Sir Alex Ferguson must find a replacement for Brazilian full-back Rafael, who will miss out through suspension.
The youngster received his marching orders for two bookable offences at White Hart Lane but must also face an FA misconduct charge and could yet be forced to sit out next Tuesday's trip to Blackpool.
Brother Fabio, plus more experienced duo Wes Brown and John O'Shea, are all in contention to fill the vacancy, with Ferguson also expected to make a couple of extra changes as his side look to retain top spot.
Birmingham have striker Cameron Jerome and winger Sebastian Larsson are available after injury for the game.
The duo missed the 1-1 home draw with Aston Villa last weekend with hamstring and hip problems respectively, but are set to return.
Liam Ridgewell is again set to deputise at the heart of the defence for Scott Dann with David Murphy given another opportunity at left-back.
Dann will be out for the remainder of the season after undergoing surgery on his damaged hamstring.
Ben Foster will return to Old Trafford for the first time since his £6million summer move from United.
United (from): Van der Sar, Kuszczak, Lindegaard, O'Shea, Brown, Neville, Ferdinand, Vidic, Smalling, Evans, Evra, Fabio, Nani, Obertan, Carrick, Fletcher, Scholes, Gibson, Anderson, Giggs, Bebe, Rooney, Berbatov, Hernandez, Owen.
Birmingham (from): Foster, Carr, Johnson, Ridgewell, Murphy, Bentley, Fahey, Ferguson, Gardner, Hleb, Derbyshire, Jerome, Larsson, Taylor, Bowyer, Phillips, Zigic, Beausejour, Mutch, Jiranek.