Worldwide research productivity in fracture surgery: A 10-year survey of publication activity.

Worldwide research contributions have allowed the field of fracture surgery to progress. However, to the best of our knowledge, no studies have documented the main characteristics of publications from different countries. The present study aimed to determine the quantity and quality of worldwide research in fracture surgery. The Web of Science database was searched to identify fracture articles published between 2005 and 2014. The contributions of countries were evaluated based on paper and citation numbers, and the research output of each country was adjusted according to population size. A total of 19,423 papers on the topic of fracture surgery were identified worldwide, and the total number of publications from 2005 to 2014 had significantly increased by 1.82-fold (P<0.001). The majority of papers (86.64%) were published by high-income countries (gross national income per capita ≥$12,736), 13.25% by middle-income countries ($1,046-12,735) and 0.11% by low-income countries (≤$1,045). The United States contributed the highest number of publications (33.34%), followed by the United Kingdom (9.03%), Germany (8.42%), China (5.58%) and Japan (4.18%). Furthermore, the United States ranked first according to total citations (72,640). Articles from Sweden achieved the highest average citations per paper (15.63), followed by Australia (12.84) and Canada (12.44). When the number of publications were adjusted for population size, Switzerland was the first (56.39), followed by Austria (35.43) and the Netherlands (30.68). In conclusion, the number of publications in fracture surgery increased from 2005 to 2014, and the majority of fracture papers were published by high-income countries, while few papers were published by low-income countries. The United States was the most prolific country, but based on population size, a number of smaller countries in Europe may be relatively more prolific.