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Updated: Jun 4, 2026

Techniques of Endoscopic Ossiculoplasty
Published on: January 26, 2024
Case series of 17 modified Weil's osteotomies for Freiberg's and Köhler's II AVN, with AOFAS scoring pre- and
M C Edmondson1, K R Sherry, J Afolayan
1Department of Trauma and Orthopaedics, Eastbourne District General Hospital, Kings Drive, Eastbourne, E Sussex BN21 2UD, United Kingdom. drmedmondson@hotmail.com
Background:
Treatment for metatarsal head avascular necrosis is largely conservative. For severe or refractory cases there are various surgical options.
Methods:
We have performed a 'modified Weil's osteotomy' of the distal metatarsal in order to manage this problem. We present the largest case series, to our knowledge, with 17 such cases. The patients were scored pre- and post-operatively using the AOFAS Forefoot scoring system.
Results:
We found that this procedure provided a mean score improvement of 36 points, with a complication rate of 5.9%.
Conclusion:
We would advocate this modified osteotomy as an effective, reliable and safe treatment option.