Gorgon Zee
Hero
If you try to shoot someone with an arrow, and the resolution mechanic for shooting arrows can't even tell us whether you hit, then that's a worthless resolution mechanic.
I think it's a bit extreme to write off all of D&D's combat mechanics as "worthless". D&D has always been cagey on what hit points represent -- presenting them as a mix of luck, physical and magic -- and so it's never been definitive about telling you if an arrow hits you.
D&D lets you choose the narrative. Mechanically, an arrow does 8 hit points (say). It's up to you to say what the narrative effect is on the 100 hit point fighter. For me, I tend to describe hits leaving you with over half your hits as near misses, scratches and bruises. But if it's falling damage, it's clearly not just near misses -- it's bruises and so on.
In contrast Fate is very clear on this; if you only take stress damage, it is never a wound or injury; only when it goes through your stress to cause a consequence is it clearly an actual injury.
I think what you're looking for is a crunchy system (so not Fate) that has explicit rules that clearly state what the physical effects of damage are without the GM needing to make stuff up (so not D&D). Savage Worlds would be my next guess as a system for you, but I think the emphasis on "fun" over "realistic" will turn you off, so I guess, like others, I'm left with Rolemaster as the most likely system to satisfy you.