J Emerg Med. 2025 Oct 14;80:44-50. doi: 10.1016/j.jemermed.2025.10.003. Online ahead of print.
ABSTRACT
BACKGROUND: The epidemiology of boxing-related upper extremity injuries in the United States (US) has been minimally described, with only one prior study examining data up to 2016.
OBJECTIVE: To update and extend national estimates of these injuries through 2023, highlighting post-2016 trends and the impact of the COVID-19 pandemic.
METHODS: The National Electronic Surveillance System database was queried for upper extremity boxing-related injuries presenting to US emergency departments from January 1, 2014, to December 31, 2023. Injuries were categorized by body part, diagnosis, and disposition. National estimates (NE) were calculated based on each hospital’s assigned statistical sample weight. Linear regression assessed trends over time.
RESULTS: A total of 106,903 boxing-related upper extremity injuries were identified. The hand (48.3%), wrist (18.9%), and shoulder (14.2%) were the most commonly affected areas. Fractures were the most frequent diagnosis (26.4%), followed by strains/sprains (24.1%), other injuries (21.3%), and contusions/abrasions (17.9%). Only 3.3% of cases required hospital admission. Injury counts dropped sharply in 2020 during the COVID-19 pandemic (NE = 7282; p < 0.01 compared to pre-COVID years of 2014-2019), followed by a rebound in subsequent years, peaking in 2023 (NE = 13,258). Linear regression showed a nonsignificant annual decrease of 76 injuries over 10 years (p = 0.70; coefficient = -75.6; 95% CI: -508.7 to 357.5).
CONCLUSION: Boxing-related upper extremities most commonly involve the hand, with fractures representing the most common diagnosis. In conclusion, the rebound in injury rates in 2023, which diverges from the pre-COVID trend of gradual decline, warrants attention.
PMID:41270318 | DOI:10.1016/j.jemermed.2025.10.003
