A 28-year-old male bicyclist is brought to the emergency department 20 minutes after being hit by a car. First responders found him to be unconscious, with a Glasgow coma score (GCS) of 6; he was intubated. He had an open injury of the right leg; a posterior splint was placed. Focused assessment with sonography for trauma (FAST) is negative for fluid in all four windows. Computed tomography (CT) of the brain and cervical spine is normal. Chest and pelvic x-rays show no bony injuries. X-rays of the right lower extremity reveal a tibia-fibula fracture.