5e Lingering Injuries

In my D&D 5e game, I have replaced massive damage with lingering injuries, but I have never posted the rules. There were a few design considerations when devising this dismemberment table:

1. I wanted something small and simple, rather than a fiddly subsystem with multiple tables for an eventuality that is frankly rather rare.
2. I wanted something painful. Dismemberment happens rarely, but it should matter when it does. Even if there is a save, it should not negate a consequence.
3. I wanted diegetic, not mechanical penalties. While -4 Strength is painful, it is also patently unfun. On the other hand, "You cannot speak." or "You have only one arm." are painful and interesting, because they force the player to actively adapt, rather than do the same old with lower bonuses.

You tell me whether I succeeded or not.

 

Jan Žižka

  

While a character cannot go below 0 hp, when a hit would result in enough surplus damage to take them below negative Constitution score in hit points, they roll on the dismemberment table.

Write the surplus damage down next to the injury taken. To remove an injury, first a medical treatment (and a successful Medicine check) is needed, then this surplus damage must be healed. Whenever a character receives (natural or magical) healing, they can decide to regain hp, or to reduce the surplus damage from one of their injuries.

d10 Dismemberments

1. Panicking, you block the blow with your weapon - successfully, but you only hold a half of your weapon now. Magical weapons get a Dexterity saving throw. On success, you were only disarmed.
2. The blow was so hard that your armour is all twisted, sundered and useless now. At least all your limbs are still attached. Magical armours get a Dexterity saving throw. On success, you were only sent flying backwards.
3. Suddenly, blackness. Until this injury is healed, you are in a coma.
4. Blood everywhere! So much blood! Until this injury is healed, gain +1 Exhaustion level for every strenuous action. Fighting or casting spells is strenuous. Lying in a ditch or shuffling around is not.
5. Something inside you is broken. Lose all Hit Dice and you cannot regain hp naturally until this injury is healed.
6. You spit teeth and blood. You cannot speak or cast spells until this injury is healed.
7. Ouch, my eye! A successful Constitution saving throw means it is too bruised to use, but can be healed. A failure means you are left with an empty socket.
8. Crunch! Lose d2 legs. A successful Constitution saving throw means they are broken, but can be healed. A failure means they are no longer attached to your body, and healing the injury only stops the bleeding.
9. Crunch! Lose a random arm. A successful Constitution saving throw means it is broken, but can be healed. A failure means it is no longer attached to your body, and healing the injury only stops the bleeding.
10. Blood is dripping from your nose, but you have to laugh. Regain 1 hp and immediately get an extra turn.

Difficulty of all mentioned checks is either half surplus damage or 10, whichever is higher.

Class: Ogre Ape

Depending on the setting, this could be an ogre, an ape, or an ogre ape. (Or a half-giant, or a goliath, even a really brawny barbarian. Any big guy/gal, really.) It has a touch of James Young's barbarian, SaltyGoo's ogre and Skerples' brawler.

Ogre Sitting by vshen

 

Quest: Visit the Ape Islands, or defeat and devour a bear by your lonesome.

Language: dialect basically unheard of Around Here

Items: loincloth, greatclub (d10)

Skills: Astrology, Cooking, Fishing, Herb Lore

A: Unconquered, Half-Naked

B: choose one of Commanding Roar or Powerful Presence

C: Unbreakable

D: choose one of Silverback Punch or Withstand

Unconquered

You are an eight foot tall slab of muscle.

Your unarmed attacks deal d4 damage. Double your base maximum HP.

This probably requires a bit of an explanation. In my current ruleset, you have base HP based on Constitution and extra HP from class levels. So if your rules have for example Meat and Grit, double the Meat. If nothing like that is applicable, maybe step up their hit dice, or simply give them +2 HP per level?

Half-Naked

You are immune to the negative effects of weather and hypothermia.

Commanding Roar

Once per encounter, you can give a one-word command to a humanoid that is smaller than you. It can choose to fall prone instead of obeying the order.

Powerful Presence

At the start of each round, you can decide how creatures smaller than you react to you: They either avoid fighting you unless there is no other choice, or they gang up on you, ignoring your teammates.

Unbreakable

Once ever when you would die, instead regain full HP and gain a cool scar.

Silverback Punch

Once per session, you can knock anything unconscious. This can be used even against things like golems or doors, where unconsciousness should be interpreted liberally.

Withstand

Once per session, completely ignore an attack or effect. If it would normally continue further, you also shield everyone behind you.

This negates secondary effects too (If a trap swings a huge stone hammer at you and you withstand it with your face, you also won't be knocked back.), but may not help much against ongoing effects. (When splashed with liquid flame, you can withstand the initial damage, but you will still be on fire.)