The options may include a distal, shaft or proximal metatarsal osteotomy, an Akin osteotomy, rotational correction or combined procedures. The choice depends on the current intermetatarsal angle, hallux position, articular alignment, sesamoids, rotation, length and joint condition.
Repeating the same procedure without explaining why the first correction was lost is rarely a sound strategy. A revision osteotomy is most useful when the joint is worth preserving, the bone can accept reliable fixation and the deformity can be corrected without creating excessive shortening or instability.
Confirm that pain is caused by correctable deformity.
Map old screw tracks and previous osteotomy planes.
Plan correction in transverse, sagittal and rotational planes.
Preserve or restore first-metatarsal length and load where possible.
Add soft-tissue or lesser-ray procedures only when clearly indicated.
Can an Austin osteotomy be repeated?
Sometimes, but not routinely. Suitability depends on the previous operation, residual deformity, available bone, joint condition and the amount and direction of correction required.