Objectives The study aimed to determine the risk of time-loss injuries in international fencing and to characterise their type, location, severity and mechanism. Variations in risk associated with sex and discipline categories are also examined. Methods Data on participation and withdrawal due to injury from 809 competitions comprising the major events of the 2010-2014 seasons (inclusive) for the Fédération Internationale d`Escrime were compiled from official results. Athletes who withdrew due to injury sustained in each competition were contacted individually to obtain follow-up information including time lost from fencing participation (practice/competition) and sequelae. Results A total of 176 injuries were recorded from 637.776 athlete exposures (AEs) in 85.686 participants (men=47.869; women=37.817) over the study period, for an overall incidence of 0.28/1000 AEs (95% CI 0.24 to 0.32). Men had significantly greater risk than women (RR=1.42, 95% CI 1.05 to 1.94); épée had a significantly lower risk than foil or sabre (RR=0.52, 95% CI 0.35 to 0.76; RR=0.47, 95% CI 0.32 to 0.69, respectively). The majority of injuries were sprains (40.8%) and strains (20.1%), which occurred in the lower extremities (72.4%); ankle sprains were the most common specific injury (25.3%). Intrinsic effort of the fencer (non-contact injury) was the most common mechanism related to a time-loss injury (47.1% of cases). The overall median time loss was 4 weeks; 32.1% of the injuries involved 2 weeks or less away from fencing participation. Conclusion The data indicate that the risk of time-loss injury in international fencing is very low and primarily involves sprains and strains in the lower extremity. What are the findings? Although there are variations in the risk of time-loss injury in elite fencing across sex, age and discipline, the risk is very low overall. Contrary to public perceptions, significant injuries from the blades (lacerations, punctures) are very uncommon and generally minor. Sprains and strains in the lower extremities comprise the majority of time-loss injuries in international competitions.
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