He was nailed smack in the center of his face. The impact probably forced his nose into his brain. Think of the forces required to crumple a car that way! I drive a compact car, so I will be smooshed beyond recognition when my turns comes.
I wouldn't have thought ANYONE could survive colliding with an 18-wheel cement tanker! You are very lucky to be among the living.
As for this UN-lucky lad, yes, I guess his arm is off-kilter, and, now that I'm taking a closer look, there's something weird about the back of his neck too.