Additional health complications? Broken arms would be a good one and better than teeth. Taken a bad fall and bust an arm? There goes your ability to use anything that requires two hands. Perhaps you could select whether your character is right or left handed and busting your shooting arm means that you have to use your other to fire pistols, making them wildly inaccurate at anything but close range. Breaking an arm could also make other tasks more complicated and time consuming. Opening a tin of food could take longer and you'd spill more. As a related aside, I quite like the fall mechanism in Miasmata. If you run down a slope too fast, you fall over and the screen goes blurry whilst you roll around the place. Something similar could be tied in with injuries. For example, whilst running away from something, you could slip/trip down a banking, fall over and break an arm. Head injuries could also be more severe than normal injuries (assuming they're not already) A blunt force trauma to the head could result in serious bleeding and death quite quickly if it isn't treated. Tie this in with the falling mechanism mentioned above and you'd have the possibility of braining yourself during a fall. Bike helmets would prevent this and give them a use other than looking like a bambi. :D EDIT: In addition to the above, perhaps breaking a limb would result in your character screaming in pain. Others in the area would then hear this. What happens after that would depend on who hears you scream...