Background: Despite recent efforts to improve medical treatment for injured bullfighters, including the foundation of a scientific society for bullfight injuries, serious injuries, in particular in villages and smaller arenas, still do occur. We are not aware of any series in the English literature that aimed to study the specific mechanisms, types, and outcomes of theseinjuries.

Methods: A review of the trauma registry of injured bullfighters who suffered any type of trauma during bullfighting and received emergency therapy by the Surgical Trauma Services between 1994 and 2004 at the Plaza de Toros Nuevo Progreso, Guadalajara, Mexico.

Results: In all, 68 out of 750 bullfighters (9.06%) required emergency assistance during bullfighting. Trauma to the upper and lower extremity was most common (66%), followed by injuries to the inguinal (8%) and perineal area (7%). Extremity injuries included penetrating wounds requiring operative debridement in 64% of cases, articular dislocations in 4%, closed fractures in 4%, and open fractures in 1% of cases. Major vascular injuries occurred in 5% of the cases. Penetrating inguinal and penetrating perineal injuries were associated with major vascular injuries to the femoral vessels, necessitating operative repair in 33% of the cases.

Conclusion: A considerable risk of serious, life-threatening injuries is inherent to bullfighting. Penetrating inguinal and perineal trauma with injury to the femoral vessels represents a specific, potentially fatal injury. A low threshold for exploration of these penetrating injuries in injured bullfighters is associated with a favorable outcome. Appreciation of the unique mechanisms and types of injuries related to bullfighting should lead to target intervention and help the evolvement of improved emergency treatment in organized bullfighting.