• Gurbinder Singh, Sergei O Alexeev, Cameron Nosrat, Mohammad Arammash, and Ryan Halvorson.
• School of Medicine, University of California - San Francisco, 533 Parnassus Ave, San Francisco, CA 94143. Electronic address: Gurbinder.Singh@ucsf.edu.
• Injury. 2025 Jan 13; 56 (2): 112154112154.

BackgroundBoxing is a sport well-known for the risk of injury. However, the epidemiology of boxing-associated fractures has not been well studied. This study aims to report the characteristics of boxing fractures that lead to presentation to the emergency room and evaluate the demographics and practices of the patients to prevent these injuries.MethodsThis cross-sectional study analyzed boxing-associated fractures over a decade (2013-2022) using the National Electronic Injury Surveillance System (NEISS) database. Patients presenting to U.S. emergency departments with boxing-related injuries were categorized by age, gender, and injury location. Descriptive statistics, chi-square tests, and ANOVA were employed to assess temporal trends and associations between injury occurrence and demographic variables.ResultsAnalysis of 959 boxing-associated fractures (BAFs) showed that hand fractures were most common (53.64%), followed by phalanx (12.73%) and facial fractures (10.91%). Significant differences were observed across body parts (χ2 = 9.74, P < .001). Associated soft tissue injuries included lacerations, contusions, sprains, strains, and hematomas, with no significant differences among these categories (χ2 = 1.47, P = 0.832). Males experienced more BAFs than females overall, but females had a significant increase over time (F(1,9) = 4.308, p = 0.032). Most fractures occurred in recreational or sports settings (34.5%), followed by home (19.1%) and school (13.24%). The highest BAF incidence was in individuals aged 21-30 (32.18%), while the lowest was in those aged 41-50 (5.47%). From 2020 to 2022, BAFs decreased in recreational settings and increased at home during 2020-2022.ConclusionHand fractures were the most common type of BAF. Males had significantly more BAFs, although the incidence of BAFs in females increased significantly since 2013. Fractures mainly occurred in recreational places, but from 2020-2022, most occurred at home. This shift coincided with the COVID-19 pandemic, suggesting increased home sparring. These findings emphasize the need for further research into protective measures and injury prevention in boxing.Copyright © 2025. Published by Elsevier Ltd.

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