here are some gameinformer cover(june issue iirc) story bullet points from
wikipedia:
-The game will use both first-person and third-person perspective.
-Main character creation is implemented by specifying the character's childhood.
-The character's mother dies in labor in a Vault hospital, after which the player chooses the character's Traits and general appearance during the father's DNA analysis. Afterwards, the father removes his surgeon's mask to reveal a face much like the one chosen by the player for the character.
-As a child in the Vault, the character receives a book titled "You're Special", whereupon you'll set the character's 7 primary aptitudes. The character receives training weapons and a PIP-boy during childhood, and the player's performance in various tests determines the rest of the attributes.
-Additionally, there will be quests inside the Vault that influence the pc's relationship with his or her father.
-Skills and Perks are similar to those in previous games: the player chooses 3 Tag
-Skills out of 14 to be the character's specialties, and the character will gain a Perk every other level. Max level will be 20.
-There will be a definite end to the game, with many possible endings based on good/evil/neutral events you trigger.
-The Vault-tec Assisted Targeting System, or V.A.T.S. will be implemented. Various actions cost action points, and both the player and enemies can target specific body areas for attacks, inflicting specific injuries. While using V.A.T.S., real-time combat is paused creating a combat system that the Bethesda developers have described as a hybrid between turn-based and real-time combat.
-The game will maintain the same level of gore. All gory deaths in the game will be shown in slow motion. One of the featured screenshots is of a super-mutant's head exploding in great detail.
-The game will feature a new health and radiation system. The player can measure an object's radioactivity and gauge the effect it will have on the character.
Karma titles, similar to those from previous games, will grant Xbox Live Achievements on that platform.
-The number '101' can be seen on the back of several characters' Vault suits. This signifies the characters home of origin, Vault 101 in Washington, D.C.
Characters will be able to create small blasts by targeting nuclear generators and using nuclear catapults.