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The United Kingdom Cooperative Crash Injury Study (CCIS) database has been used to produce a sample of restrained, front-seat car occupants who survived a frontal impact. The lower limb was found to be the most frequently injured body region in car crashes of all impact types and the second most injured region in frontal impacts. 67% of all lower limb fractures in this sample were found to occur below the knee. 31% of these fractures occurred at the ankle. A review of literature reveals that injury of the lower limb above the knee produces worse disabilities and longer recovery times than injury to below the knee. The costs incurred as a result of above knee injuries are estimated as being greater than those below the knee. A review of European type approval legislation reveals that car design is not regulated sufficiently to prevent lower limb injury. Further work is suggested using the CCIS database in order to get a better understanding of the mechanisms involved with a view to suggesting areas where changes could be made to improve this situation.