Safety in the presence of lightning.

Not enough emphasis is usually placed on the proactive ability to recognize the lightning hazard. Instead, most literature and training materials treat the reactive mode. The latter approach emphasizes the posture to take when a person is caught by surprise in the open by a thunderstorm when the lightning threat is at its greatest; in other words, it is too late for precautions. The same reactive approach concentrates on what a person is wearing or holding when lightning is overhead instead of how the person came to be in this situation in the first place. Rather than focusing on these last-minute factors, the primary issue must be on the ability of a person, whether in a baseball game, riding a bike, or on a golf course, to recognize in advance the existence of a major lightning threat. This proactive approach emphasizes advance planning and recognition of a potential threat from lightning. A complete plan involves a sequence of decisions on a time scale from days to seconds. Although most of the available information in pamphlets and safety guidelines is correct concerning the reactive phase of lightning safety, the hazard remains important because of the lack of emphasis on planning and awareness.

Axial wedge osteotomy of the first metatarsal head (an adjunctive procedure for correction of hallux abducto valgus).

The authors have introduced an adjunctive procedure for correction of the osseous axial eversion of the first ray with hallux abducto valgus deformity. They believe that recurrence of bunion deformity is reduced with correction of this osseous abnormality. Consecutive illustrations are presented with recognition of the individual surgeon's ability to modify the procedure to allow for correction of deformities associated with hallux abducto valgus.