Study – Updated Bare Knuckle Boxing Injury Data

Last year data was presented at the Association of Ringside Physicians Annual Conference giving the first glimpse of the safety track record of bare knuckle boxing compared to traditional boxing. The data revealed that bare knuckle boxers were suffeirng fewer concussions and fewer broken hands but also more cuts and abraasioins.

Now, (and adding to this site’s database of combat sports safety studies,) Dr. Muzzi, the primary author behidn the data, published an aritlce with updated informaiton shedding light on the current statistics of bare knuckel boxing injury rates.

The study, titled Epidemiology of professional bare-knuckle fighting injuries, and published in Journal of the Physician and Sports Medicine, reviewed data from all state sanctioned BKB fights from Florida, Missouri, Mississippi, Kansas and Alabama from June 2018-November 2020. In total 141 bouts took place involving 282 individual combatant participants.

Like the previous findings the data supported that fewer concussions were occurring compared to gloved boxing with the author concluding “ Concussions are relatively uncommon compared to other injuries” with the most common injuries’ being lacerations and broken hands.

The full abstract reads as follows:


Professional bare-knuckle fighting (BKF) is a variation of boxing which held its first modern legal event in 2018 in Wyoming. Since then, the sport has expanded with state-sanctioned events held in Florida, Missouri, Mississippi, Kansas, and Alabama. The purpose of this study was to evaluate the epidemiology of injuries in bare-knuckle fighting bouts and to discern any trends which may distinguish it from traditional boxing with padded gloves.


Observational data collection for all state-sanctioned professional bare-knuckle fighting bouts was conducted sequentially over a two-year period from June of 2018 through November of 2020. Information related to fight outcome, injury diagnosis, and injury location was documented. This data was then analyzed and the incidence rates by injury type and location were calculated.


There were 141 bouts conducted during the study period. Out of the 282 individual combatants, 105 (36.6%) sustained at least one injury during the event and 123 total injuries were recorded. In total, 98 (34.8%) lacerations were recorded; on average, 6.2 +- 4.5 sutures were required per laceration. There were 5 superficial hand lacerations and 80 facial lacerations. Seventeen (6.0%) fractures occurred, with 8 hand fractures, 6 nasal fractures, 2 orbital fractures, and 2 dental fractures. There were 8 (2.8%) periorbital hematomas sustained by fighters. Transfer to the hospital was required on 5 (1.8%) separate occasions, twice for orbital fractures and 3 times for traumatic brain injuries. In all, there were 8 (2.8%) concussions with symptoms.


The most frequent injuries in BKF include lacerations and hand fractures. Concussions are relatively uncommon compared to other injuries.


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