A 36-year-old man who fel...

A 36-year-old man who fell off the top of an 8-foot ladder and suffered acute right leg discomfort arrives at the emergency department. He claims to have fallen and hit the ground on his right leg after losing his balance. Upon physical examination, he has a deformed right distal tibia, although the skin and soft tissues are unharmed. His distal pulses are unharmed, and there is only slight swelling around the distal tibia. Radiographs were taken (Figures 1 and 2). He smokes at least one pack of cigarettes daily but maintains good health and takes no prescription drugs.