The top fifty most influential articles on hip fractures

Abstract

Purpose: Hip fractures are one of the most common disabling fractures in elderly people and peri-operative management has advanced considerably over the past decades. The purpose of this study was to evaluate the change of scientific focus by creating a top 50 list of the most influential papers on this topic.

Methods: The Clarivate Web of Science Search was used to identify the most cited articles. The used search phrase was [(hip OR pertrochanteric OR (femoral neck)) AND fracture AND (surgery OR treatment)]. The number of citations, citation density, study type, study design, published year, fracture type, country, evidence level and published journal were recorded.

Results: The top 50 articles were published between 1973 and 2014 and cited between 88 and 496 times. The mean citation density increased noticeably after the year 2000, representing the knowledge gain of the last 20 years. The topics surgical treatment (n = 19), risk factor assessment (n = 19), perioperative hemodynamic management (n = 7), additional treatment (n = 4) and general reviews (n = 1) were covered. Twenty-five articles were published from institutions in Europe, 24 from institutions in North America and one from an institution in Asia.

Conclusion: While studies about surgical treatment options and risk factor assessment have been historically important, there was a rise of articles about additional treatment options for osteoporosis and the optimal postoperative care after the year 2005. The presented lists and map of citation classics give an overview of the most influential studies on hip fractures.

Keywords: Bibliographic analysis; Citation analysis; Hip fracture; Perioperative management.

Fig. 1

Flowchart of the search algorithm. The used search phrase was [(hip OR pertrochanteric OR (femoral neck)) AND fracture AND (surgery OR treatment)]. The top articles of all time (left) and the top articles from 2015 to 2020 (right) were evaluated

Fig. 2

Number of studies per decade. All articles were published between 1973 and 2014 and a distinct increase was seen in the current millennium

Fig. 3

Number of studies in each topic (light grey = all time, dark grey = 2015 to 2020). Nineteen articles deal with the topic of surgical treatment, 19 with risk factor assessment, seven with peri-operative haemodynamic management, four with additional treatment and one article was a general review paper

Fig. 4

Study design of the most cited papers (light grey = all time, dark grey = 2015 to 2020). Twenty-seven articles were therapeutic, 13 prognostic, eight reviews and one basic science article

Fig. 5

Study types of the most cited papers (light grey = all time, dark grey = 2015 to 2020). Eleven articles were conducted as randomized controlled trials, three as non-randomized controlled trials, four as prospective and twelve as retrospective cohort studies. Four were prospective and seven retrospective case series, two reviews, five systematic reviews and meta-analysis, respectively

Fig. 6

Evidence levels of the top 50 articles. Level IV was the most frequent evidence level (n = 24), followed by levels II (n = 13), III (n = 6), I (n = 5) and V (n = 2)

Fig. 7

Continents and countries of origin of the Top50 most cited papers. * = Asia; CHN, China; BE, Belgium; IT, Italy; FR, France; NOR, Norway; UK, United Kingdom

Fig. 8

World map of the most cited papers