Eye Trauma in Mixed Martial Arts and Boxing.

PURPOSE: To evaluate and compare eye and face trauma in mixed martial arts (MMA) and boxing. DESIGN: Retrospective cohort study. METHODS: Data from boxing and MMA competitions were extracted from the Nevada Athletic Commission (NAC) between 2000 and 2020. Details of competitions, contestants, outcomes, and injuries were extracted. RESULTS: In total 1539 boxing injuries (from 4313 contests) and 1442 MMA injuries (from 2704 contests) were identified. Boxing had higher eye injury rates compared to MMA ( p < 0.0001), with an odds ratio of 1.268 (95% CI, 1.114-1.444). Eye trauma represented 47.63% of boxing injuries and 25.59% of MMA injuries, with periocular lacerations being the most common eye injury in both. Orbital fractures represented 17.62% of eye injuries in MMA and 3.14% in boxing contests. However, 2%-3% were retinal in both sports, and 3.27% were glaucomatous in boxing. MMA contestants had an odds ratio of 1.823 (95% CI, 1.408-2.359) for requiring physician evaluation following an eye injury compared with boxing. MMA contestants also had a higher rate of face ( p < 0.0001) and body ( p < 0.0001) injuries. For both sports, an increased number of rounds and being the losing fighter were associated with increased odds of eye and face injury. CONCLUSION: Although boxing has a higher rate of eye injuries, MMA eye injuries are more likely to require physician evaluation. MMA contestants also have a higher rate of orbital fractures and face and body trauma. A detailed postfight examination and long-term follow-up of ocular injury in combat sports will be vital in proposing reforms to prevent eye trauma.

Characteristics of Facial Trauma in Professional Mixed Martial Arts.

Background: Injuries are common in mixed martial arts (MMA) competitions. However, the risk factors for facial injury have not been delineated. Objective: Identify the facial injuries and associated risk factors of professional MMA fights. Methods: The Nevada State Athletic Commission medical injury reports from all professional Ultimate Fighting Championship bouts from 2010 to 2020 was reviewed. Fighter characteristics, details of the competition, and injuries sustained were collected. Binary logistic regressions determined significant predictors of facial injury. Results: A total of 1462 fighters were included. Most participants were male (91.0%) with mean age of 29.5 ± 4.1 years. Most fights took place between 135 and 185 lbs., lasted ≥3 rounds (59.4%), and resulted in judges' decision (50.5%) or knockout (31.2%). The facial injury rate was 15.8%, which were predominantly lacerations (12.0%) and fractures (3.6%). Multivariate regression revealed being male (p = 0.026), heavier weight (p = 0.028), more rounds fought (p = 0.019), losing (p < 0.001), and nonsubmission outcome (p = 0.017) predicted facial injury. Conclusion: Facial injuries are common in MMA fighting. The risks should be iterated to participants in this sport.

National level data analysis of facial lacerations in Korea using the National Health Insurance Service (NHIS) database.

ABSTRACT: No national epidemiological investigations have been conducted recently regarding facial lacerations. The study was performed using the data of 3,634,229 people during the 5-year period from 2014 to 2018 archived by the National Health Information Database (NHID) of the Health Insurance Review and Assessment Service. Preschool and children under 10 years old accounted for about one-third of patients. Facial lacerations were concentrated in the "T-shaped" area, which comprised forehead, nose, lips, and the perioral area. The male to female ratio for all study subjects was 2.16:1. Age and gender are significantly related with each other (P < .001). Mean hospital stays decreased, and numbers of outpatient department visits per patient were highest for hospitals and lowest for health agencies. Over the study period, hospital costs per patient in tertiary and general hospitals increased gradually. Preschool and school-aged children are vulnerable to trauma. Male patients outnumbered female patients by a factor of more than 2. The "T-shaped'" area around forehead is vulnerable to injury. Total cost of medical care benefits per patient in tertiary hospitals was about 7 times on average than in health agencies. Regarding functional, behavioral, and aesthetic outcomes, more attention should be paid to epidemiologic data and hospital costs for facial lacerations.

Prevalence of dentofacial injuries among combat sports practitioners: A systematic review and meta-analysis.

