Resident Indiana University School of Medicine Indiana University School of Medicine Indianapolis, Indiana
Background: Boxing, kickboxing, and mixed martial arts (MMA) are combative sports that impose high injury rates. The risk of facial injury between these sports in unknown. Learning Objectives: Understand the risk factors for facial injury in fighting sports. Study Objective: Compare facial injury profile and risk factors between professional MMA, boxing, and kickboxing events. Design Type: Retrospective review Methods: The Nevada State Athletic Commission ringside physician injury reports were examined from all professional kickboxing, boxing, and MMA fights from 2002-2020. Comparisons between sports and injured fighters were performed. Results: A total of 5,402 predominantly male (94.6%) professional fighters aged 27.9±4.8 years across 1,080 boxing, 440 kickboxing, and 731 MMA bouts (2701 total) were examined. Contests lasted a median of 3 rounds (range, 1-12) and primarily resulted in judges’ decision (55.1%) or knockout (39.0%). The overall facial injury rate was 12.0%, mostly involving lacerations (9.9%) of the scalp and periorbital region (81.9% of lacerations). Fractures were uncommon (2.8%) and usually involved the nose and/or orbit (64.1% of fractures). The rate of overall facial injury was highest in MMA (15.8%, p<0.001) compared to boxing (10.7%) and kickboxing (10.3%). Injured fighters were more likely to be male (p=0.001), endure longer bouts (p<0.001), and lose (p<0.001) by decision (p<0.001). After adjusting for fighter weight, sex, and rounds fought, MMA incurred the highest rate of facial injury among the three sports. Conclusion: Although all combative sports impose significant injury risk, MMA is associated with the highest likelihood of incurring a facial injury.