Studying accidents with Volvo cars in Sweden, the reduction of AI2+ upper extremity injury risks is less than the overall MAIS2+ injury risk reduction over the last two decades. A subset of occupant injury cases with detailed information is used to identify and categorise the upper extremity fractures and by that enhance knowledge about probable mechanisms. This in turn, is an important step in the development of means of protection. Upper extremity fractures are found predominantly in frontal impacts and drivers tend to be more exposed. Factors such as age and the numerous possible arm positions influence the occurrence.