Many podiatrists use the Austin-Youngswick osteotomy for hallux limitus, despite the lack of statistical evidence indicating it is a procedure that should ever be performed. The idea behind the Austin-Youngswick osteotomy is to correct for elevatus or a long 1st metarsal by performing a decompression osteotomy which will shorten and/or displace the 1st metarsal head

The first issue with the procedure is compare it to Cheilectomies since they are both used for Grade one and early Grade 2 hallux limitus.  If you are using grade 3 stop reading the article and stop operating.  The biggest issue people have with Cheilectomy is that the arthritis will return after a period of time (doesn’t stop orthopods with knee scopes).  The promoters of the Austin-Youngswick osteotomy have outsmarted the competition by never producing long-term studies about the procedure and performing cheilectomies, when they perform Austin-Youngswicks.  (Editors note: a lot of podiatrists do Cheilectomies incorrectly; you take 30%head not just the excessive bone).  So if your cheilectomies last less than a year, it could be a surgeon issue not a procedural issue.

When the studies are examined Roukis JFAS 2001, did the procedure on 50 patients follow up in one year and statistics indicate improvement.  He would have had the same results with a Cheilectomy at that follow up, without the risk of the osteotomy or the more rigorous post-op course. If you are still performing this operation please read Roukis JFAS 2010http://www.sciencedirect.com/science/article/pii/S1067251610003339

Essentially his article states, the Austin Youngswick in the literature indicate it has more complications and poorer results than a Cheilectomy.  So essentially if you are doing this procedure you are ignoring scientific basis and being stubborn.  The time is now for podiatrists to stop doing this procedure and for residencies to stop teaching it.