A 28-year-old male bicyclist is brought to the emergency department about 30 minutes after he was hit by a car.
In the field, he was found to be unconscious with a Glasgow coma score (GCS) of 6, and subsequently intubated. He also had an open injury of the right leg. The affected limb was immobilized with a posterior splint.
Focused assessment with sonography for trauma (FAST) is negative for fluid in all four windows, while chest and pelvic x-rays are negative for acute bony injuries. However, x-rays of the right lower extremity reveal a tibia-fibula fracture.