BACKGROUND/AIM: Combat sports might result in injuries to the face and teeth. However, it is unclear how often they occur and which sports presents the highest rates. The aim of this study was to investigate the prevalence of dentofacial injuries in combat sports participants. MATERIAL AND METHODS: A systematic review was performed. Six main electronic databases and three grey literature databases were searched. Studies were blindly selected by two reviewers based on pre-defined eligibility criteria. Studies that evaluated the prevalence of dentofacial injuries (teeth, alveolar bone, jaw, lips, and/or cheekbones) among combat sports participants were considered eligible. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. The software r statistics version was used to perform all meta-analyses. Cumulative evidence of the included articles was evaluated using GRADE criteria (Grading of Recommendations Assessment, Development and Evaluation). RESULTS: From 1104 articles found on all databases, 27 were finally included. Eighteen studies were judged at low, seven at moderate, and two at high risk of bias. The following sports were investigated: boxing, capoeira, fencing, jiu-jitsu, judo, karate, kendo, kickboxing, kung fu, muay thai, sumo, taekwondo, wrestling, and wushu. Results from the meta-analysis suggested a dental pooled prevalence of 25.2% (12.3%-40.8%, i2  = 100%) and dentofacial pooled prevalence of 30.3 (18.1%-44.1%, i2  = 100%). Considering the sports' categories individually, jiu-jitsu had the highest pooled prevalence of dentofacial injuries (52.9% [37.9%-67.8%, i2  = 92%]), while judo was the sport with the lowest pooled prevalence (25.0% [7.6%-48.2%, i2  = 98%]). Among Panamerican sports, boxing had the highest prevalence of dental injuries (73.7% [58.7%-86.3%, i2  = 0%]). For dentofacial injuries, the GRADE criteria were considered low. CONCLUSIONS: Overall pooled prevalence of dentofacial injuries in combat sports was approximately 30%. Raising awareness regarding the frequency of these injuries might encourage the use of protective devices and reduce complications related to these incidents.

Adding Injury to Insult: A National Analysis of Combat Sport-Related Facial Injury.

OBJECTIVES/HYPOTHESIS: To estimate the incidence of patients presenting to emergency departments (EDs) for facial trauma sustained from participation in combat sports and evaluate injury patterns and patient demographics. METHODS: The National Electronic Injury Surveillance System (NEISS) was evaluated for facial injuries from wrestling, boxing, and martial arts leading to ED visits from 2008 to 2013. Relevant entries were examined for injury mechanism, location, type, as well as other patient characteristics. RESULTS: There were 1143 entries extrapolating to an estimated 42 395 ED visits from 2008 to 2013. Injury rates for boxing, marital arts, and wrestling were, respectively, 44, 56, and 120 injuries per 100 000 participants. Males comprised the majority (93.7%). A plurality of injuries involved lacerations (46.0%), followed by fractures (26.2%) and contusions/abrasions (19.3%). The proportion of fractures was highest among boxers (36.9%). Overall, the most common mechanisms of injury were punching, kicking, and head butting. CONCLUSIONS: The significant number of ED visits resulted from combat sports facial trauma, reinforcing the importance of familiarity with injury patterns among practitioners managing facial trauma. As most injuries involve individuals younger than 19 despite guidelines suggesting children and adolescents avoid combat sports, these findings may be used for patient education and encouragement of the use of personal protective equipment. Furthermore, injury patterns reported in this analysis may serve as an adjunct for enhancing clinical history taking and physical examination.

Low Risk of Injuries in Young Adolescents Participating in Top-Level Karate Competition.

BACKGROUND: Prospective studies on injuries in martial arts competition are scarce, especially those involving young practitioners, but the upsurge of children and adolescents taking part in organized training and competition in these sports requires clarification of the injury risk that they represent for youths. HYPOTHESIS: Top-level karate competition for young adolescents (cadets, or 14- to 15-year-olds) has a low injury rate and can be safely promoted. STUDY DESIGN: Descriptive epidemiological study. METHODS: Prospective recording of the injuries resulting from all bouts in 3 consecutive World Karate Championships (2009, 2011, and 2013) for cadets was performed. Data were collected prospectively in situ with checklists that described competitor sex, bout category, and weight as well as injured area, diagnosis, mechanism of injury, severity, and treatment. RESULTS: A total of 1020 bouts were reviewed, 671 in the male category and 349 in the female category. A total of 61 injuries were recorded. Of those, only 3 were time-loss injuries. During the 2009 and 2011 championships, there was 1 injury per 25.6 fights, while during the 2013 championship the number of injuries increased, with 1 injury per 10 fights (P = .003). There was no statistical difference in the total injury rate between the male and female categories (P = .71), with an odds ratio of 1.16 (95% CI, 0.52-2.55). CONCLUSION: The injury rate for cadet top-level karate competition found in this prospective study is much lower than the rates previously published for karate or other martial arts competitions, but there seems to be a marked increase as more championships are held, which is a matter of concern.

