A 34-year-old male was involved in a motor vehicle crash. On admission to the trauma center, he was alert, his Glasgow Coma Score was 15, his blood pressure was 130/85 mm Hg, and his heart rate was 104 beats per minute. The patient had a closed midshaft fracture of the left femur, an open comminuted fracture of the right tibia and fibula, and an open comminuted fracture of the right elbow. His admission hemoglobin level was 11.7 g/dL and his platelet count was 230 000/mm3. The initial chest radiograph and computer tomographic (CT) scan of the chest were all normal. The CT scan of the head was reported as a normal CT scan with no evidence of intracranial pathology, brain edema, or increased intracranial pressure. The patient was resuscitated and monitored for 8 hours and subsequently taken to the operating room where he underwent internal fixation of the femur and external fixation of the tibia and the elbow.