England all-rounder Ben Stokes looks set to miss the Ashes series in Australia after undergoing a second operation on a broken index finger, England's cricket board (ECB) said on Thursday.
Stokes, 30, sustained the injury playing in the Indian Premier League in April and after the first operation he returned in July, leading England to a 3-0 one-day international series win over Pakistan despite needing injections to play.
Stokes then decided to take an indefinite break from cricket to focus on his mental health after pulling out of the home Test series against India, which began in August.
"Stokes had two screws and scar tissue removed from the index finger of his left hand," the ECB said in a statement.
"He will now undergo an intensive period of rehabilitation for the next four weeks under the supervision of the ECB's medical team."
Stokes has been omitted from England's squad for the Twenty20 World Cup in the UAE and Oman, and now looks likely to miss his second Ashes series. He was ruled out of the 2017-18 tour after an incident at a Bristol nightclub.
The first match of the five-Test series against Australia is due to start on December 8, although there have been concerns over whether the series will go ahead at all.
The ECB and Cricket Australia (CA) have been engaged in talks this week after England players had raised concerns about the conditions for the tour, including quarantine conditions and whether families would be allowed to travel.
Earlier this week, the ECB admitted the series could be called off if the conditions were not deemed "sufficient" or if too many England players opted against travelling to Australia.
However, the latest round of talks on Thursday were reported to be positive, while England captain Joe Root has confirmed his participation in the series and will likely be joined by a full-strength squad.
Another meeting between the ECB and CA will take place on Friday, when a final decision is expected to be made.