Six occupants of a refuse lorry were injured when it overturned near Birmingham city centre.
West Midlands Ambulance Service was called to Six Ways island, Birchfield Road, Aston, shortly before 13:00 GMT.
The driver, a 20-year-old man, was trapped with back injuries and taken to the Queen Elizabeth Hospital.
Another man in his 20s suffered a fractured leg and was taken to City Hospital, as were two other men with minor injuries.
Two further passengers were assessed at the scene for minor injuries.