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Craniofacial Injuries in Combat Sports: Patterns Across Boxing, Wrestling, and Martial Arts
Shray Mehra1, Rohan Mangal, Nicholas A Mirsky
1Division of Plastic Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL.
The Journal of Craniofacial Surgery
|August 8, 2025
Summary
Wrestling, martial arts, and boxing cause many head and face injuries, especially in young males. Wrestling leads in overall injuries, while boxing has more facial fractures and martial arts more eye injuries.
Area of Science:
- Sports Medicine
- Public Health
- Trauma Surgery
Background:
- Combat sports like boxing, wrestling, and martial arts are increasingly popular in the US.
- This popularity raises concerns regarding the incidence and patterns of craniofacial injuries.
- Limited large-scale epidemiologic data exists comparing these injury patterns across different combat sports.
Purpose of the Study:
- To analyze and compare craniofacial injury patterns across boxing, wrestling, and martial arts.
- To identify demographic and injury characteristics associated with these sports.
- To inform targeted injury prevention strategies.
Main Methods:
- Utilized National Electronic Injury Surveillance System (NEISS) data from 2014-2023.
- Filtered craniofacial injuries using NEISS product codes for head, face, neck, ear, eye, and mouth.
- Calculated national estimates and stratified injury characteristics by sport, age, sex, injury location, and diagnosis.
Main Results:
- An estimated 186,471 craniofacial injuries occurred over the decade.
- Wrestling accounted for the highest proportion of injuries (50.7%), followed by martial arts (29.4%) and boxing (20%).
- Adolescents (10-19 years) and males were disproportionately affected; common diagnoses included lacerations, concussions, and fractures. Boxing showed the highest facial fracture rate, while martial arts had the most ocular injuries.
Conclusions:
- Combat sports present a significant risk for craniofacial trauma, particularly in young athletes.
- Wrestling is a major contributor to head and neck injuries, contrary to assumptions favoring striking sports.
- Findings underscore the need for sport-specific prevention, protective equipment, and continued surveillance to improve safety.
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