sprint in Poland last August.

The 24-year-old, who won two stages on the 2019 Vuelta, spent several days fighting for his life and needed multiple operations to reconstruct his face.

He returned to competition at the Tour of Turkey in April and went on to win the fifth stage of the Tour of Wallonie last month.

Groenewegen was banned for nine months for his part in the accident before returning to action in the Giro d'Italia. 

Wednesday's 184km fifth stage is from Tarancón to Albacete and is expected to be contested by the sprinters yet again. 

VIDEO: La Vuelta Stage 4 Highlights

2021 La Vuelta Stage 4 Top 10

1 Fabio Jakobsen (Ned) Deceuninck-QuickStep 3:43:07
2 Arnaud Demare (Fra) Groupama-FDJ
3 Magnus Cort (Den) EF Education-Nippo
4 Alberto Dainese (Ita) Team DSM
5 Michael Matthews (Aus) Team BikeExchange
6 Piet Allegaert (Bel) Cofidis
7 Jordi Meeus (Bel) Bora-Hansgrohe
8 Matteo Trentin (Ita) UAE Team Emirates
9 Jasper Philipsen (Bel) Alpecin-Fenix
10 Riccardo Minali (Ita) Intermarché-Wanty-Gobert Matériaux

2021 La Vuelta GC after Stage 4

1 Rein Taaramäe (Est) Intermarché-Wanty-Gobert Matériaux 13:08:51
2 Kenny Elissonde (Fra) Trek-Segafredo 0:00:25
3 Primoz Roglic (Slo) Jumbo-Visma 0:00:30
4 Lilian Calmejane (Fra) AG2R Citroën Team 0:00:35
5 Enric Mas Nicolau (Spa) Movistar Team 0:00:45
6 Miguel Angel Lopez Moreno (Col) Movistar Team 0:00:51
7 Alejandro Valverde (Spa) Movistar Team 0:00:57
8 Giulio Ciccone (Ita) Trek-Segafredo
9 Egan Bernal Gomez (Col) Ineos Grenadiers
10 Mikel Landa Meana (Spa) Bahrain Victorious 0:01:09