Abstract: A telephone line worker was adding a new telephone line on a utility pole. He climbed 4.6 to 6.1 meters up the pole to work on a terminal box located just below a crossbrace on the pole. He was just below the box, but needed to get to the other side of the pole to access the box. He switched his feet and hands on the step bolts and swung half his body around the pole when his hand or foot slipped. He fell to the ground, landing on his left leg. Emergency medical services transported the injured employee to a hospital. The employee sustained a spiral fracture of his left leg below the knee, a compression fracture of three vertebrae, and a hairline fracture below his left pinky finger. Doctors performed multiple surgeries on the employee's left leg and placed him in a back brace so that his fractured vertebrae could heal. He was hospitalized for his injuries. The employee had not used his positioning strap before or during his transition on the pole.