Epidemiology of combat sport-related fractures treated in United States emergency departments

Objectives: To determine the incidence and demographic characteristics of combat sport-related fractures treated in U.S. emergency departments and compare demographic variables, injury characteristics, and disposition among boxing-, wrestling-, and martial arts (MA)-related fractures. Methods: The National Electronic Injury Surveillance System (NEISS) was queried for boxing, wrestling, and MA-related fractures from 2014 to 2023. Analyses included descriptive statistics and comparative tests (chi-square, Fisher's, Mann-Whitney U, Kruskal-Wallis). Results: Of 22,233 combat sport-related injuries, 4391 (19.7%) were fractures: 929 boxing (21.2%), 1938 wrestling (44.1%), and 1524 MA (34.7%). NEISS weighted estimates correspond to 80,182 injuries and 14,555 fractures annually. Fractures comprised the greatest proportion of total injuries in boxing (21.6%) (p = 0.002), and the mean age at the time of fracture was highest in the boxing group (25.18 ± 11.49 years) (p < 0.001). Boxing fractures most often involved the hand (50.4%), wrestling the shoulder (15.7%), and MA the toes (15.9%) (p < 0.001). Pediatric patients (