Prevalence and prevention of dental injuries in young taekwondo athletes in Croatia.

AIM: The aim of this study was to evaluate the occurrence of dental and facial injuries, the habit of wearing mouthguard and the awareness regarding injury prevention and first aid after tooth avulsion among young taekwondo athletes in Croatia. MATERIALS AND METHODS: A survey on a sample of 484 taekwondo athletes was conducted, which included 271 male (56%) and 213 female (44%) athletes aged between 8 and 28 years. The questionnaire submitted to the athletes contained 15 questions about dental trauma, use of mouthguard, dental trauma prevention, level of awareness about tooth avulsion and replantation and disturbances associated with mouthguard use. Collected data were evaluated according to gender, age groups and duration of actively engagement in taekwondo. Descriptive statistics and Chi-square tests were used for comparisons between groups. RESULTS: From the survey 300 (62%) of 484 athletes had sustained one serious injury and 103 (21%) had sustained an orofacial injury, while 194 (40%) had observed another player sustaining a dental injury. Higher number of orofacial injuries was observed in males (24%) than in females (18%). Furthermore, 98 (20%) athletes have experienced one or more dental injuries, and out of these 98 suffering dental injury 60 were male (61%) and 38 were female (39%). The frequency of orofacial injuries in the older group (42%) is higher than in three younger groups (younger cadets 25%; cadets 13%; juniors 20%) (p<0.05). Mouthguard wearing was recorded in 465 athletes (96%), 47.1% of them wear stock mouthguard, 47.6% wear boil and bite mouthguard, but only 5.3% were custom-made mouthguards. Most of them (96%) consider that mouthguards are useful for injury prevention in taekwondo. CONCLUSION: The results of this survey show that dental and orofacial injuries occur in taekwondo in all age groups but mostly in the senior group. Taekwondo players know the importance of mouthguard use, but only 5% use custom made mouthguards. This is not adequate for dental injury prevention and highlights the important role of dental professional in education of athletes for advocating the use of custom made mouthguards.

Outcome analysis of sports-related multiple facial fractures.

In this paper, we report a retrospective study of 236 patients with facial bone fractures from various sports who were treated at the Department of Plastic and Reconstructive Surgery, Inha University Hospital, Incheon, South Korea, between February 1996 and April 2007. The medical records of these patients were reviewed and analyzed to determine the clinical characteristics and treatment of the sports-related facial bone fractures. The highest frequency of sports-related facial bone fractures was in the age group 11 to 20 years (40.3%); there was a significant male predominance in all age groups (13.75:1). The most common causes of the injury were soccer (38.1%), baseball (16.1%), basketball (12.7%), martial arts (6.4%), and skiing or snowboarding (11%). Fractures of the nasal bone were the most common in all sports; mandible fractures were common in soccer and martial arts, orbital bone fractures were common in baseball, basketball, and ice sports, and fractures of the zygoma were frequently seen in soccer and martial arts. The main causes of the sports injuries were direct body contact (50.8%), and the most commonly associated soft tissue injuries were found in the head and neck regions (92.3%). Nasal bone fractures were the most common (54.2%), and tripod fractures were the most common type of complex injuries (4.2%). The complication rate was 3.0%. Long-term epidemiological data regarding the natural history of sports-related facial bone fractures are important for the evaluation of existing preventative measures and for the development of new methods of injury prevention and treatment.

Martial arts injuries.

