|Hector Barbossa's peg leg from the Pirates of the Caribbean movies.|
A lost hand or eye is also a perfect chance to throw in some weird magic items. Hell, even Adventure Time does it.
|Adventure Time, Finn lost his arm, gets weird flower growing out of it.|
Once you reach 0 or less HP you roll against Constitution, adding up any negative hit points and current Exhaustion as a negative modifier to the roll. If you succeed you are knocked out (0 - -4HP), bleeding to death in 1d10 minutes (-5 - -Constitution HP). If you fail the roll you need to roll on the table below and add your current negative HP to the roll. If you drop below negative Constitution HP you are dead, no roll necessary. For more info on Exhaustion, see this post.
Death & Dismemberment2d8+Negative HP
2-3 Last Stand: Gain d4 hp per every other level in a rush of adrenaline. The extra hp are drained after combat ends and the character falls unconscious for 2d6 turns.
4 Impressive Facial Scar +1 Charisma
5-6 Ugly scar.
7-8 Bad bruising 1d6 Exhaustion.
9-10 Broken ribs 1d6 Exhaustion and +1 encumbrance until fully recovered.
11-12 Bruised joint (knee, elbow, shoulder) 1d6 Exhaustion and +2 encumbrance until fully recovered.
13-14 Hand or Feet damaged. A finger or toe is cut/ripped off from d4: 1 right hand, 2 left hand, 3 right foot, 4 left foot. 2d6 Exhaustion.
15-16 Broken/crushed bone. 2d6 Exhaustion. Limb useless and +3 encumbrance until fully recovered +2d4 weeks.
17-18 Facial damage. 2d6 Exhaustion and d8: 1-2 Nose (-1 Charisma), 3-6 Ear (+1 in 6 chance of being surprised.) 7-8 Eye (-2 Ranged attacks)
19-20 Severed Limb. 2d6 Exhaustion and d4: 1 right or 2 left hand (-1d4 Strength, unable to use 2 handed weapons unless specifically made. Unable to use skills such as Climbing, First Aid, Tinkering, Sleight of hand. (-1 in the skills with a hook/prosthetic hand specifically made for this, a well made prosthetic can also give back all but one lost point in Strength)), 3 right or 4 left foot (-1d4 Dexterity +4 encumberance points, unable to use stealth or climbing (+3 encumbrance with crutch, +1 encumbrance with peg leg and -1 in the skills, a well made prosthetic can also give back all but one lost point in Dexterity)).
21 Mortally wounded, only magical healing to push you up into positive hp within 1d4 rounds can save you. 3d6 Exhaustion.
Obviously there will be other issues for someone who loses a hand than just the -1d4 in Strength, but there is no point in listing everything the character may have troubles with. When I talked to my players about this one of them seemed to look forward to getting a chance to play a character called "Two-Hooks" in the future. He even had an answer to the question of how Two-Hooks wipes.