9% of Bare Knuckle Boxing Bouts Result in Facial Fractures

Adding to this site’s data base of combat sports safety studies, a recent study was published in the Journal of Oral and Maxillofacial Surgery reviewing facial injury rates from hundreds of regulated bare knuckle boxing bouts.

In the study, titled, Maxillofacial Trauma Patterns in Bare-Knuckle Fighting, the authors reviewed the results of professional bare-knuckle matches that occurred in the BKFC promotion between June 2018 and March 2022. There were 301 bouts in this period. In these 211 maxillofacial injuries were identified most of which were lacerations. Included in the injuries were 27 facial fractures. A facial fracture rate of close to one fracture in every 10 bouts.

For more on bare knuckle boxing injury rates and types here is information from a study published last year.

The full abstract reads as follows. The full study can be found here.


The purpose of this study is to analyze patterns and trends of maxillofacial injuries in Bare-Knuckle Fighting. Results comparisons with other combat sports are provided in the discussion.

Materials and Methods

The study design is a retrospective cohort study. Data was collected by a single ringside physician who participated in all bouts. Predictor variables were number of rounds and final fight result (i.e., Knockout, Technical Knockout, Decision). Primary outcome variable was frequency of maxillofacial injury, and secondary outcome variables were type of injury (laceration/fracture) and traumatic brain injury (TBI). Chi-square test was used to determine if there was any statistical significance between the predictor variables.


Study sample consisted in fighters who suffered maxillofacial injuries during the matches from June 2018 and March 2022 (n=177). A total of 177 fighters sustained maxillofacial trauma in 301 matches and a total of 211 maxillofacial injuries were identified. Of the 211 injuries, 184 were lacerations and 27 were fractures. Proportionally more injuries occurred in matches that lasted 5 rounds (33%), a significant association was found between number of rounds fought and frequency of injury (P < 0.00001). From a total of 107 TKO, 74% of them caused at least 1 injury, from 96 KO 60% caused at least 1 injury, and from 89 fights that ended in decision 83% of them caused at least 1 injury. A statistically significant association was found between final fight result and frequency of injury. (P < 0.00001) (P value less than 0.05 (95% CI (Confidence Interval)) was considered statistically significant.


Maxillofacial injuries were predominantly associated to longer fights and fights which result were KO/TKO. Traumatic brain injury was associated to KO results, which mostly occurred in first and second rounds.

2 thoughts on “9% of Bare Knuckle Boxing Bouts Result in Facial Fractures

  1. The fracture rate is 1-6 % in the study. The facial fracture rate in this study included Nasal bone fractures. which accounted for 44% of the facial bone fracture. The nasal bone is the most common facial fracture in combative sports. The facial fracure rate in BKF is lower than MMA and no different from boxing

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