OBJECTIVE: To review the current evidence for the epidemiology of pediatric injuries in martial arts. DATA SOURCES: The relevant literature was searched using SPORT DISCUS (keywords: martial arts injuries, judo injuries, karate injuries, and taekwondo injuries and ProQuest (keywords: martial arts, taekwondo, karate, and judo), as well as hand searches of the reference lists. MAIN RESULTS: In general, the absolute number of injuries in girls is lower than in boys. However, when expressed relative to exposure, the injury rates of girls are higher. Injuries by body region reflect the specific techniques and rules of the martial art. The upper extremities tend to get injured more often in judo, the head and face in karate and the lower extremities in taekwondo. Activities engaged in at the time of injury included performing a kick or being thrown in judo, while punching in karate, and performing a roundhouse kick in taekwondo. Injury type tends to be martial art specific with sprains reported in judo and taekwondo and epistaxis in karate. Injury risk factors in martial arts include age, body weight and exposure. CONCLUSIONS: Preventive measures should focus on education of coaches, referees, athletes, and tournament directors. Although descriptive research should continue, analytical studies are urgently needed.

[Competitive karate and the risk of HIV infection--review, risk analysis and risk minimizing strategies]. / Wettkampfkarate und die Gefahr einer HIV-Infektion--Ubersicht, Risikoanalyse und Strategien zur Risikominimierung.

Bleeding facial injuries are not uncommon in competitive karate. Nevertheless, the risk of an infection with HIV is extremely low. Guidelines about the prevention of HIV infections are presented. Especially in contact sports and martial arts the athletes, judges and staff have to recognize and employ these recommendations. Bleeding wounds of the hands due to contact with the opponents teeth can be minimized by fist padding.

A 16 year study of injuries to professional kickboxers in the state of Victoria, Australia.

OBJECTIVES: To determine the rate and type of injuries occurring to registered professional kickboxers in Victoria, Australia over a 16 year period. METHODS: Data describing all fight outcomes and injuries sustained during competition for the period August 1985 to August 2001 were obtained from the Victorian Professional Boxing and Combat Sports Board. RESULTS: A total of 382 injuries were recorded from 3481 fight participations, at an injury rate of 109.7 injuries per 1000 fight participations. The most common body region injured was the head/neck/face (52.5%), followed by the lower extremities (39.8%). Specifically, injuries to the lower leg (23.3%), the face (19.4%), and intracranial injury (17.2%) were the most common. Over 64% of the injuries were superficial bruising or lacerations. CONCLUSION: The nature of kickboxing, whereby kicking the opponent is the prime movement and the head a prime target, is reflected in the distributions of body regions most commonly injured by participants. Further research into injury patterns in different styles of kickboxing and the mechanism of injury occurrence is required. Exposure adjusted prospective studies are needed to monitor injury rates over time.

Emollients in the prevention of frostbite.

47% of Finnish conscripts had had at least one frostbite of the head (42% on the ears, 23% on the face) at the age of 19. Non-medicated ointments are traditionally used in Finland for protection against facial frostbite without scientific evidence of their benefit. In studies on cold protecting emollients it was found that 21% of the male conscripts in Finland had used them in the cold. 84% of the users had experienced their effect as somewhat or clearly protective. However, in a controlled prospective epidemiological study of 913 cold injuries of the head, the use of cold protective ointments was associated with an increased risk of frostbite to the head (odds ratio 4.5 for ear frostbite, 5.6 for nasal frostbite and 3.3 for frostbite on other parts of the face). The thermal insulation provided by different emollients in the cold was minimal in in vitro experiments using a skin model. In in vivo studies with test subjects the skin on the applied half of the face cooled at least as quickly as the untreated half. However, when white petrolatum was applied, the subjective skin perception of a test persons was warming in the majority of the tests, in contrast to objective measurements. "Protecting" emollients seem to cause a false sensation of safety leading to an increased risk of frostbite probably mainly through neglect of efficient protective measures.

Injury rates in Shotokan karate.

OBJECTIVE: To document the injury rate in three British Shotokan karate championships in consecutive years. In these tournaments strict rules governed contact, with only "light" or "touch" contact allowed. Protective padding for the head, hands, or feet was prohibited. METHODS: Prospective recording of injuries resulting from 1770 bouts in three national competitions of 1996, 1997, and 1998. Details of ages and years of karate experience were also obtained. RESULTS: 160 injuries were sustained in 1770 bouts. The overall rate of injury was 0.09 per bout and 0.13 per competitor. 91 (57%) injuries were to the head. The average age of those injured was 22 years, with an average of nine years of experience in karate. CONCLUSIONS: The absence of protective padding does not result in higher injury rates than in most other series of Shotokan karate injuries. Strict refereeing is essential, however, to maintain control and minimise contact.