Case series of 17 modified Weil's osteotomies for Freiberg's and Köhler's II AVN, with AOFAS scoring pre- and post-operatively

BackgroundTreatment for metatarsal head avascular necrosis is largely conservative. For severe or refractory cases there are various surgical options.MethodsWe 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.ResultsWe found that this procedure provided a mean score improvement of 36 points, with a complication rate of 5.9%.ConclusionWe would advocate this modified osteotomy as an effective, reliable and safe treatment option.