The sequence of events which occurs in adult pedestrian-automobile collisions is well known. The height and design of the bumper and hood relate to the variety of these injuries. Leg, knee, thigh and pelvis injuries are seen by the orthopaedic surgeon. Frequently they are multiple and severe, resulting in significant damage to the bones and their surrounding soft tissues. Either the initial injury, or early complications of the injury, may lead to significant problems. Accurate diagnosis and skillful treatment of the injuries may lead to improved long-term results.