Objective To determine the incidence of injuries and associated risk factors, as well as the severity of injuries sustained by professional male MMA athletes competing at the Extreme Fighting Championships Africa (EFC Africa) from 2010 to June.

Design Results from this descriptive study were compared to a similar study done in the United States of America (USA).

Setting Medical records of all professional events (2010–2014) were obtained from EFC Africa (custodian).

Participants Data was obtained from 173 male competitors aged 18 to 44 years, participating in 300 professional MMA fights.

Outcome measures Statistical analyses include descriptive statistics and a stepwise logistic regression. The odds of an injury were predicted with six independent variables: fight outcome, age, weight division, number of fights, injuries in preceding fight and years of fighter experience.

Main results Injuries to the head, face and neck were most common (45.9%), followed by traumatic brain injuries (knock-outs) (16.6%) and hypoxic brain injuries (chokes) (10.2%). Losing a fight was a significant predictor of injury when a stepwise logistic regression model was employed (p=0.040). The odds ratio indicated that preceding fight injury almost doubled the risk of sustaining an injury in following fight (1.91; p=0.163). TBI in the SA group (16.6%) was substantially higher than the USA group (1.8%).

Conclusion The high rate of TBI’s in SA competition is concerning. This could reflect superior refereeing in the USA group, as fights may be ended sooner by referee stoppage, versus allowing fights to continue until one fighter is knocked-out.

Competing interests None.