The lower limb is frequently injured during motor vehicle accidents. Some injuries, such as severe pelvic fractures, posterior dislocations of the hip, fractured femurs, and tibial plateau fractures, have their most common cause as motor vehicle related trauma. Musculoskeletal injuries usually take months to heal. Even optimal treatment leaves a significant percentage of those injured with permanent impairments. For some injuries the impairment may develop and/or worsen as the “recovered” victim ages. The long term consequences of major injuries of the musculoskeletal system are discussed in this paper.